Common symptoms of postmenopause

Medically reviewed by Rosanna Sutherby, PharmD on March 25, 2021. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


Most people are familiar with the common symptoms of menopause; however, not everyone can name the most common postmenopause symptoms. While there is significant overlap between the two, it’s important to be able to tell the difference to have the best understanding of your own health.

So whether you’ve recently discovered that you’ve entered into this postmenopause phase by taking an at-home postmenopause test and are simply wondering what you can expect from this phase of life, here’s an in-depth look at the different postmenopausal symptoms, how long they can last, and the potential impacts they can have on your health.

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How do I know if I’m menopausal or postmenopausal?

When you reach midlife as a woman, you’ll enter menopause. This life stage consists of three stages, including perimenopause, menopause, and postmenopause.

Perimenopause is the menopausal transition, and it is when your ovaries slowly start making less of the hormone estrogen. Most women will start to go through perimenopause in their 40s. However, some women will experience this change before the age of 40. healthcare providers call this premature, or early, menopause. If you are looking to check for early menopause, consider taking our perimenopause test.

For most women, the menopause transition lasts eight to 10 years, as long as they don’t have premature menopause. Then, roughly one to two years before the start of menopause, estrogen hormone levels drop even further. This causes women to start experiencing the traditional symptoms of menopause, or perimenopausal symptoms.

Menopause is what occurs when you’ve not had your menstrual cycle for 12 consecutive months. In addition to no longer having a menstrual period, your ovaries have also stopped releasing eggs and producing as much estrogen.

You’ll know that you’ve entered menopause when you’ve gone a year without having a period. Having menopause symptoms, including hot flashes, vaginal dryness, and weight gain, is another indicator that you’ve hit this menopausal status.

Postmenopause is what comes after menopause, and this stage lasts for the rest of your life. Some postmenopausal women start to notice that their symptoms lessen or even disappear during this time. However, in some cases, it’s possible to experience certain menopause and postmenopause symptoms for 10 years or more.

Related: What does postmenopausal mean?

You’re considered postmenopausal when you haven’t had a menstrual period with vaginal bleeding for at least a year. Your healthcare provider can also perform bloodwork to assess your levels of certain reproductive hormones to confirm that you’ve entered the postmenopausal phase of life.

What are the common symptoms of postmenopause?

The various symptoms that menopausal and postmenopausal women can experience during this phase of life include:

  • Vasomotor symptoms, such as hot flashes, hot flushes, and night sweats
  • Urogenital atrophy, including incontinence, vaginal dryness, and painful intercourse
  • Psychological symptoms, including anxiety, depression, irritability, and mood swings
  • Cognitive symptoms, such as trouble concentrating and confusion
  • Sleep difficulties like insomnia
  • Osteoporosis symptoms, including back pain, stooped posture, and loss of height
  • Cardiovascular disease symptoms

Each woman is different, so the types of postmenopause symptoms, as well as their intensity and duration, can vary.

Vasomotor symptoms

A vasomotor symptom is a term that refers to common menopausal issues, including hot flashes, hot flushes, and night sweats. These symptoms are so common that up to 75% of perimenopausal women experience them. Most women will experience vasomotor symptoms for one to two years after menopause. However, hot flashes and night sweats can last for a decade or longer in some women.

Hot flashes and night sweats can be very unpleasant, as they can interfere with work, sleep, and other daily activities. These symptoms can also make it more difficult to concentrate and lead to mood swings during the menopause transition. As a result, vasomotor symptoms are one of the top reasons why women seek menopause treatments. Although researchers know that these symptoms are a consequence of menopausal estrogen deficiency and withdrawal, they don’t completely understand why women have hot flushes. Right now, scientists believe that an event in the hypothalamus (a small region of the brain near the pituitary gland) causes an increase in skin and core body temperature as well as in metabolic rate. This is thought to cause women to feel overheated and begin sweating.

Urogenital atrophy

When estrogen levels decline, it can cause urogenital atrophy. This means that changes occur in the vagina and the urethra (the tube that allows urine to exit the body). Urogenital atrophy can lead to a variety of postmenopause symptoms in these parts of the body.

Many postmenopausal women report vaginal dryness, but that isn’t the only symptom that can occur. It’s also possible to experience vaginal pruritus (itching) and pain during sexual intercourse. Additionally, dysuria (painful or difficult urination), urinary urgency (feeling the urge to urinate), and urinary incontinence (the involuntary leakage of urine) can occur.

