What to expect after the menopause - postmenopausal symptoms

We recently wrote a blogpost on the symptoms of the menopause, detailing what to expect when entering the perimenopause until menopause occurs.  Generally, the symptoms are bothersome, but they are a normal part of the menopause transition and therefore nothing to be concerned about.  After you reach menopause, which is defined as having no period for a year or more, you have entered the postmenopausal stage. There are some common symptoms of the postmenopausal stage, and the risk for more serious complications also increases at this time in life, due to your body adjusting to the absence of reproductive hormones.

In this blogpost, we talk about the common symptoms and complications of the menopause, and some of the conditions for which you are at a higher risk once in the postmenopausal stage. The topics covered are associated with menopause, but it should be noted there are many other causes of these conditions as well. The normal aging process, for example, also increases your risk of developing these medical issues. Being aware of these complications should encourage you to discuss further with your doctor if you note any of the symptoms occurring after menopause and are concerned.

Heart disease

As estrogen levels decline, your risk for heart disease increases.  A link has been found between decreased estrogen levels and an irregular heart beat leading to heart palpitations.  Therefore, if you feel your heart is beating more rapidly than normal or you feel dizzy then discuss your symptoms with your doctor. As postmenopausal women are more likely to have a heart attack than men, it becomes even more important that you follow a healthy diet, maintain normal weight, ensure your blood pressure and cholesterol remain within expected limits to protect your heart, and quit smoking if you do.

Osteoporosis

Estrogen helps maintain bone density by supporting osteoblast production, which are the bone-producing cells. When you are no longer producing estrogen after menopause, therefore, osteoblasts are unable to produce enough new bone, and bones can become brittle and weak which increases your risk of fractures. In the first few years after menopause your bone density decreases rapidly which increases your risk of osteoporosis. Postmenopausal women with osteoporosis are susceptible to spine, hip and wrist fractures.  To reduce your osteoporosis risk maintain regular exercise, and a healthy diet rich in calcium and vitamin D.

Sexual dysfunction

Vaginal dryness in post-menopausal women is common and easily treatable symptom, but it is often not recognized or discussed with a doctor. After menopause there is decreased moisture production and loss of elasticity in the vagina, which during sexual intercourse can lead to discomfort and bleeding.  Decreased sensation from the vaginal dryness may lead to a decrease in libido as a result. Over-the-counter water based vaginal moisturizers and lubricants can ease this symptom, and if you discuss the symptom with your doctor, they may suggest you would benefit from a vaginal estrogen treatment.

Urinary complications

During the postmenopausal stage, the uterus lining becomes thinner, and the urethra shorter as it is no longer required for reproduction. This can result in uncontrollable urinary leakage, however, which is more noticeable during sudden movements such as laughing or coughing. These changes also allow microorganisms to enter the urinary tract more easily and can lead to an increase in urinary tract infections, so be aware of symptoms including fever, chills, burning when urinating, a frequent urge to urinate and lower abdominal pain. If you’re concerned about these symptoms then enter them into the Isabel Symptom Checker and discuss the results with your doctor to determine the cause and get treatment.

Weight gain

Weight gain is often associated with the menopause, and although hormonal changes do have a effect on your overall body shape, causing weight gain in particular areas such as the abdomen, it is actually much more likely that women in their 40’s and 50’s are prone to weight gain as part of the normal aging process. As you age, it becomes hard to maintain muscle mass, and low muscle mass can slow your metabolism making it easy to gain weight.  Abdominal weight gain due to abdominal fat is a major risk factor in developing heart disease and therefore its important to make healthy lifestyle changes to reduce and maintain a healthy weight.

Skin changes 

Aging and the lack of estrogen in your body makes the collagen in your skin less elastic.  Skin may become thinner, drier and less elastic, which causes wrinkles in the skin but also makes it more prone to injury. Moisturizers can help keep skin hydrated and improve symptoms of dryness, and you should generally be more aware of the delicate nature of your skin.

When should I see a Doctor?

Maintaining your regular visits with your doctor are never more important for preventative health care than at this time in your life, and highlighting any existing or new symptoms you are experiencing since the menopause occurred is paramount.  Some screening tests you will be offered as part of your preventative health care in the postmenopausal period include colonoscopy, mammography, triglyceride screening, breast and pelvic exams and maybe thyroid testing if your symptoms indicate a need for this. If you are finding postmenopausal symptoms difficult, then your doctor may  prescribe Hormonal Replacement Therapy (HRT), to alleviate the common symptoms which can be experienced with a woman’s estrogen levels falling. HRT may cause vaginal bleeding, which can make diagnosis of the perimenopause and subsequent menopause difficult, but could also be a sign of other issues such as a uterine infection, cervical cancer or uterine polyps. If you experience any irregular bleeding after you have reached the menopause, it is very important to discuss this with your doctor.

Being aware of your symptoms during these life changes will enable you to become more informed and have a better partnership with your doctor in addressing your health care needs, so keep checking your symptoms and taking control of your own health. If you are concerned about any of the symptoms mentioned in this blogpost, we suggest putting all your symptoms in the Isabel Symptom Checker and taking the results with you to the doctor.