What to expect during postmenopause: life after menstruation

Menopause is the point at which you have your final menstrual period. You can only be certain of this after going a full year without menstruating. From that moment onwards, you are in postmenopause. It is a natural stage in every woman’s life.

The average age for entering postmenopause is 51, although this varies from person to person. Some women experience it earlier, while others transition later.

After your final period, you are no longer fertile. Your ovaries cease producing oestrogen and progesterone and instead produce only testosterone. The high hormone levels of your reproductive years are no longer required, as you can no longer conceive.

However, this does not mean your body stops producing oestrogen and progesterone entirely. Your adrenal glands (two small glands located above your kidneys) take over much of this function. This is why it is important to care for your adrenal glands during this phase, but more on that later.

So, while your body continues to produce sex hormones, it does so in smaller quantities.

As your body adapts to lower hormone levels, you may experience various symptoms as it seeks a new balance. The reduced oestrogen levels can make you feel different from before. Additionally, this phase may bring an increased risk of osteoporosis and cardiovascular disease.

Symptoms that may occur during postmenopause include:

• Vaginal dryness
• Burning sensation in the vulva
• Urinary tract infections
• Weight gain
• Poor sleep
• Joint pain
• Skin ageing
• Hair loss
• Hot flushes
• Low mood

In addition to low oestrogen levels, ageing also contributes to these symptoms, making it sometimes difficult to distinguish between the two. Is it postmenopause, or is it simply the ageing process?

Over time, hormonal symptoms usually diminish during postmenopause. However, some issues, such as dry mucous membranes (like vaginal dryness or dry eyes), may persist due to consistently low oestrogen levels.

Some believe that you must continue hormone therapy during postmenopause to compensate for low oestrogen levels and avoid related symptoms. However, it is a myth that you need to use hormones for this reason.

Menopause is a natural process that every woman goes through. Yes, progesterone and oestrogen levels are lower than before menopause, but your body also requires less of these hormones as you enter a new stage of life. Your body still produces oestrogen (e.g., in the adrenal glands and from abdominal fat), albeit in smaller amounts. This is sufficient for healthy ageing, provided you take good care of yourself.

View the hormonal changes as a signal to prioritise self-care. You can significantly reduce age-related risks by making adjustments to your diet and lifestyle.

It’s about adapting to your body’s changes. Healthy eating and regular exercise remain crucial, as do rest and supplementing certain vitamins and minerals. What should you focus on?

• Adopt a healthy diet. Eat plenty of fruits and vegetables, and ensure your meals include sufficient proteins, fats, and complex carbohydrates. Avoid sugars and refined carbs, and reduce or eliminate alcohol (a major risk factor for cardiovascular diseases).
• Consider supplements to address deficiencies. Calcium and vitamin D are particularly important during postmenopause to prevent osteoporosis. Solgar® Ultimate Bone Support, for example, contains calcium, vitamin D, copper, and zinc, contributing to bone health*.
• Prioritise relaxation. Chronic stress affects your hormonal balance. Your adrenal glands produce the stress hormone cortisol, which is functional in the short term. However, prolonged cortisol production can suppress certain bodily functions and hormone production. Take breaks, practise breathing exercises, and set priorities. Ideally, slow down and enjoy the calm of this phase.
• Exercise daily and include strength training. Daily physical activity—whether walking, cycling, running, or yoga—keeps your bones healthy and improves overall health. Strength training, in particular, helps strengthen muscles and bones and prevents physical discomfort. The 7-Minute Workout is a great option.
• Improve your balance. Activities like yoga and Pilates enhance your balance, reducing the risk of falls (which can lead to fractures).
• Monitor your cholesterol and blood pressure. Experts recommend annual checks of your cholesterol levels and blood pressure. These values can change during postmenopause, allowing you to address any issues early.
• Schedule other important health screenings. These include mammograms, cervical screening, bowel screenings, and osteoporosis risk assessments with your doctor. Even if you feel healthy, these check-ups are essential for detecting potential problems early.

* Health claims pending approval by the European Commission.

Many women in the UK take the contraceptive pill during menopause to prevent pregnancy. While this makes sense if you do not wish to conceive, the pill also affects the female body in other ways. For instance, it can suppress menopause symptoms, including changes in your menstrual cycle.

If you’re on the pill, you may not experience menopause symptoms or notice changes in your cycle. In other words, you might not know whether you’ve already gone through menopause. This isn’t inherently good or bad, but it is something to be aware of. Whether you continue taking the pill during menopause depends on your personal situation and needs.

👉 Dr Jael Loefstop explains: What you need to know about taking the contraceptive pill during menopause.

In some cases, starting or continuing hormone therapy during postmenopause is advisable, such as if you have a family history of osteoporosis or are still experiencing severe menopausal symptoms. The general guideline is to begin before age 60, as the risks of hormone therapy outweigh the benefits after this age. Additionally, hormone therapy should not be used for more than five years, according to the guidelines of the Dutch College of General Practitioners. Read more about hormone therapy.