Post menopause

7-minute read

Key facts

Post-menopause is the stage of life after menopause.
During post-menopause, some symptoms such as hot flushes usually become less concerning or disappear altogether.
Your risk of cardiovascular disease and osteoporosis naturally increase in post-menopause.
Post-menopause is a good time to get important health checks such as a mammogram and pelvic exam.

What is post-menopause?

Post-menopause refers to the stage after the menopause, and marks the end of the reproductive stage of your life.

You may spend up to a third of your life in post-menopause.

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

What are the symptoms of post-menopause?

During post-menopause, perimenopausal symptoms such as hot flushes may slowly disappear.

Other symptoms related to your vagina, vulva and urinary system can continue after menopause. These may include:

vaginal dryness
vaginal itching
pain with intercourse (sex)

Your pelvic floor muscles may become weaker, and you may need to urinate (wee) more often.

You may develop urinary incontinence (poor bladder control). This may be:

urge incontinence — a sudden urge to wee, followed by an involuntary loss of urine
stress incontinence — the loss of urine with coughing, laughing or lifting

You may also get urinary tract infections more often.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes post-menopause?

Usually, menopause happens naturally when your ovaries stop releasing eggs. Menopause symptoms are caused by a drop in the levels of the hormone oestrogen.

If you’ve had an oophorectomy (your ovaries removed) you will go through menopause immediately after surgery.

When should I see my doctor?

See your doctor if you have symptoms that interfere with your daily life or if you are concerned about abnormal vaginal bleeding.

Any abnormal vaginal bleeding needs to be checked by a doctor, to rule out uterine cancer.

Your doctor may also suggest other health checks such as a:

mammogram
pelvic examination
cervical screening test

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is post-menopause diagnosed?

Post-menopause officially begins 12 months after your final period (the menopause).

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

How is post-menopause treated?

There are things that you can do to help improve your health post-menopause, such as:

exercising regularly
reducing how much caffeine, sugar, salt and alcohol you consume
not smoking
eating a healthy diet that includes foods containing calcium and vitamin D
getting enough sleep

These can all help to lower your risk of chronic disease.

Some females take menopausal hormone therapy or hormone replacement therapy (HRT).

Can post-menopause be prevented?

Post-menopause is a life-stage and cannot be prevented.

What are some complications post-menopause?

As you age, your oestrogen levels fall and your risk of chronic diseases increases.

Cardiovascular disease

Your risk of cardiovascular disease increases post-menopause.

There is evidence that menopausal hormone therapy (MHT) can help prevent cardiovascular disease if taken within 10 years of menopause.

It’s also important to keep a healthy lifestyle with:

a balanced diet
regular exercise
not smoking
reducing how much alcohol you drink

You may also need to take medicine for high blood pressure or cholesterol.

Bone health and osteoporosis

After menopause, you have a higher risk of developing osteoporosis. Osteoporosis is where your bone tissue breaks down more quickly than it builds up.

The loss of oestrogen due to menopause makes you more susceptible to osteoporosis.

Lifestyle and diet should be your main ways of preserving bone mass after menopause. This means:

eating a balanced diet
taking regular weight-bearing and resistance exercise
not smoking
minimising how much alcohol you drink

You should also be sure to include enough calcium in your diet.

Calcium comes from foods such as:

dairy
canned fish with bones (salmon, sardines and others)
almonds
tofu
leafy green vegetables and legumes

MHT can help stop your bones getting weaker. It is more effective the longer you take it.

Obesity, metabolic syndrome and diabetes

Many women notice changes to their weight post-menopause. This can be due to changes in your hormones. Your body stores more fat and burns calories less efficiently.

If you gain weight, your risk of developing metabolic syndrome and diabetes may increase.

The best ways to help with weight gain are by:

increasing your exercise and activity levels
reducing stress
eating a healthy diet
reducing your alcohol intake

Can I still get pregnant after menopause?

You can still get pregnant during perimenopause, but not usually after menopause. If you don’t want to become pregnant, you are advised to:

females under 50 years, use contraception for 2 years after your last period
females over 50 years, use contraception for one year after your last period

Should I continue to get cervical screening?

