So… What is Postmenopause?

Most people know what menopause is, and what you can expect during it. However, not much is said about what happens after menopause. Once a woman’s reproductive years have come to an end, and menopause is complete, she enters a phase which is known as postmenopause. 

In this article, we will discuss what postmenopause entails, what to expect during postmenopause, and how postmenopause and hormone replacement therapy can help you with symptoms.

What is the difference between Perimenopause, Menopause, and Postmenopause?

Many women find themselves wondering: Why does menopause happen?

Natural menopause, that is not brought on by any type of medical treatment, is the permanent ending of menstruation. The natural menopausal transition process is gradual, and is categorized into three stages:


Also known as “Menopause Transition”, the perimenopausal process may begin 8 to 10 years prior to menopause kicking in. During the perimenopause stage, a woman’s ovaries start to produce less estrogen gradually. According to observational studies, women can expect the perimenopausal process to begin sometime in their 40’s, and for some – their 30’s. How long does perimenopause last? Up until menopause starts, when the ovaries stop releasing eggs entirely. Keep in mind, a swift and accelerated drop in estrogen occurs during the last couple years of perimenopause. During this time, many women will experience menopause symptoms. Women are still having their menstrual cycle in this stage, and can get pregnant.


In short, menopause is the point in a women’s health life when she no longer has menstrual periods. Ovaries have stopped producing most of their estrogen, and eggs are no longer released at this point. The official menopause diagnosis comes when a woman goes 12 consecutive months without a period.


Postmenopause refers to the years after menopause has occurred. Due to the fact that menopause is now over, most women will experience fewer menopause symptoms such as hot flashes. However, since the body is now extremely low on estrogen, postmenopausal women are at a significantly greater risk for a number of health conditions, such as heart disease and osteoporosis. There are ways to prevent these conditions – medication, hormone therapy, healthy lifestyle changes and more can reduce the chances of being diagnosed with a disease related to a lack of estrogen. Every woman is unique, so make sure you talk with your doctor about steps you can take to avoid your individual risk of disease.


Common Postmenopause Symptoms

Want to know what to expect while postmenopause?

Unlike its counterpart, menopause, postmenopause symptoms include an increase in energy levels and a new-found sense of well-being. No one would complain about that! 

On the other hand, there are some negative postmenopausal symptoms, such as:

  • Stress Urinary Incontinence (SUI) – According to studies, nearly 40% of postmenopausal women report suffering from mild to severe urinary incontinence. It’s mentioned that the loss of bladder control increases during physical activities, like laughing, coughing, exercising, or sneezing. Low levels of the estrogen hormone is what causes weakening of the bladder muscles.
  • Vaginal discharge, dryness, or itching – These postmenopausal symptoms can be a sign of vaginal atrophy. The vaginal walls become thin due to a decrease in the production of estrogen. 
  • Weight gain – Many women report an inexplicable amount of weight gain, averaging an increase of 5 to 10 kgs. 
  • Insomnia and other sleep issues – Reports say some women find it difficult to sleep regularly during their first few years of postmenopause. 

Postmenopausal Signs – How Do I Know I’m Postmenopausal?

Once a woman is postmenopausal, their hormone levels will remain at a constant low level. The ability to become pregnant will diminish, and you will no longer experience a monthly menstrual cycle. You will know that you’re in the postmenopause stage when you have not had a period for 12 consecutive months. 

As previously mentioned, there are several risks for women who are postmenopausal. They include osteoporosis, cardiovascular disease, depression and other mental health issues, changes in vaginal health, such as vaginal dryness or itching.

How long does Postmenopause last?

So, how long do postmenopause symptoms last?

You can expect to experience postmenopause symptoms for up to 6 years after completing the menopause cycle. That said, the average number of years women experience postmenopausal symptoms ranges from 4 to 5 years, with the symptoms decreasing in frequency and intensity as the years go by. Hot flashes are among the most common postmeopause symptoms.

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Can I Get Pregnant After Menopause?

Once the menopause cycle has come to a complete stop, you can no longer conceive a child or get pregnant. 

How Often Should I Visit My Doctor While Postmenopausal?