Although it’s less common, postmenopausal bleeding is another vaginal symptom that can occur. This is often due to endometrial atrophy, vaginal atrophy (atrophic vaginitis), or issues like uterine polyps and fibroids. However, in rarer cases, bleeding after menopause can be a sign of endometrial, or uterine, cancer. As a result, it’s important to visit your healthcare provider if you notice vaginal bleeding after you haven’t had your menstrual cycle for 12 consecutive months.

Psychological and cognitive symptoms

Estrogen deficiency during menopause can also lead to certain mood swings and cognitive issues. Depression is one of the most common, as an estimated 20% of women will have depression at some time during menopause. Typically, the risk of depression is higher during perimenopause, and it decreases during postmenopause.

Estrogen increases the effects of serotonin and norepinephrine (neurotransmitters in the brain). As a result, researchers believe menopausal depression is due to the fluctuating and declining levels of estrogen during the perimenopause years.

In addition to depression, some postmenopausal women may also experience anxiety, lack of motivation, irritability, mood swings, memory problems, and difficulty concentrating. Again, scientists think that lower levels of estrogen likely lead to these postmenopause symptoms.

Sleep difficulties

Researchers have found that 40-50% of postmenopausal women report insomnia, or difficulty sleeping. Mood disorders, such as depression and anxiety, can lead to sleep trouble. However, menopausal insomnia has also been associated with estrogen deficiency.

Additionally, many women report that night sweats make it more difficult to sleep at night. While others may have difficulty with sleep due to sleep apnea caused by postmenopausal weight gain.

Osteoporosis symptoms

Because postmenopausal women experience estrogen deficiency, many women develop osteoporosis and related symptoms after menopause. Osteoporosis is a bone disease that’s characterized by weak, brittle bones that are more prone to fracture. Due to changes in bone density and menopausal bone loss, women with osteoporosis may also experience backaches, mobility issues, and a slow decrease in height.

In addition to being a postmenopausal woman, being Asian or Caucasian, having a small body frame, and having a family history of osteoporosis are also risk factors. However, getting regular exercise, avoiding cigarettes, and increasing calcium and vitamin D intake can all help prevent and treat osteoporosis symptoms.

Cardiovascular disease symptoms

The menopausal decrease in estrogen levels can also increase the risk of heart disease in women. Before the age of 55, you have a lower risk of developing heart disease than a man your age. However, after the age of 70, you have the same risk of heart disease as a man.

It’s important to note that menopause does not cause heart disease. Instead, the natural decline in estrogen seems to be one of the reasons why postmenopausal women have an increased risk of cardiovascular disease.

How long do postmenopausal symptoms last?

Because menopause is so different for each woman, how long menopause symptoms last can vary. For example, one woman may experience symptoms like hot flashes and depression for one or two years after menopause. In contrast, another woman may be dealing with these symptoms for a decade or longer.

It’s also important to note that some issues that can occur as part of menopause, including having an increased risk of osteoporosis and heart disease, need to be monitored throughout the postmenopausal period.

How do you treat postmenopausal symptoms?

The way that your healthcare provider will treat your menopause symptoms will likely vary depending on the issues you’re experiencing. One of the most common options is hormone replacement therapy. Sometimes known as HRT or estrogen therapy, this treatment can help improve many postmenopause symptoms. However, you’ll want to also take progesterone if you are pursuing HRT and you still have your uterus. There’s no need to worry though, as there are plenty of benefits of progesterone after menopause.

In addition to menopausal hormone therapy, your healthcare provider may also recommend one or more of the following menopause treatments.

  • Vaginal estrogen. This option comes as a vaginal cream, tablet, or ring, and it can treat vaginal dryness. Treating vaginal dryness can also improve pain during sex and itching.
  • Antidepressants. For postmenopausal women who are experiencing depression or anxiety, antidepressants can help improve mood.
  • Vitamin D and calcium. To help prevent and treat osteoporosis, your healthcare provider may prescribe these nutrients in supplement form.

Learn more about your postmenopausal hormone health with the Everlywell at-home Postmenopause Test, which allows you to easily check your estradiol and progesterone levels from the comfort of home.


References

1. Menopause, Perimenopause and Postmenopause. Cleveland Clinic. URL. Accessed March 25, 2021.

2. Dalal PK, Agarwal M. Postmenopausal syndrome. Indian J Psychiatry. 2015;57(Suppl 2):S222-S232.

3. Menopause and Heart Disease. American Heart Association. URL. Accessed March 25, 2021.

4. Menopause and your health. Office on Women's Health. URL. Accessed March 25, 2021.

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