You should still have a cervical screening test every 5 years until you’re 74 years of age. This helps to prevent cervical cancer or find it earlier.

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

Resources and support

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

To find an Australian doctor who specialises in menopause and healthy ageing, go to the Australasian Menopause Society website.

Other languages

Do you speak a language other than English?

Jean Hailes for Women’s Health has fact sheets on menopause and women’s health translated into several community languages.
The International Menopause Society has videos explaining menopause subtitled in Vietnamese, Cantonese and Mandarin.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: December 2023

Need more information?

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Early Menopause – Chemotherapy and Radiation Therapy | Fact Sheet | Australasian Menopause Society Hub

Download: Early Menopause – Chemotherapy and Radiation Therapy | Fact Sheet MAIN POINTSChemotherapy and radiation therapy for cancer and other conditions can cause temporary or permanent loss of your menstrual periods and menopause.Before the age of 40, this is known as premature ovarian insufficiency (POI).Between the ages of 40 and 45, this is known as early menopause.Early menopause and POI can cause infertility and have short- and long-term health consequences such as heart disease, osteoporosis and memory problems.Some women who have chemotherapy remain fertile, so it is important to use contraception if you do not want to become pregnant or if your doctor advises you that it is not safe to become pregnant.Speak with your doctor about treatments and other options to manage any infertility and long-term health consequences.Chemotherapy and radiation therapy for cancer and other conditions can cause temporary or permanent loss of your menstrual periods, which can lead to menopause and infertility.If this occurs before the age of 40, it is known as premature ovarian insufficiency (POI) and between the ages of 40 and 45, it is known as early menopause. POI and early menopause can also happen for other reasons (see AMS fact sheet – Menopause before 40 and premature ovarian insufficiency).Chemotherapy and radiation therapy can be toxic to the ovariesChemotherapy or radiation therapy can cause early menopause because these treatments are toxic to the ovaries, especially when used at high doses to treat cancer. Whole-body radiation therapy and radiation in the pelvic area are more likely to affect your ovaries. At birth, ovaries contain one million immature eggs (primordial follicles). The number of eggs naturally decreases until, at menopause, less than 1000 eggs remain. When chemotherapy or radiation therapy damages the ovaries, women can have fewer remaining immature eggs and/or the immature eggs are unable to mature. Loss of your period after chemotherapy or radiation therapy can either be temporary or permanent. If your period returns, that does not necessarily mean that your fertility returns.Risk factors for entering early menopauseThe likelihood of entering POI or early menopause after chemotherapy or radiation therapy increases:with increasing agewhen there are fewer eggs in the ovaries before treatment startswith higher doses of chemotherapy or radiationwith radiation therapy of the whole body or pelvic areawith some types of chemotherapywhen doses of chemotherapy and radiation are given together.Symptoms and health consequences of POI and early menopauseThe signs, symptoms and health consequences of POI and early menopause after chemotherapy and radiation therapy include: missing your period or having infrequent periods – an early symptom of POI or early menopausemenopausal symptoms (either with or without your period) includinghot flushesmood changesproblems sleepingaching jointsdry vagina or poor lubrication during sexual arousal.psychological distress and increased risk of anxiety and depression because of:a diagnosis of cancer or severe medical illnesstreatment with chemotherapy/radiotherapy and the related longterm consequencesinfertility – women often feel confused, sad, old before their time and have mixed feelings about other women’s pregnancies.short and long-term health risks – infertility, osteoporosis and heart disease.Diagnosis of POI and early menopausePOI and early menopause are difficult to diagnose and the process can take many months. This can be a very stressful time and women should speak with their healthcare team for support and management options. Criteria for a diagnosis of POI or early menopause include:more than four months without a periodfollicle stimulating hormone (FSH) levels in the menopausal range on two occasions at least 4–6 weeks apart.Managing fertility issuesChemotherapy and radiation therapy might affect your fertility. Thinking about whether you will be able to have children and preserving your fertility can be overwhelming, especially when added to the stress of a diagnosis of cancer or other serious illness. Speak with your healthcare team and get the support you need. If losing fertility is a possibility, your doctor might be able to suggest options to try to preserve your ability to have children. Monthly injections with a gonadotrophin releasing hormone analogue during chemotherapy may help to preserve ovarian function. The most effective option is to have your eggs or embryos frozen before you begin treatment. Some women who have chemotherapy remain fertile, so it is important to use contraception if you do not want to become pregnant or if your doctor advises it is not safe to become pregnant. Some types of contraception are