Post menopause

What is post-menopause?

Post-menopause refers to the final stage of the menopause process, and marks the end of the reproductive stage of life. During post-menopause, your body learns to function with low hormone levels, and symptoms caused by fluctuating hormones may become less troubling — or disappear altogether.

Post-menopause officially begins 12 months after your final period (the menopause). Most Australian women enter menopause between 45 and 60 years of age. The average age of menopause is 51 years.

What causes post-menopause?

For most women, the same hormone level changes that triggered the menopausal process affect when post-menopause occurs. However, certain factors may influence when post-menopause begins:

• Lifestyle habits — women who drink alcohol and smoke often may transition into post-menopause more quickly and with greater difficulty.
• Stress — women who experience high and constant levels of stress may enter the post-menopause stage of life early.
• Surgery — women who have their ovaries removed (oophorectomy) due to cancer treatment or prevention will experience menopause immediately after surgery and shift to the post-menopause stage quickly.

What changes should I expect post-menopause?

For some women, symptoms such as hot flushes experienced during perimenopause and (the menopause) gradually disappear post-menopause. Other women still experience symptoms including vaginal dryness for some time after menopause. Here are a few other changes to be aware of:

Post-menopausal bleeding

Any bleeding that happens 12 months after your final period needs to be checked by a doctor, to rule out uterine or endometrial cancer.

Weight gain or redistribution

Many women notice changes to their weight post-menopause. While menopause doesn’t cause women to gain weight, the decrease in oestrogen levels can cause body fat to shift from the hips to the abdomen. It’s important to maintain a healthy diet and weight and take part in regular physical activity to help reduce the risk of chronic disease.

When should I see my doctor?

Seek medical advice if you are concerned about abnormal bleeding, or experience symptoms that interfere with your daily life. Your doctor may also suggest other health checks such as a mammogram, pelvic examination or cervical screening.

Managing treatments post-menopause

How long should I continue MHT?

Menopausal hormone therapy (MHT), or hormone replacement therapy, is a common way to manage menopause symptoms. It’s a good idea to review your reasons for using MHT at least once a year with your doctor.

How safe is MHT?

The most recent and comprehensive reviews of MHT show that many healthy women can safely take it for years to manage menopausal symptoms, but it’s important to first check with your doctor to see if MHT is right for you. If you opt to start MHT, take the lowest effective dose for only as long as you need to, and review with your doctor regularly to decide whether you should continue treatment.

MHT is not appropriate if you have a history of oestrogen-dependent cancer, such as breast or uterine cancer. It also may not be appropriate if you have established cardiovascular disease.

Should I use complementary therapies?

Many women try non-hormonal options to manage menopause symptoms such as hot flushes and night sweats. It’s important to seek medical advice before trying any treatment — including herbal therapies. Some remedies may be expensive and unproven, or may interact with other treatments.

What are some complications post-menopause?

A woman’s risk of certain diseases increases as they age, and their oestrogen levels fall.

Cardiovascular disease

A woman’s risk of cardiovascular disease increases post-menopause. This is due to an increase in total cholesterol but specifically, LDL (‘bad’ cholesterol). There can also be less HDL (‘good’ cholesterol) in your body. It’s important to maintain a healthy lifestyle with a balanced diet, regular exercise, not smoking and minimising how much alcohol you drink. In some cases, medication for high blood pressure or cholesterol may be needed.

Bone health and osteoporosis

After menopause, women have a higher risk than men of developing osteoporosis (where your bone tissue breaks down more quickly than it builds up). A woman loses the most bone mass in the first 3 years post-menopause. Smoking, poor exercise habits, alcohol and too much caffeine can all increase the risk of osteoporosis.

Post-menopausal women should have regular bone health checks, and be sure to include enough calcium in their diet from foods such as dairy, canned fish with bones (salmon, sardines and others), almonds, tofu, leafy green vegetables and legumes.

Can I still get pregnant?

No — post-menopause means your ovaries no longer release enough hormones to support a pregnancy.

Should I continue to get cervical screening?

Yes — you should still have a cervical screening test every 5 years until you’re 74 years of age, to reduce your risk of cancer. Changes to your vagina after menopause may