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Life After Menopause | 10 Critical Symptoms You May Expect

Irene Garzon BSc (Hons) Midwifery
by Irene Garzon BSc (Hons) Midwifery
Last updated June 18, 2024
Reading Time: 9 min
Life After Menopause

So many things we hear about life after menopause and how it changes women’s lives are negative.

Although there’s a lot of negativity when talking about this stage in life, many menopausal women also experience their lives blooming and taking on a wonderful new turn where they feel freer, more liberated and happier about themselves.

Menopause – what is it?

Menopause means a woman has gone through 12 consecutive months without a menstrual cycle, in the absence of pregnancy.

It’s a normal stage in a woman’s life and it simply means the ovaries have reduced their activity to a minimum, making women’s sex hormones levels, especially estrogen levels, drop.

The average age western women reach menopause is 51 years old. The age at which you reach menopause depends a lot on your genes.

The period from the time your first symptoms start until the post menopause period begins lasts, on average, between 5 and 6 years; it is called perimenopause.

Menopause symptoms

Menopause is a process that begins with perimenopause. Your ovaries start to reduce their activity several years before menopause is reached. This reduces the levels of estrogen, which plays a very important role in woman’s fertile life span.

When the ovaries’ activity starts to decrease, menopausal symptoms start to manifest. Some of these symptoms are emotional and others are physical symptoms.

Here are some of the most common symptoms of menopause:

#1 Irregular periods,
#2 Vaginal dryness,
#3 Hot flashes,
#4 Chills and shivers,
#5 Night sweats,
#6 Sleep problems,
#7 Mood swings,
#8 Lower metabolism, which leads to weight gain,
#9 Fragile hair and brittle nails,
#10 Loss of breast volume.

Early in perimenopause, you might not notice your symptoms, or perhaps they aren’t frequent or don’t bother you. At this stage, relieving menopause symptoms with natural methods, such as a healthy diet, can be effective.

As time goes on, if you feel your symptoms are too difficult to handle and you can’t cope with them, make sure you talk to your healthcare provider.

Perimenopausal symptoms can be very debilitating and hormone replacement therapy can be a lifesaver for many women.

Some healthcare professionals are reluctant to offer hormone replacement therapy, no matter how debilitating a woman’s menopausal symptoms might be. If this is true in your case, make sure you keep looking for a professional who listens to you and doesn’t dismiss your concerns.

Personality change after menopause

As we age, we become wiser and more experienced. Menopause doesn’t cause a sharp personality change but postmenopausal women might seem more secure in themselves, more independent, and even more fearless than before.

Many postmenopausal women feel liberated from the demands of society to look and act a certain way. During her younger years, how a woman looks or how attractive she is sometimes has more value than who she is and what she feels about herself. When society reduces its pressures on women who are past their fertile years, that’s when they can finally live without those kinds of societal expectations.

Many women have spent their best years putting others before them. Many older women, especially mothers, find a way to dedicate their post menopause years to themselves and find this self knowledge, care, and pampering very rewarding.

Health after menopause

Life after menopause is defined as a great stage of female sexual health by most women who experience it. They actually feel as though a weight has been lifted from their shoulders and, if they don’t have any limiting health problems, they tend to regard it as a liberating, joyful life period.

There are, however, some health conditions or even health problems linked to menopause. Although they happen to a small proportion of menopausal women, they can seriously hinder a woman’s overall health. This is why it’s important to consider exercise and a healthy diet as part of your self care when you are approaching menopause.

Let’s look at some of these possible postmenopausal conditions.

Postmenopausal syndrome

All the symptoms that manifest in women as a consequence of menopause constitute the postmenopausal syndrome.

Unfortunately, this definition highlights the fact that women are not treated fairly in the medical system. For many decades, medical research has used men as the default subject of their studies and has drawn general conclusions for men and women.

Because menopause is an exclusively feminine issue, medical research has wrongly looked at it from the perspective of illness, when it’s a complete physiological process.

The first definition of ‘syndrome’ in every dictionary is very similar and uses words such as ‘illness’, ‘disease’, ‘problems’, ‘disorder’, and ‘abnormality’.