not safe for women with certain cancers or illnesses so talk to your doctor about what is best for you. For those who have developed POI or early menopause, some women choose to live a childfree life, while others adopt or foster children.Treatment of POI and early menopauseWomen with POI/early menopause should discuss with their doctor the possibility of using hormone therapy. In women more than 50 years of age, hormone therapy is called menopausal hormone therapy (MHT). In women who are aged less than 50, the same hormone therapy can be called hormone replacement therapy (HRT) because the treatment is replacing the hormones that the ovaries would be producing if you hadn’t had chemotherapy or radiation therapy.If you choose to use HRT, your doctor might advise you to continue this treatment until the typical age of menopause (51 years).HRT options include:oestrogen tablets, patches, gels and topical vaginal treatments – if you have had a hysterectomy (see AMS fact sheet – What is MHT and is it safe?)oestrogen plus progesterone – if you have not had a hysterectomycombined oral contraceptive pill as a replacement hormone – if you have no significant risk factors (such as risk of blood clotting, past blood clots or if you are a current smoker).Oestrogen therapy is not suited to everyone and is best avoided if you have breast or endometrial cancer. Your doctor can suggest non-hormonal options to help manage hot flushes and other symptoms. If contraception is required, hormonal options include the oral contraceptive pill or an intrauterine device plus oestrogen (usually as a patch or gel). If your doctor does not recommend hormones for your situation, discuss non-hormonal contraceptive options.Managing health risks associated with POI and early menopauseAdopting healthy lifestyle changes (see AMS fact sheets – Lifestyle and behaviour changes for menopausal symptoms and Weight management and healthy ageing) can reduce the risk of some of the health impacts associated with POI and early menopause. These health impacts include:osteoporosis or bone losscardiovascular/heart diseaselearning and memory disturbancesemotional issues.It is widely known that regular physical activity, a healthy diet and healthy sleep patterns can improve these problems, no matter what the cause. In addition, regular check-ups (including blood tests and bone scans) with your doctor can help you to manage your health.OsteoporosisOsteoporosis in women with POI and early menopause can be caused by:low levels of oestrogenlow levels of calcium in the dietsmokinglow levels of physical and weight-bearing activitysome types of chemotherapy and medications.In addition to lifestyle changes (quitting smoking, engaging in regular weight-bearing activities, and ensuring adequate dietary intake of calcium and vitamin D) women should have regular bone density scans every one or two years. Use of HRT can also help to maintain bone density.Cardiovascular or heart diseasePOI and early menopause can result in an earlier increase in the risk of heart disease in women.Taking HRT early and continuing treatment until the age of a natural menopause (50–55 years) can reduce the risk of heart disease. A healthy lifestyle and regular check-ups for high blood pressure, diabetes and fats in the blood will help you manage your heart health.Learning and memory problemsThere is evidence that chemotherapy can cause memory problems, but there is limited evidence that low levels of oestrogen affect memory.Taking HRT early and continuing treatment until the age of a natural menopause (51 years) might reduce the risk of learning and memory problems.Emotional issuesIn addition to a diagnosis of cancer (or severe medical illness) requiring chemotherapy/radiation therapy, women also have to cope with possible infertility and other long-term health impacts.It is only natural to feel distressed and some women might have anxiety and depression. Women often feel confused, sad, old before their time and have mixed feelings about other women’s pregnancies. Psychological counselling can ease this distress. Support from the woman’s partner, family and friends is also important.Support groupsIn addition to the support of family, friends and a healthcare team, some women find it useful to talk to other women in the same situation. Available support groups include:ACCESS Australia (Australia’s National Infertility Network) – www.access.org.auCancer Australia – www.cancer.org.auThe Daisy Network Premature Menopause Support Group – www.daisynetwork.orgNew Zealand Early Menopause support group - www.earlymenopause.org.nzWhere can you find more information?If your symptoms are bothering you or you feel you need more support, your doctor can help. Your doctor can tell you about the changes in your body and offer options to manage your symptoms. Other fact sheets about treatment options include:Menopause before 40 and premature ovarian insufficiencyWhat is Menopausal Hormone Therapy (MHT) and is it safe?9 myths and misunderstandings about Menopausal Hormone Therapy (MHT)Non-hormonal treatment options for menopausal symptomsComplementary medicine options for menopausal symptomsLifestyle and behaviour changes for menopausal symptomsWeight management and healthy ageingPOI/ Early menopause and osteoporosisThe Healthtalk Australia Early Menopause online resource contains women’s stories, information, question prompt list and links to services: https://healthtalkaustralia.org/early-menopause-experiences-and-perspectives-of-women-and-health-professionals/If you have any concerns or questions about options to manage your menopausal symptoms, visit your doctor or go to the Find an AMS Member service on the AMS website.

