Postmenopause, the last stage of the menopausal transition, occurs when you haven’t had a period for 12 consecutive months. This new phase of life may come with some health changes to be aware of.

Starting in perimenopause, the body’s hormone levels begin to fluctuate. During postmenopause, your hormones remain at a constant low level.

This can increase your risk of certain health conditions, including osteoporosis (bone weakening) and heart disease. Symptoms that started in perimenopause may also continue well into postmenopause.

It’s important to know about these effects and take steps to reduce your risk. A healthcare professional can help you understand your risk and make a plan to maintain your health.

The risk of osteoporosis increases with age, but the decline in estrogen levels that comes with menopause is also a risk factor.

The body is constantly breaking down and rebuilding bone. Without enough estrogen, bones can’t rebuild efficiently and become weaker and less dense.

Osteoporosis makes you more susceptible to fractures, particularly in the hips, spine, and wrists. You may be able to prevent or slow osteoporosis by making some lifestyle adjustments, such as:

You may also want to talk to your doctor about medications that can help protect your bones, like biphosphonates or calcitonin. Some people may also benefit from hormone therapy, but it’s not right for everyone.

Like osteoporosis, the risk of cardiovascular disease and the factors that can contribute to it — like high blood pressure and high cholesterol — increases with age. However, menopause can also further raise these risks.

A 2022 research review notes that estrogen typically helps protect against heart disease by having certain effects in the body, like regulating cholesterol and helping the blood vessels function properly. When estrogen levels decline, these processes can be disrupted.

Many of the lifestyle changes that can help reduce the risk of osteoporosis can also help lower your heart disease risk. Try to eat a balanced diet, get regular physical activity, and avoid smoking.

If you already have risk factors like high blood pressure or high cholesterol, your doctor may also recommend medications.

In addition to osteoporosis and heart disease, some people may experience a continuation of symptoms and health changes from perimenopause into postmenopause.

Vasomotor symptoms

Though vasomotor symptoms like hot flashes are more common in people experiencing perimenopause and early postmenopause, they may persist long after your periods have stopped.

Hormone therapy can be helpful, but it’s generally only recommended for people under 60 or within 10 years of menopause onset. If you don’t meet those criteria, you may benefit from other medications, like selective serotonin reuptake inhibitors (SSRIs) or fezolinetant (Veozah).

Mental health

People experiencing perimenopause often notice mood changes, and some may notice new or worsening anxiety or depression. These mental health symptoms may continue into postmenopause, requiring treatments like therapy or medications.

Vaginal symptoms

Unlike some other menopause symptoms, vaginal symptoms like dryness don’t improve over time without treatment.

Water-soluble lubricants containing ingredients like hyaluronic acid may help relieve your symptoms, make sex more comfortable, and lower the risk of infections. Vaginal estrogen therapy may also be an option for some people.

It’s important to remember that everyone’s experience is different. One person may notice their symptoms improving after menopause, while others may continue to experience disruptive effects for years afterward.

Finding a menopause specialist who can help you manage your symptoms and maintain your health in the long term is one of the best things you can do. Try searching for a practitioner in your area with The Menopause Society’s directory.

If you haven’t already, talk with a doctor about your potential health risks and how you can manage them.

Lifestyle changes are a good place to start. It can help to evaluate your eating and exercise habits and make a note of other possible risk factors, like alcohol consumption or tobacco use.

If necessary, your doctor may recommend medications to manage certain aspects of your health, like blood pressure or bone density.

Stay in contact with your doctor and ask them about health screenings or tests that can help you monitor your health. They may recommend:

  • pelvic exams
  • pap smears
  • mammograms
  • other gynecological screenings
  • other cancer screenings
  • osteoporosis tests, such as bone density scans
  • regular immunizations

The postmenopausal years can come with higher risks of certain health conditions, including osteoporosis and heart disease. However, there are steps you can take to lower your risks and maintain your health.

Talk with your doctor about health screenings, lifestyle changes, and medical treatments that may help.