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Once menopause has occurred, a woman is said to be in postmenopause a stage she will be in for the rest of her life. In the United States, postmenopausal women can look forward to living another 25 years or more.
What are some common symptoms?
Postmenopausal women produce less estrogen, so there are some symptoms that they might have. About 10 percent to 15 percent of postmenopausal women will have vaginal dryness, which can lead to painful intercourse. Women who have had a hysterectomy and undergone surgical menopause may experience incontinence and decreased sex drive. And some women will find that the hot flashes and night sweats that started during perimenopause last for a few years. Most women, however, feel much better once the hormonal "storms" of perimenopause go away and they talk of increased energy and new vitality. The anthropologist Margaret Mead described this feeling as "postmenopausal zest."
What are some postmenopausal issues?
The health issues of greatest concern for postmenopausal women are the diseases of aging: heart disease and osteoporosis.
Heart disease - In the United States, heart disease is the leading cause of death in women. Although the average age of a heart attack is 74, many women in early postmenopause will want to reevaluate their lifestyles to reduce their risk. Some lifestyle changes may include:
- Establishing a heart-healthy eating pattern.
- Getting regular physical activity. Check with your doctor before you begin.
- Maintaining a healthy weight. Ask your doctor what weight is healthy for you.
- Quitting smoking.
Treatment options may also include a low-dose aspirin regimen in women with heart disease and cholesterol- and blood pressure-lowering drugs. These have been proven most effective in preventing heart attacks. Although estrogen replacement was initially thought to prevent heart attacks, more recent data has indicated that it may actually increase them. The American Heart Association no longer recommends estrogen therapy (ET) or hormone therapy (HT) for the prevention of heart disease.
Osteoporosis - As we age, we gradually lose bone, leading to an increase in hip fractures in our 80s, and in some women, an increase in fractures of the spine at an earlier age. It is important for women in early menopause to adopt lifestyle changes that will maintain bone. Some positive choices that should be incorporated into your lifestyle may include:
- Quitting smoking.
- Limiting alcohol intake.
- Exercising several times per week including weight training. Check with your doctor before you begin.
- Taking at least 1,200 mg of calcium a day.
- Taking vitamin D.
Women who have osteoporosis might also consider treatments that block bone loss and have been shown to lower the chances for fractures. Medications include bisphosphonates (Fosomax®, Actonel® and Boniva®) and selective estrogen receptor modulators (SERMS) such as raloxifene® or Evista®. Hormones, such as calcitonin and a form of parathyroid hormone, are important for women with fractures and can help in severe cases of osteoporosis. Although estrogen replacement has been shown to decrease the loss of bone density, it has fallen out of favor for treatment of osteoporosis because of risks for heart disease and stroke.
This article was reviewed and updated June 2007.
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