Read more on Australasian Menopause Society website

Non-Hormonal Treatment Options for Menopausal Symptoms | Fact Sheet | Australasian Menopause Society Hub

Download: Non-Hormonal Treatment Options for Menopausal Symptoms | Fact Sheet MAIN POINTSYour doctor can suggest prescription medication options for your menopausal symptoms if you are unable to or do not want to use menopausal hormone therapy (MHT).Prescription medication options can help with hot flushes, sweats and changes in mood and sleep patterns.There is a registered medication specifically developed for the management of flushes and sweatsSpecific antidepressants and epilepsy medications can help with menopausal symptoms in many women.At menopause, changes in hormone levels can cause symptoms for many women – for example, hot flushes, mood and sleep changes. If your symptoms are bothering you, your doctor can help you to understand your symptoms and your treatment options.Non-hormonal prescription medications are one of the treatment options available for managing symptoms. You might ask your doctor about these options because: you are not able to use menopausal hormone therapy (MHT) for medical reasons, you might not want to use MHT, lifestyle changes alone might not be enough if you have more severe symptoms. Your doctor can explain the best non-hormonal treatment options for your situation. Only your doctor can prescribe medications that can help with hot flushes, sweating and changes in sleep patterns and mood.FezolinetantThis is a treatment that blocks the nerve pathways in the hypothalamus that are involved in the production of hot flushes and sweats. It can reduce the frequency and severity of flushes.Epilepsy treatmentsEpilepsy drugs (gabapentin and pregabalin) have been used for many years to treat epilepsy and nerve pain and are safe and have few side effects. These medications can help with hot flushes and sweats in around 70% of women.AntidepressantsAntidepressants (usually low dose) have been used for many years and some types help about 70% of women with more severe flushes and sweats. Options in this class of drugs include:venlafaxine (a Serotonin-Noradrenaline Reuptake Inhibitor or SNRI)escitalopram and paroxetine (Selective Serotonin Reuptake Inhibitors or SSRIs).Paroxetine might decrease the effectiveness of tamoxifen, a medication sometimes used for women living with breast cancer. If this is an issue, ask your doctor about other options.Emerging TreatmentsStellate Ganglion BlockThis is a new potential treatment option involving a small injection of a local anaesthetic at the base of your neck.This nerve block is not yet available in most clinics.What are the other treatment options?If your symptoms are bothering you, your doctor can help. Your doctor can tell you about the changes in your body and offer options for managing your symptoms. Other treatment options include:Lifestyle changes: Improving diet, regular exercise and stopping smoking improve overall wellbeing and can make symptoms easier to tolerate. Some psychological treatments e.g. cognitive behavioural therapy (CBT) and hypnosis may also help (See AMS fact sheet - Lifestyle and behavioural modifications for menopausal symptoms)Menopausal Hormone Therapy (MHT, formerly known as HRT): if other things do not work and you are able to have hormone treatment (See AMS fact sheets – What is Menopausal Hormone Therapy (MHT) and is it safe?)Complementary therapies: (See AMS fact sheet – Complementary medicine options for menopausal symptoms)If you have any concerns or questions about options to manage your menopausal symptoms, visit your doctor or go to the Find a Practitioner service on the AMS website.