For example, the Cambridge dictionary defines syndrome as ‘a combination of medical problems that shows the existence of a particular disease or mental condition’.

The symptoms of a completely physiological stage have been classified as a syndrome, rather than as a normal, physiological event in a woman’s life. Similar to pregnancy and birth, menopause has also been pathologized by the medical community.

Postmenopausal depression

The North American Menopause Society says “women are more at risk of experiencing depression during perimenopause and after menopause”.

A woman’s risk of depression from perimenopause onwards is double the risk of getting depression before menopause. This covers the whole of a woman’s fertile life span, and includes postnatal depression and any other type of depression women might experience before menopause.

Many women feel more vulnerable during menopause. This is not only because of the physical changes to their reproductive system but because of the emotional weight many of them carry on their own.

Many women are able to identify sources of stress and tension that can lead to serious mental health problems. Other women, however, are unable to identify unhealthy behaviors that, if not corrected, might lead to depression, anxiety or other serious mental health conditions.

Make sure you speak with your healthcare providers if you’re struggling to cope with your transition into menopause. They can help you relieve the symptoms of menopause with hormone therapy, and will be able to refer you to an appropriate professional if you need further support.

Estrogen levels have a direct effect on the release of serotonin, a hormone involved in mood regulation. During the menopausal transition, changing levels can have a strong effect in lowering women’s mood and even causing disorders.

This usually resolves as the body adapts to its new postmenopausal status but it isn’t always the case. Make sure you receive professional support for as long as you need it.

Can a woman go crazy during menopause?

Women, as well as men, can develop a mental disorder at any stage of their lives. Apart from postmenopausal depression, women aren’t at an increased risk of suffering a mental illness during or after menopause.

Let’s reiterate menopause is a completely normal and physiological event in women’s lives. None of the physical changes that occur during this period will interfere in a woman’s mental health status per se.

If a woman has difficulty coping with hormone changes, she might need hormone replacement therapy to help her navigate this period. Rather than assume she needs medication for her moods, it’s important healthcare providers focus on hormone therapy to optimize hormone levels first, especially if her menopausal symptoms are quite debilitating and interfere greatly with her daily life or even threaten her mental health.

You can find more information about menopause symptoms in;  menopause signs, symptoms and treatment article.

Symptoms unfairly attributed to menopause

Osteoporosis

The female skeletal structure needs to be strong enough to support not only our body weight but also the weight increase we experience with every pregnancy. At the same time, the pelvis needs to be shaped in a particular way to facilitate birth when the time comes.

Estrogen plays an important role in protecting bone health. During our fertile years, high estrogen levels make sure that our bone mass and bone density are optimal.

After menopause, much less estrogen is secreted, so our bones aren’t as well protected as they used to be. This makes women more prone to bone fractures, due to reduced bone density.

This means our bone health is at its best under the influence of optimal levels of estrogen. Hormone therapy in the perimenopause stage can help slow down, or even prevent, rapidly developing problems with bone density.

Studies show a woman’s bone health during menopause is quite similar to that of a man of the same age. Men are more prone to bone fractures before the age of 50. After this age, women’s risk of developing fractures starts to increase, overtaking the risk men have. This is attributed to levels of androgens (male hormones) being associated with a decreased risk of falls. Following a hip fracture, however, the mortality risk is significantly higher in men, compared with women.

Heart disease

Just as estrogen protects the skeletal structure, this hormone also protects the heart. It needs to be able to cope with the increased blood volume and extra work a woman’s heart takes on during pregnancy.

There’s a deficiency in robust study data related to cardiovascular disease in women, as women remain underrepresented in the majority of cardiovascular clinical trials.

Women have risk factors of developing heart disease than men don’t have. These include endometriosis, polycystic ovary syndrome, diabetes, and high blood pressure that develops in pregnancy.

These conditions are unrelated to menopause. However, once the protection estrogens offer is no longer there, the risk of heart disease in women increases.

Urinary incontinence

Genitourinary syndrome of menopause is described as any number of menopausal symptoms that include genital, sexual, and urinary symptoms. The urinary symptoms are classified as urgency, dysuria (pain when passing urine), and recurrent UTIs. Some of the symptoms of this syndrome might exacerbate an already weakened pelvic floor.