There is a common misconception that postmenopausal women are less at risk for serious health conditions brought on by menopause, therefore they can visit the doctor less often.

The truth is, getting regular check-ups and preventive screening tests are the most important thing you can do for yourself postmenopause. These tests include pelvic exams, pap smears, breast exams and mammograms. 

Vasomotor Menopause Symptoms

More than 75% of women report experiencing vasomotor symptoms, or hot flashes. Hot flashes can last for 1-2 years after menopause for most women, while others experience them for up to 10 years post menopause. 

What is Hormone Replacement Therapy?

Menopausal hormone therapy (MHT), also known as postmenopausal hormone therapy, estrogen replacement therapy and hormone replacement therapy, is a treatment in which doctors treat the negative symptoms of menopause, such as hot flashes, and vaginal dryness. 

Estrogen Therapy

A common replacement therapy approach for postmenopause hormone is a low dose of estrogen for women, particularly those who’ve had a hysterectomy – a surgery performed to remove the uterus. Estrogen is available in many different forms. The most popular are daily pill versions or the patch, however, estrogen is also available in a vaginal ring, gel or spray.

Estrogen Pill 

Among the most common forms of estrogen, the pill is a good treatment for menopausal symptoms. 

Estrogen Patch

The estrogen patch is worn on the skin of your abdomen. Patches come in various strengths, with some patches that require replacement every few days, and others that last a full week before needing replacement. 

Topical Estrogen

Another way of getting more estrogen into your body, is through topical creams, gels and sprays. As with patches, these methods of estrogen treatment are absorbed through the skin – directly into the bloodstream. Generally speaking, your doctor will have you use these topical estrogen prescriptions once daily, however, it’s important to follow the directions you’re given at the time of your appointment. 

Vaginal Estrogen

Vaginal estrogen comes in cream form, vaginal ring, or vaginal estrogen tablets. These treatments are usually prescribed to women who are experiencing a significant amount of vaginal dryness, itching, or burning during intercourse. 

Estrogen, Progesterone, Progestin Hormone Therapy

Often called combination therapy, this form of hormone therapy involves a combination of estrogen and progestin, which is the synthetic form of progesterone. Usually this type of hormone therapy is made specifically for women who still have their uterus. By taking estrogen with progesterone, a woman can lower her risk for cancer of the endometrium, which is the lining of the uterus.

Although progesterone is generally used as a form of birth control, it can also help women with many menopausal symptoms such as hot flashes.

Oral Progestins

Progestin medications are taken in pill form, and include medroxyprogesterone acetate and the synthetic progestin pills norethindrone or norgestrel. Medical experts say they treat menopausal patients with natural progesterone, rather than synthetic progestins, as the natural has no negative effect on a woman’s lipids and is a good choice for women who have high cholesterol levels. 

Intrauterine Progestin

Although these devices are not approved for use specifically to treat menopause symptoms in the United States, low-dose IUD (intrauterine devices) can help ease negative symptoms. If you’ve had an IUD when entering perimenopause, your doctor may recommend keeping it in until after menopause is complete. 

Who Should NOT take Hormone Replacement Therapy?

There are certain chronic conditions that can worsen, or be negatively affected by hormone replacement therapy methods. You may want to avoid HRT if you have one or more of the following:

  • Blood clots
  • Cancer (breast, uterine, or endometrial)
  • Liver disease
  • Heart disease
  • Known or suspected pregnancy
  • Potential for heart attacks or previous heart attack
  • At risk of having a stroke or have had a stroke
  • High blood pressure

What are the Side Effects of Hormone Replacement Therapy (HRT)?

As with most everything, there are hormone replacement therapy side effects, such as:

  • Bloating
  • Swelling or tenderness of the breasts
  • Headaches
  • Mood swings or mood changes
  • Nausea
  • Vaginal bleeding or spotting

Is Hormone Replacement Right for Me?

No one, other than your medical doctor or specialist, can tell you whether or not hormone replacement therapy is right for you. Discuss the options with your doctor and weigh both pros and cons of hormone replacement therapy. Knowing your medical history, your doctor should be able to help you determine if hormone replacement is right for you.