Read more on Australasian Menopause Society website

Menopause what are the symptoms? | Fact Sheet | Australasian Menopause Society Hub

Download: Menopause what are the symptoms? | Fact Sheet Also see associated Infographic MENOPAUSE AT A GLANCEEvery woman is affected by menopause in some way – either they experience symptoms or other physical changes.The average age of menopause is 51 years but you can enter menopause earlier.Hormonal changes cause menopausal symptoms.Most women will have some symptoms.Most women have symptoms for 5 to 10 years.Menopause occurs when you have not had a menstrual period for 12 months. Menopause is a natural part of life occurring at around age 51 years but can also happen for other reasons including after:surgery to remove ovaries (oophorectomy) and/or your womb/uterus (hysterectomy) chemotherapyradiotherapy to your pelvis.At menopause, you stop producing oestrogen (the main sex hormone in women) and this can lead to menopausal symptoms. Oestrogen levels can vary in the time leading up to the final menstrual period (called the perimenopause). Early symptoms - change in menstrual periods Menopausal symptoms often start before periods stop. Many women have a change in their menstrual cycle (period) before their periods stop. You should see your doctor if your periods become heavy or more frequent.Hot flushes and night sweatsHot flushes and night sweats can range from mild to quite severe. Some women find these symptoms disturb their sleep – they may even need to change the sheets during the night because of heavy sweating.Almost all women experience hot flushes and sweats, but these are not always troublesome.Problems sleepingSome women have problems sleeping even if they don’t have hot flushes and night sweats.Changing hormone levels can affect your body clock or make it more difficult for you to fall asleep or stay asleep. This can happen especially if you have other conditions that affect your sleep – for example, pain, snoring or if you have consumed alcohol or caffeine before bed.Pain in your joints and tirednessStudies have shown that the hormonal changes of menopause can cause some women to feel pain in their joints or make them feel more tired than usual.Anxiety or mood changesMost of us feel anxious at times, but you might find that things that you can usually cope with make you feel overwhelmed with anxiety. You might also feel upset, sad or angry in situations thatwould not have bothered you before.These increases in anxiety and mood changes can be caused by hormonal changes.Dry vaginaSome women feel discomfort in their vagina, especially during sex. This is a common symptom caused by a decrease in moisture produced by the lining of the vagina. Overactive bladder or discomfortWomen can also find they have bladder changes during menopause. If you have this symptom, you might find you need to urinate more often, you can’t “hold on” or your bladder might feel full and uncomfortable.What can you do about your symptoms?Understanding menopause and developing a strategy to manage your symptoms can improve your health and lifestyle. If your symptoms are bothering you, your doctor can help. Your doctor can tell you about the changes in your body and offer options for managing your symptoms. Many treatment options are available and include:Lifestyle changes (See AMS Fact Sheet Lifestyle and Behaviour Changes for Menopausal Symptoms)Menopausal Hormone Therapy (See AMS Fact Sheet What is MHT and is it safe?)Non-hormonal treatment options (See AMS Fact Sheet Non-hormonal treatment options)Complementary therapies (See AMS Fact Sheet Complementary Medicines and Therapies: Options for Menopausal Symptoms)If you have any concerns or questions about options to manage your menopausal symptoms, visit your doctor or go to the Find a Practitioner on the AMS website.

Read more on Australasian Menopause Society website

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Post menopause

Key facts

What is post-menopause?

What are the symptoms of post-menopause?

What causes post-menopause?

When should I see my doctor?

How is post-menopause diagnosed?

How is post-menopause treated?

Can post-menopause be prevented?