A woman’s bladder control depends mainly on the state of her pelvic floor muscles. Her abdominal muscles also play an important role in keeping the abdominal contents in place.

When the health of the pelvic floor has not been properly looked after, its muscles weaken and start to lose strength; this can affect the pelvic organs, especially the bladder. It can be very hard to cope with, and many women don’t realize it can be addressed.

Lack of pelvic floor awareness and knowledge of how to care for its muscular health – in women and professionals –plays an important role in the development of urinary incontinence.

You can read more about your pelvic floor health in 7 Great Times To Do Your Pelvic Floor Exercises, Does Vaginal Birth Damage The Pelvic Floor? and The Lie That A C-Section Can Save Your Pelvic Floor.

How long does post menopause last?

Post menopause is the period in a woman’s life that occurs after menopause.

It lasts until the end of a woman’s life. The length of this period varies between women, depending on when they reach menopause and how many years they live.

Does life after menopause get better?

For many women life does get better. I’ve worked with postmenopausal women for quite a few years and the vast majority say that life is much better now.

The kids are grown up and have flown the nest (or soon will), they don’t have to worry about menstrual cycles anymore and many rediscover their sex drive. Their previously busy lives become calmer, they get more time to themselves to focus on what they really like doing, and they often experience a boost to their sex lives.

Let’s explore a woman’s sex life after menopause a bit further.

Sex life after menopause

Menopause has been given quite a bad press. We’re often given the impression of fun coming to an end while women sit in front of the TV, binge watching soap operas and taking on a crafty activity.

Some women enjoy that and that’s absolutely fantastic. That’s one of the best parts of the postmenopausal years: having more time to do what you really enjoy doing.

For many women, though post menopause is also a time when they rediscover a very satisfying sex life, despite what is portrayed on popular media, which focuses on drugs for erectile dysfunction and vaginal dryness.

This is because the brain is our most active sexual organ and, for many postmenopausal women, other factors play in their favor when it comes to sexual desire and sex drive.

The inability to get pregnant, the absence of a monthly menstrual period, and the extra time to explore their sexuality as they please all play a major life changing role in postmenopausal women’s sexual lives.

Orgasm after menopause

The capacity to orgasm doesn’t depend on estrogen levels as much as the levels of oxytocin. This hormone is secreted when we are happy, when we enjoy life and have fun, when we laugh and when we’re in love. We secrete the highest amounts during orgasm (only surpassed by the amount when we give birth naturally).

Without so many things in our minds, or others living under the same roof, many women develop a higher and more intense capacity to orgasm.

Where does sperm go after menopause?

The anatomy of a woman’s reproductive system doesn’t change with menopause. It works differently but the connections, cavities, and structures remain the same.

Most of the sperm comes right out of the vagina after having sex, especially if the woman is in a vertical position or as soon as she stands up afterwards.

The sperm that make it through her cervix will eventually die and come out.

What age do women stop getting wet?

It’s true that vaginal dryness is one of the more annoying menopausal symptoms. However, we know our sex drive lives mainly in the brain and that helps lubrication and getting ready for sex.

If vaginal dryness is a problem when some postmenopausal women have penetrative sex, there are many lubricants and gels on the market that will help to overcome this small obstacle. Vaginal dryness doesn’t have to stop menopausal women from enjoying a wonderful sex life.

If vulvovaginal atrophy presents, it can be addressed with estrogen therapy.

Do breasts shrink after menopause?

Once breasts are fully developed during puberty, the amount of breast tissue a woman has remains the same until she dies.

It is when the levels of sexual hormones drop that the reproductive organs and tissues that depend on reproductive hormones are also affected.

Life will make our skin less elastic and gravity will also play a role as we age. Therefore, life and the natural aging process are the main culprits to blame for saggy boobs as we grow older.

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Irene Garzon BSc (Hons) Midwifery

Irene Garzon BSc (Hons) Midwifery

Irene was a midwife, writer and educator specialised in women's sexual health. She's worked in most areas of midwifery and as an educator in the UK, Spain, Bangladesh, Iran and Nepal (for now!). Her professional passion is to help people understand the importance of being born, where the mother owns this process and how care providers ought to provide the right care.

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