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Guide to Menopause
|What Is Postmenopause?
Menopause is divided into 4 different stages. The first stage, perimenopause is where ovarian function starts becoming erratic. Symptoms may not be noticeable or they can manifest as irregular periods, hot flashes, headaches and insomnia (to name a few, see menopause symptoms for more). This first phase of perimenopause can last anywhere between 5 and 15 years. The next phase is menopause; this has occurred when a woman's periods have ceased for 12 consecutive months without spotting. The first five years after menopause is the early postmenopause phase, and the next five years onwards is the late postmenopause phase. A woman is usually finished with all phases of menopause by the age of 60. Where a woman has undergone a hysterectomy or has suffered menstruation irregularities due to chemotherapy and therefore has no periods, postmenopause is determined by a blood test (menopause testing). This test can check for levels of follicle stimulating hormone (FSH). Very high levels indicate postmenopause.
Don't Miss: Our article on how menopause affects the body.
What Are The Symptoms?
The first 5 years after menopause (known as early postmenopause) is an important phase in terms of risk factors for osteoporosis. It is also typically when a woman starts Hormone Replacement Therapy (HRT). Gradually however as perimenopause hormone fluctuations settle, hot flashes become milder or disappear, mood swings reduce and energy levels return. Emotionally and physically a woman moves into a new phase of her life, and typically can expect to live a full third of her life after menopause. 10 to 20 percent of postmenopausal women will still however experience ongoing issues related to reduced estrogen including:
• Vaginal dryness/atrophy which can lead to painful intercourse and a low libido in menopause, as well as vaginitis.
• Urethritis and cystitis which is linked to vaginal dryness. Urinary tract infections are very common.
• Stress incontinence, leaking urine in small amounts induced by sudden movements like coughing, sneezing, laughing and lifting.
• High blood pressure, also known as hypertension.
• Wrinkles, as collagen gradually declines so more wrinkles appear (urk!).
• Weight gain is also another postmenopause symptom. See Weight gain during menopause.
• Hot flashes typically reduce by postmenopause, although some women are unfortunate enough to experience flashes for up to 10 years after their last menstruation.
• Other common symptoms include short term memory loss, sleep disorders, foot and leg cramps, dizziness and headaches. To those who had children, it may remind them of pregnancy symptoms all over again!
• Before menopause women are at lower risk of developing cardiovascular disease (see: heart attack in women and stroke in women) compared to men because estrogen helps lower ‘bad’ LDL cholesterol. As estrogen levels decline during menopausal phases, a woman's risk of developing cardiovascular disease increases.
• Postmenopausal bleeding is NOT common and IS a cause for concern. Even if bleeding is only minor or spotting, consult your doctor immediately to rule out uterine cancer.
How Is It Treated?
• Hormone Replacement Therapy (HRT), in particular estrogen replacement therapy is the most common form of treatment in the early postmenopausal phase. Due to cancer risks, HRT is not recommended beyond this time frame.
• Women should ensure they intake enough calcium to minimize the risks of developing osteoporosis. Calcium combined with a vitamin D supplement for absorption is recommended, as well as a balanced diet including oily fish, low fat dairy products and green leafy vegetables. See osteoporosis prevention for more tips.
• Exercise can help reduce postmenopause symptoms. Aim for at least 30 minutes a day of moderate aerobic exercise such as swimming, brisk walking or cycle. Include some weight bearing exercise like lifting light weights or playing tennis twice a week to delay or prevent bone loss. See also menopause treatment for more ideas.
• Soy products including soya milk, beans, tofu, tempeh and soy nuts are good sources of protein and isoflavones. These ingredients mimic the activities of estrogen and help reduce postmenopausal symptoms such as stress incontinence, vaginal dryness and even hair loss resulting from menopause.
• Kegels exercise may help prevent urinary incontinence by strengthening pelvic floor muscles.