A few things to know about post-menopause
By Dr. Mary James, ND
Most of the women I talk to don’t have a clear idea what will happen to their bodies post menopause. Sometimes they (wrongly) fear the worst, often they buy into a cliché, but most of all — they just aren’t getting good medical information.
Unfortunately, this doesn’t surprise me. Most doctors barely address the issues and concerns of post-menopause, often inferring that women can relax because “the worst is over.”
So let’s zero in on what you should expect, what you need to know, and how you can take advantage of all that menopause has to offer.
Those hot flashes will stop — right?
If you think all your symptoms will go away once you’re fully in menopause (meaning one full year without a period), you’re only partially right. In the first stages of post-menopause, hormones are often still fluctuating as your body adjusts to its new estrogen normal. You’ll eventually have less estrogen, but you’ll still have some for a while.
Conventional medicine suggests that women with hot flashes (up to 80% of menopausal women), will only be bothered by them for 6-24 months total and then those hot flashes will ease up in post-menopause. Not so fast. For many women, this just isn’t the case.
Hot flashes that start before menopause actually tend to last a long time: up to 7 to 11 years for many women. However, a fair number of women don’t get hot flashes until much later, in post-menopause. For them, hot flashes and night sweats can last about 3 ½ years. While that’s not exactly “easing up,” it’s accurate information that can help a woman know what possibilities she should plan for.
What about hormonal migraine headaches after menopause?
Hormonal migraines are so closely tied to the monthly cycle that premenopausal women can often predict when they’ll have one. For these headache sufferers, migraines can get worse as they get closer to menopause, sometimes increasing in frequency by as much as 60%. A decrease in estrogen is considered a common migraine trigger.
But for some migraine sufferers, there’s good news as hormones begin to settle down post-menopause. Hormonal migraines can become less frequent, or even go away completely, in the years after the last period. Though slightly less miserable tension headaches can replace migraines in some women, they’re not necessarily related to hormones anymore.
Some women get migraines for the first time in post-menopause and women who’ve had hysterectomies seem to have it even worse. The research continues to confirm that while headaches overall are a uniquely personal symptom, hormonal changes are at least part of the problem.
Post-menopausal vaginal dryness
As a symptom, post-menopausal vaginal dryness is ridiculously common, and can throw women for a loop. As estrogen wanes, vaginal tissues will change. They can thin and become irritated to the point of being painful, especially during intercourse, which is a pretty big bummer.
The women who cope best with vaginal dryness are those who quickly accept the fact that they need (and want!) to use lubrication for sex and just to be comfortable. They go natural and try out different lubes, or experiment with aloe vera gel or food-based oils (sweet almond or coconut are top picks) until they find one they like to use regularly, even when they’re not having sex.
Some women with severe vaginal dryness need to resort to one of the newer generation of hormone applications, but I suggest trying other methods first. And remember that just having sex, or engaging in a little fun self-stimulation, can help keep your vaginal tissues healthier and moister.
While we’re on the subject of sex in post-menopause…
Vaginal dryness aside, your libido can go into hiding after menopause. Lots of women (and their partners) assume this is an emotional issue, but there are plenty of physical reasons for this. If you don’t want to have sex anyway, this will be less of an issue for you.
But having sex is good for your health, whether you have a partner or not. Drops in estrogen and testosterone don’t just shrink your sex drive — they can even change how it feels to be touched. This can slow down the initial stage of sex, i.e., arousal, making it less satisfying.
Your sexual response may change in post-menopause but I am here to tell you: change is okay! It can even lead to bigger and better sexual enjoyment, and if you have a partner, it can be fun to experiment with new ways of relating. Just give yourself the time, and whatever else you need, to get turned on.
Listen to your body and schedule some solo sessions to discover what feels especially good to you now.
Be proactive about bone health — it will make you feel stronger
One big gift you can deliver to your body is to take extra care of your bones after menopause. They’re at tremendous risk for losing density and strength. Get enough vitamin D, eat antioxidant-rich foods and take extra key supporting minerals like calcium, magnesium, zinc and vitamin K7. Start yesterday, if you know what I mean.
And try like hell to get some regular exercise. Even if you feel a little achy and tired, push yourself to go for a bike ride or a walk, even if you’re just ambling. Yes, it’s good for your heart too, and gets your circulation moving oxygenated blood all over your body.
Physical movement is also good for your soul and your spirits and makes you feel younger and more alive. So make it a habit to walk right past the couch and out the door and go outside as often as you can.
Every woman in post-menopause has earned the right to feel good and have the energy to do what she wants every day. The more you take care of your body right now, the healthier and happier you’ll be throughout post-menopause.
- Nancy E. Avis, PhD; Sybil L. Crawford, PhD; Gail Greendale, MD; et al. Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition. JAMA Intern Med. 2015;175(4):531-539. doi:10.1001/jamainternmed.2014.8063. Accessed 8.14.17.