Many symptoms occur postmenopause, including hot flashes, weight fluctuations, and vaginal dryness. Some of these symptoms are temporary, while others may last longer in some people.

Postmenopause is the period after the point when a person’s menstrual cycle stops completely. This cessation, known as menopause, typically happens between ages 40 and 58, according to The North American Menopause Society (NAMS).

When menopause occurs, the ovaries cease to produce eggs, estrogen, and progesterone. Estrogen and progesterone are the hormones responsible for regulating menstrual cycles and contributing to pregnancy.

In this article, we discuss postmenopause and the related symptoms. We also look at the long-term impact of postmenopause and potential treatments to improve symptoms.

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Postmenopause characterizes the extended stage of life where people no longer get monthly periods. It is one of the following three stages of menopause that take place over several years:

  • Perimenopause: A transitional stage that refers to the period before menopause, including the 12 months following a person’s last period.
  • Menopause: A doctor will diagnose a person as being in menopause 12 months after a person’s final period.
  • Postmenopause: The time that follows menopause.

The duration of symptoms during the menopause transition is different for everyone. On average, it lasts for 4.5 years.

Many symptoms overlap between perimenopause and menopause. However, the following symptoms often accompany the postmenopause stage:

Fluctuating weight

People may experience weight gain or weight loss after menopause. However, the connection between fluctuating weight and postmenopause is unclear.

A person who has a more sedentary lifestyle could gain weight more quickly due to a decrease in estrogen, particularly around the abdomen, hips, and thighs.

Some people may also lose weight due to reduced muscle mass accompanying postmenopause, though this decreased muscle mass usually correlates with increased body fat.

Even active people may find it challenging to prevent excess weight postmenopause and find that previous exercise routines and dietary habits need modifying.

Changes in vaginal discharge and dryness

Many people experience changes in vaginal discharge or increased dryness in and around the genitals postmenopause. These symptoms may stem from vaginal atrophy, a condition where the vaginal walls become narrower.

Vaginal atrophy affects 15% of people before menopause and 40–57% after menopause. Common symptoms of vaginal atrophy include:

  • vaginal dryness
  • burning or itching around the genitals
  • pain during vaginal intercourse
  • a yellow-tinged vaginal discharge
  • spotting or bleeding

Vaginal discharge may also become less frequent postmenopause, which may increase the risk of painful intercourse. NAMS say this decrease in natural vaginal discharge results from a sharp dip in estrogen and progesterone, which are responsible for healthy discharge and natural lubrication.

Hot flashes

Hot flashes are among the most common symptoms of the menopause transition. Hot flashes usually begin during perimenopause and may last into the postmenopausal stage.

There is no definite marker for when hot flashes start or stop. NAMS state that most people experience hot flashes for 6 months to 2 years. However, others may experience hot flashes for as long as 10 years, or indefinitely for a small number of individuals.

Sleep disruption

Many people report sleep disturbances throughout the menopause transition, often due to:

  • hot flashes
  • night sweats
  • an increased urge to urinate
  • anxiety

Sleep disruption tends to increase as people age. It affects:

  • around 16–42% of people premenopause
  • around 39–47% of people perimenopause
  • around 35–60% of people postmenopause

In addition, decreased estrogen and progesterone levels may contribute to disturbed sleep.

For example, a lack of estrogen may make a person more prone to anxiety and depression, leading to sleep disturbances. Furthermore, progesterone has natural sedation and anxiolytic effects, which help regulate the sleep cycle. Decreased progesterone can make it more difficult to fall asleep and stay asleep.


Once a person is postmenopause, the ovaries stop releasing eggs, and the person can no longer get pregnant naturally.

If a person wants to try for pregnancy postmenopause, they can use eggs they had frozen before menopause or donor eggs. However, they will also require hormone therapy to help prepare the body for implantation and carrying a baby to term.

People can consult a fertility expert to determine whether IVF after menopause is a suitable option for them.

No more periods

Periods stop postmenopause, providing relief from premenstrual syndrome symptoms, such as hormonal headaches, bloating, and mood disturbances.

