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postmenopause

Alternative Names
change of life

Definition
Menopause occurs in a woman's life once her menstruation has stopped permanently. Menopause is considered complete, and the woman is considered to be in postmenopause once her menstruation has stopped for one full year. This usually occurs between the ages of 35 and 58.

What is going on in the body?
When a woman reaches menopause, her oestrogen level has declined enough so that she has no monthly bleeding and bearing children is no longer possible.

What are the signs and symptoms of the condition?
Hormone levels do not usually decline in a uniform way. They rise and fall again and again over time. These hormone fluctuations are what cause the various symptoms that women have during this time of life. These hormones affect a woman's breasts, vagina, bones, blood vessels, digestive system, urinary tract, and skin.

The symptoms of postmenopause will vary from woman to woman. Some women may continue to have symptoms of perimenopause, including: Within 4 or 5 years after her last period, a woman may start to get urinary tract infections.

Women also may have vaginal drying. The walls of the vagina become thinner and dryer. The walls lose elasticity and are women are more prone to vaginal infections. Sexual intercourse may be painful. Some women may not have much interest in sex, while others report an increased interest in sex following menopause.

What are the causes and risks of the condition?
Menopause is caused by natural ageing. During menopause a woman's oestrogen level decreases. This eventually causes a woman to stop menstruating.

What can be done to prevent the condition?
All women will go through menopause and move into postmenopause.

How is the condition diagnosed?
A doctor can diagnose postmenopause by a woman's history and her symptoms. A blood test can be used to determine oestrogen levels.

What are the long-term effects of the condition?
A woman who is postmenopausal is at higher risk for Urinary tract infections, vaginal yeast infections, osteoporosis, and heart disease. These conditions are due to the lower levels of oestrogen in her body.

What are the risks to others?
Postmenopause is not contagious, and poses no risk to others.

What are the treatments for the condition?
While menopause itself is not treated, the symptoms that go along with menopause are sometimes treated. All of the risks due to oestrogen loss may be prevented or treated. Some ways to do this include making lifestyle changes and taking hormone replacement therapy.

Oestrogen replacement therapy saves more bone tissue than large doses of calcium. Calcium supplements may be taken by those women who do not get enough calcium through their diet.

urinary tract infections may come back again and again. To prevent these infections, a woman should urinate frequently, especially before and after sexual intercourse. She should also drink plenty of fluids and keep the genital area very clean.

What are the side effects of the treatments?
There is a lot of disagreement about the long-term risks of hormone replacement therapy, or HRT. Researchers believe that the longer a woman is exposed to the oestrogen in her body, the greater her risk of breast cancer. It is not clear whether women who take oestrogen will increase their risk of breast cancer. Some studies say that it will, some say that it will not. Long-term use of HRT may increase the number of women who get breast cancer from 10 to 13 women per 10,000 women.

Hormone replacement therapy may not be recommended if a woman:
  • has a family history of breast cancer
  • started menstruating before age 12
  • stopped menopause after age 50
  • delayed pregnancy until later in life
  • is at a higher risk of blood clots, because of her history or other medical conditions
A doctor can help a woman sort through all the risks, risk factors, and benefits of treatments. Side effects can include headaches, bloating, and irritability. A woman who is using hormone replacement therapy during perimenopause may want to reassess using HRT after menopause.

What happens after treatment for the condition?
Most symptoms of menopause go away after a woman stops getting her period. She will continue to be at risk for osteoporosis and heart disease unless she takes oestrogen.

How is the condition monitored?
Postmenopause is monitored by yearly gynecological examinations. If a woman has menstrual bleeding 6 months or more after her last period, she should contact her doctor.

Author: Terry Mason, MPH
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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