Postmenopause: Let's be aware of this!

Has it been more than a year since your monthly period stopped? Do you still feel discomfort and changes in your body after passing the big milestone called menopause? Then you are in the period called "Postmenopause". Many women don't talk about this much, but this is a very important stage in our lives. So don't be afraid, today we will talk about this period, the changes that occur during it, and how to stay happy and healthy.

Simply put, what is postmenopause?

Postmenopause is the period after menopause. To be precise, this is the time when your monthly periods start again after 12 consecutive months of no periods . During this time, your ovaries stop releasing eggs (ovulation). This means that your ability to have children is over.

This is not the end of life, but a new beginning. Symptoms that were very bothersome to you during menopause, such as hot flashes and night sweats, may gradually decrease or disappear completely during this time.

But during this time, our body has very low levels of the hormone estrogen . This hormone is very important for keeping our bones strong. Therefore, when estrogen decreases, the risk of osteoporosis increases slightly.

How long does postmenopause last?

Once you enter postmenopause, it will last for the rest of your life. Hormone levels will remain low, your monthly period will not return, and you will no longer be able to conceive a child because you will no longer be able to ovulate.

This condition usually occurs around the age of 52. But it can vary from person to person. The important thing is not your age, but whether it has been more than a year since your period stopped.

Can symptoms still occur during this time?

Yes, many people may still experience some of the same symptoms they had during menopause. But most of the time, they are less intense. This is all because our body's reproductive hormone levels are low. Some people may even have no symptoms at all.

But see if you also have these symptoms:

Is it possible to have vaginal bleeding during postmenopause?

Absolutely not. This is very important. Vaginal bleeding during postmenopause is not normal . Sometimes, vaginal dryness can cause a small spot of blood to appear after sex. However, if you are bleeding in any other way, it could be a sign of a thickening of the lining of the uterus (endometrial hyperplasia), uterine fibroids, infection (endometritis), or cancer. So, even if you have a small amount of blood, you should definitely see a doctor.

Health risks to be aware of during postmenopause

As the hormone estrogen, which used to be our protector, decreases, the risk of developing certain diseases increases slightly during this time. There is nothing to fear, as we can protect ourselves from them by being aware of this.

1. Thinning of bones (Osteoporosis)

After menopause, bone density decreases rapidly due to the decrease in estrogen. Bone mass can decrease by about 1% - 2% per year. When bones become very thin, even a small fall increases the risk of fractures.

• What can be done?
• Eat foods rich in calcium: Include milk, cheese, yogurt, small fish with shells (salyo, halibut), leafy greens like spinach, kale, and fortified cereals in your diet.
• Vitamin D: Vitamin D is essential for the body to absorb calcium. Vitamin D is obtained from exposure to sunlight in the morning. If necessary, you can also take a vitamin D supplement on medical advice.
• Exercise: Things like weight lifting and brisk walking strengthen bones.
• Bone Density Test: Your doctor may recommend a test to measure the density of your bones, if necessary.

2. Cardiovascular disease

Before menopause, the hormone estrogen helps protect our heart and blood vessels. But as that protection decreases during postmenopause, the risk of developing diseases like heart attack and stroke increases. Also, since many people are less physically active during this time, the chances of developing high cholesterol and high blood pressure are also higher.

• What can be done?
• Healthy diet: Reduce foods high in oil, salt, and sugar. Eat more vegetables, fruits, legumes, whole grains, and fish.
• Regular exercise: Do something like walking or swimming for at least 30 minutes a day.
• Avoid smoking: Smoking is very harmful to the heart.
• Manage chronic diseases: If you have diseases like diabetes, high blood pressure, or cholesterol, manage them well according to your doctor's instructions.

3. Urinary and reproductive system problems (Genitourinary syndrome of menopause)

Although this is a somewhat complicated name, it simply refers to problems in the vagina and urinary system caused by a decrease in estrogen.

• Vaginal dryness: The tissue becomes thin, dry, and may become itchy and inflamed. This can make sexual intercourse painful.
• Urinary system problems: As the tissues of the bladder and urethra weaken, you may experience frequent urinary tract infections and have difficulty controlling your urine.

• What can be done?
• You can use vaginal lubricants and moisturizers available on the market.
• If these problems persist, your doctor may recommend topical creams containing estrogen or other treatments.

Postmenopause and mental health

This time can be challenging both physically and mentally.

• Things like anxiety, anger, and depression can occur.
• You may feel sad that the time when you were able to have children is over.
• The feeling of getting older can be stressful.

These feelings are normal. You are not alone. Talking about this with a trusted friend or family member can be very helpful. Or, talking to a counselor or psychiatrist can give you a lot of strength to cope with this new phase of life.

Treatment and lifestyle changes to manage symptoms

There are various ways to manage the discomforts that arise during this time.

Medical treatment

Depending on your symptoms, your doctor may recommend treatments such as:

• Hormone Therapy (HT): This is the most effective treatment for many symptoms. It involves replacing the deficient hormones with hormones from outside the body. However, it does carry some risks (e.g., blood clots, breast cancer), so only your doctor can decide if this is right for you based on your health history.
• Antidepressants: Some types of antidepressants can help control mood swings as well as hot flashes.
• Vaginal creams: Creams containing estrogen can be used to treat vaginal dryness and pain.
• Other medications: Medications like Gabapentin and Oxybutynin are sometimes given to control hot flashes.

Lifestyle changes

Besides medication, there are many things you can do yourself.

• Exercise regularly: Things like walking, yoga, and weight lifting strengthen bones and muscles. They're also great for mental health.
• Eat a healthy diet: Eat a diet low in oil, sugar, and salt, and rich in vegetables, fruits, and herbs. Limit alcohol consumption.
• Maintain a healthy weight: Controlling your body weight can protect you from diseases like heart disease and diabetes.
• Stay social: Get together with friends, do community service, or engage in a hobby you enjoy. This will give you the mental support you need.
• Meditation: Practicing something like meditation is very useful for calming the mind and reducing stress.

Frequently Asked Questions

Is it possible to get pregnant during postmenopause?

If your period has stopped for more than a year, you are unlikely to get pregnant because you are not ovulating. However, if you do not want children until a year after your period has stopped, talk to your doctor about using birth control.

Should Pap tests be done even during postmenopause?

Yes, absolutely. It's not a good idea to stop getting gynecological checkups just because you've stopped menstruating. You should continue to have Pap smears, mammograms, and other annual health checkups as recommended by your doctor.

Will my body go back to the way it was after menopause?

No, your body will not return to the way it was before menopause. However, for many, the annoying symptoms such as hot flashes, sweating, and mood swings will subside and you will begin to feel a great sense of relief. However, for some, these symptoms may persist for years.

Postmenopause, menopause, after menopause, women's health, estrogen, osteoporosis, Hot flashes, Sinhala medical article