The long-term impact of postmenopause on a person’s health includes positive and negative components. Some of these include:

Increased risk of osteoporosis

A decrease in bone density, as well as an increase in the risk of developing osteoporosis, typically accompany postmenopause. Osteoporosis is a condition that indicates low bone mass, where bones are more likely to break or fracture.

Research indicates that approximately 20% of bone loss occurs during the menopausal and postmenopausal stages of life. Additionally, osteoporosis affects 1 in 10 females over the age of 60 worldwide. Early menopause may also make some people particularly prone to developing osteoporosis.

Increased risk of heart disease

According to the American Heart Association, estrogen may have a protective effect on the heart, particularly the inner layer of the artery wall, where it helps keep blood vessels flexible.

Since estrogen plummets during postmenopause, people may have a higher risk of developing heart disease or experiencing strokes.

Increased risk of developing obesity

Studies suggest that obesity and metabolic syndrome occur during menopause three times more often than before menopause.

The rapid decline in estrogen during menopause and postmenopause is associated with the loss of subcutaneous fat and an increase in abdominal fat.

Diminished likelihood of unplanned pregnancy

After menopause, people cannot become pregnant naturally, meaning that birth control is no longer necessary for pregnancy prevention. However, some people may still require barrier methods of birth control to prevent sexually transmitted infections (STIs).

A doctor may order tests during menopause or postmenopause to rule out other conditions that often produce overlapping symptoms, such as ovarian failure or thyroid conditions. Tests may include blood work to check levels of follicle stimulating hormone (FSH) and estrogen, and a thyroid function test.

Doctors may use the test results to help determine the stage of menopause a person is experiencing.

A person should seek treatment from a doctor if postmenopause symptoms become unmanageable. Doctors often recommend the following methods for relief:

Hormone replacement therapy

Since a decrease in estrogen may contribute to postmenopause symptoms, hormone replacement therapy (HRT) can be an effective solution for many people.

Doctors may recommend a combination of estrogen and progestin therapy. Progestin is the synthetic form of progesterone. Additionally, transdermal estrogen delivery helps protect bones against osteoporosis and may even increase bone density.

Long periods of HRT are associated with cardiovascular and cancer risks. However, short-term treatment is often beneficial for treating postmenopause symptoms.

Bioidentical hormones

Bioidentical hormones are a relatively new alternative to HRT, and many consider this approach to be the more “natural” of the two solutions.

Bioidentical hormones are synthetic hormones that are chemically identical to those that a person’s body produces. Though the FDA approves many varieties, the FDA has not yet approved any compounded forms.

There is no evidence that bioidentical hormones are healthier or more effective than traditional hormone therapy.

Vaginal estrogen

Vaginal atrophy is a common symptom of menopause and postmenopause, and vaginal estrogen may be beneficial in helping restore lubrication to the vagina.

Vaginal estrogen may be helpful for people who do not get relief from standard lubricants.

Low-dose vaginal estrogen in the form of creams, rings, and tablets is a safer way to treat vaginal symptoms than HRT, according to the National Women’s Health Network.

Low-dose antidepressants

Many people experience psychological changes and disturbances during menopause and postmenopause. A doctor may prescribe low-dose antidepressants to help people manage depression or anxiety.

Research shows that antidepressants are an effective treatment for depression and depressive symptoms during menopause.

Some people may consider taking vitamins or supplements to alleviate postmenopause symptoms. Supplements may target postmenopause systems, but their effects are largely unproven.

Popular vitamins, supplements, and natural remedies people try postmenopause include:

  • black cohosh for hot flashes
  • flaxseed for night sweats
  • calcium and vitamin D for bone strength
  • wild yam as an alternative to hormones

Calcium and vitamin D increase bone mineral density during menopause. However, the effects of other supplements remain inconclusive.

Postmenopause is the third stage of menopause, after a person’s menstrual cycle has stopped entirely for at least 12 months.

Many people may find the postmenopause stage provides relief from the recurring symptoms of perimenopause and menopause. However, some symptoms may carry over into postmenopause, and doctors may prescribe a variety of treatments.