What is postmenopause?

Postmenopause is the stage after menopause. It marks the end of the reproductive stage of your life.

Perimenopause is the stage leading up to menopause when your periods become less regular.

Menopause is when you have had your last period. It usually happens between 45 and 55 years of age.

Postmenopause begins 12 months after your final period.

What are the symptoms of postmenopause?

Common symptoms of postmenopause include:

• hot flushes and night sweats — these often begin during perimenopause but can continue for years after menopause
• sleep problems
• mood and emotional changes — such as feeling sad, anxious, irritable (annoyed) or having difficulty concentrating or remembering things
• body changes — such as weight gain, dry skin, dry eyes, thinning hair or sore joints and muscles
• changes in sexual function — such as lower interest in sex (libido) or pain during sex from vaginal dryness

Other symptoms that affect your vagina, vulva and urinary system may begin or continue after menopause:

• vaginal dryness
• vaginal itching or irritation
• needing to urinate (wee) more often
• urinary incontinence (poor bladder control)

During perimenopause your ovaries make less oestrogen and progesterone, the hormones that control your menstrual cycle. Hormonal changes lead to menopausal symptoms, which may continue during postmenopause, but will usually improve over time.

What causes postmenopause?

Postmenopause happens when your ovaries stop releasing eggs. This is part of the body's natural ageing process.

If you had surgery to remove your ovaries, you will go through menopause suddenly, at the time of surgery.

When should I see my doctor?

See your doctor if postmenopausal symptoms are bothering you or affecting your daily life.

Any vaginal bleeding after menopause needs to be checked by a doctor.

Your doctor may refer you to a:

• gynaecologist (specialist in female health)
• psychologist
• endocrinologist (hormone specialist)
• dietitian

How is postmenopause diagnosed?

Postmenopause is diagnosed when you have not had your period for 12 months in a row and there is no other reason, such as:

• pregnancy
• hormone treatment
• illness

It is usually diagnosed based on your age, symptoms and period history.

How is postmenopause treated?

There are different ways to manage symptoms and support your health after menopause.

Treatment depends on your symptoms and preferences. Your doctor will talk with you about different options, such as:

• menopause hormone therapy (also known as hormone replacement therapy)
• non-hormonal prescription medicines
• lifestyle and behavioural changes — regular exercise, healthy eating, good sleep and stress management can ease your symptoms and improve wellbeing

Some people try supplements or herbal remedies. There is no strong evidence that these work for menopausal symptoms.

If you have vaginal dryness, you can use lubricants to feel more comfortable.

How do I stay healthy after menopause?

Some things you can do to support your health after menopause include:

• regular exercise
• limit how much alcohol you drink
• quit smoking
• eat a healthy diet that includes calcium and vitamin D
• get enough sleep

Can I still get pregnant after menopause?

You can still get pregnant during perimenopause but not usually after menopause.

If you do not want to become pregnant, ask your doctor how long to use contraception after your last period.

Should I continue to get cervical screening?

You should still have a cervical screening test every 5 years until you are 74 years of age.

Changes to your vagina after menopause may mean that cervical screening is uncomfortable. Talk with your doctor about your choices.

What are the complications of postmenopause?

Because oestrogen stays low after menopause, your chance of some health problems may increase.

These may include:

• bone thinning (osteoporosis)
• urinary and vaginal changes
• thinning of your skin and slower wound healing
• depression or anxiety

You may also have a higher chance of:

• heart disease
• tooth loss
• diabetes

Can postmenopause be prevented?

Postmenopause is a natural stage of life and cannot be prevented.

Lifestyle changes can help reduce symptoms and lower your chance of complications.

Resources and support

Australasian Menopause Society has fact sheets on many topics related to menopause.

NSW Health has a list of perimenopausal and menopausal symptoms to help you have conversations with your doctor. The list is available in English and other languages, including an easy-read version. There is also a checklist for Aboriginal and/or Torres Strait Islander females.

Partners and families can learn more at:

• Jean Hailes — information for partners
• NSW Health — understanding menopause for partners and families

Jean Hailes also has easy read fact sheets and videos in an accessible format to help people living with disabilities understand information.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.