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Postmenopause: what to expect

Many women focus on getting through the menopause, but there’s very little information about what happens afterwards. Here we explain some of the things you may experience.

Written by Charlotte Haigh on January 3, 2019 Reviewed by Dr Heather Currie on January 9, 2018

We’ve all heard about hot flushes and night sweats, but not many women know about the changes our bodies face after the menopause. But there are certain aspects of post-menopause health and wellbeing that you need to be aware of.

What does postmenopausal actually mean?

The years before your periods stop completely is the perimenopause – your hormones are in flux, causing symptoms such as hot flushes – and the menopause is technically your last period.1 Once you’ve gone 12 months with no periods, you’re officially postmenopausal.

For many women, this can be very liberating: not only are you free from periods and any issues you had with them, most perimenopausal symptoms usually vanish too. This means you may feel healthier and more energetic than you have for some time.2 However, there are some specific health issues that may now appear on the horizon.

Osteoporosis and heart disease

Post-menopausal women have a higher risk of developing osteoporosis and heart disease, both linked to declining levels of the female hormone oestrogen.3

Osteoporosis

Oestrogen tells bone cells to stop breaking down, so your bones can become more fragile after the menopause. The average woman loses 25% of her bone density between menopause and the age of 60, and it continues to decline throughout your life.4

What you can do: Exercise, particularly weight-bearing exercise such as walking and dancing, helps maintain bone density. It’s important to keep your levels of bone-protective calcium topped up too, by eating plenty of green leafy veg, dairy, nuts and seeds. Vitamin D is also important, as it helps your body use calcium.5 The government recommends that all adults take a 10mcg vitamin D supplement every day.

Cardiovascular disease

Oestrogen helps protect your heart and blood vessels but after menopause your risk of cardiovascular disease (CVD), including heart disease, increases. You may be more at risk of developing circulatory disorders such as high blood pressure and stroke, too.6

What you can do: Eating a healthy diet, staying active and stopping/avoiding smoking are the best ways to reduce your risk of CVD.7 Your GP can assess your risk and offer tailored advice, if needed, while HRT may be beneficial for certain women who have a particular risk of developing CVD.8

Changes to your body shape – and weight

Many older women blame the menopause for putting on weight, but there’s not a lot of evidence that hormone changes lead directly to weight gain. Experts think it’s more likely due to the ageing process, a slowing metabolism, and being less active.9 That said, research suggests menopause may cause fat to be redistributed around your stomach, meaning many women change from a pear shape to an apple shape. However, carrying extra weight around the middle is known to up your risk of developing type 2 diabetes and CVD.10

What you can do: Use this time of life to get to – or stick to – a healthy weight. You may need fewer calories in your 50s and beyond, so focus on a fresh wholefood diet, and cut down on sweet or fatty treats and alcohol. Exercise can also help you maintain muscle mass, which keeps your body burning calories more efficiently.11

Changes to your skin, hair and nails

Research suggests your skin loses around 30% of its collagen – the substance that keeps it ‘elastic’ – in the first five years after menopause, and then it drops dramatically. You may notice your skin becomes much drier or spot the appearance of deeper wrinkles, too. At the same time, lack of oestrogen causes the hair on your head to thin, and/or it may appear elsewhere (hello, stubborn chin hairs).12

What you can do: Upping your intake of vitamin C, iron, zinc and biotin can make a difference to the quality of your skin, hair and nails. You can get all these beauty-boosting nutrients through a diet packed with varied fruit and veg, or consider taking a supplement. Switching up your skincare routine, perhaps to milder cleansers and richer moisturisers, may help too.13

These changes to the skin on your face can also affect the skin on your body – including your vagina. A lack of oestrogen and falling collagen levels can trigger vaginal thinning,14 which can impact your sex life and also lead to bladder problems. Discover the tips and tricks to help improve your sex life post-menopause.

Shop Menopause Relief Advice is for information only and should not replace medical care. Please check with your GP before trying any remedies.

Sources 
1. Mayo Clinic. Menopause. Available from: https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
2. Cleveland Clinic. Perimenopause, Menopause and Postmenopause. Available from: https://my.clevelandclinic.org/health/diseases/15224-menopause-perimenopause-and-postmenopause
3. As above
4. Cleveland Clinic. Perimenopause, Menopause and Postmenopause. Outlook and prognosis. Available from: https://my.clevelandclinic.org/health/diseases/15224-menopause-perimenopause-and-postmenopause/outlook--prognosis
5. Women’s Health Concern: Osteoporosis after menopause. Available from: https://www.womens-health-concern.org/help-and-advice/factsheets/osteoporosis-bone-health-following-menopause/
6. British Heart Foundation. Menopause and Heart Disease. Available from: https://www.bhf.org.uk/informationsupport/support/women-with-a-heart-condition/menopause-and-heart-disease
7. As Source 4
8. As Source 4
9. North American Menopause Society. Changes in weight and fat distribution. Available from: https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-weight-and-fat-distribution
10. As above
11. Mayo Clinic. Menopause weight gain. Available from: https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/menopause-weight-gain/art-20046058
12. American Academy of Dermatology. Caring for your skin in menopause. Available from: https://www.aad.org/public/skin-hair-nails/skin-care/skin-care-during-menopause
13. Cleveland Clinic Health Essentials. Caring for your skin and hair at menopause. Available from: https://health.clevelandclinic.org/keep-your-skin-hair-looking-great-after-menopause-video/

14. Lee, J. The menopause: effects on the pelvic floor, symptoms and treatment options. Available from: https://www.nursingtimes.net/the-menopause-effects-on-the-pelvic-floor-symptoms-and-treatment-options/5009317.article

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