After menopause: 4 questions women ask about post-menopause

Today's topic

Today on A.Vogel Talks Menopause, I take a look at what happens after menopause. I get asked so many questions from women wanting to know what happens after menopause, what symptoms they are likely to get, how are they going to feel, and what changes are they going to see in their body, post-menopause.

So, what I'm going to do for the next two weeks, is answer some common post-menopause questions, including ones on body changes and symptoms that might be experienced.

1. What stage is after menopause

There are three stages of menopause - peri-menopause, menopause and post-menopause. So, what is meant by post-menopause? This is quite a difficult question to answer because different sources will say completely different things, and it can be very confusing.

My interpretation is that two years after your periods have stopped. So, that would be when you've had no periods, no spotting, no odd period showing up now and again. This normally indicates that you are what's considered to be post-menopausal or past the menopause.

Now, the problem with this is that a lot of women think that after menopause (post-menopause), your symptoms suddenly stop and that's it. Everything goes back to normal. However, this two-year period is really only to do with the fact that because you haven't ovulated, because you haven't had periods for two years, then you are not likely to get pregnant, so the risk of pregnancy ends practically at the two-year point.

Symptoms can go on after this and as I said before, this can be quite confusing. Some women will tell me that their periods stopped six, seven years ago and they're still experiencing menopause symptoms.

So, post-menopause basically means two years after your periods have stopped, you are very unlikely to get pregnant. But the hormonal changes can go on for quite a while afterwards. Some women may find that their symptoms only last about a year or so, and then, they feel as if everything's okay. For other women, it can literally be up to 10 years in some cases.

2. Do hormones go back to normal after menopause?

No. They don't go back to normal. In menopause, what's happening is that your production of progesterone, oestrogen, and testosterone decrease. Now, in most women, they don't disappear completely, so you don't suddenly end up with no hormones at all.

What happens is that they fall to a much lower level than beforehand, but your body can still produce them, especially oestrogen and testosterone, through various means for quite some time.

During this time, your body tries to adapt to lower levels of these hormones and once they have found their base level, if your body has adapted well, that's the point when you can feel fine. And women do tell me that after a few years post-menopause, they feel back to normal, their moods have stabilised and their symptoms have eased off or completely disappeared. So, you can feel as good, if not better, than you did before.

But this depends on so many things. One of the things we found over the years is that stress and lifestyle can play a huge part in how long or short it can take your symptoms to disappear after menopause.

So, looking after yourself well, taking care of yourself, having a good diet can shorten this post-menopausal stage with symptoms.

3. What happens to the uterus and ovaries after menopause?

This is a very individual thing. It depends on the number of hormones you're still producing post-menopause. It can also depend on hereditary factors, as well as lifestyle factors.

So, for some women, there may be very few changes. For other women, there can be significant changes. I've had women tell me they've gone for a scan, and the doctor said, "I can't see your ovaries anymore or your uterus has shrunk." So, the only way you're likely to find out is if you are getting some kind of medical investigation.

4. Can you get hot flushes and night sweats years after menopause?

Yes. And this is probably the one symptom that can last for years and years. I get women contacting me who are seven, eight years post-menopause, and are still experiencing hot flushes.

However, hot flushes or night sweats may not necessarily be hormone-related after all this time. There can be other issues. As I mentioned before, stress is a huge one. So, if you've had a stressful menopause, if life has been really stressful, if you're under a lot of pressure which let's face it, in this day and age, a lot of women are, then these can trigger flushes and sweats.

At this time, you're still having to be active. You're still working. You're maybe looking after family at home or looking after elderly parents. So, your stress levels can increase dramatically the older you get. And this can affect your nervous system. It can end up being stuck on flight-or-fight. And one of the main symptoms in that situation for women is hot flushes and night sweats.

It can also be a health issue. Other health issues can creep into menopause and post-menopause and cause hot flushes. So, you're looking at things like an overactive thyroid, adrenal stress, low vitamin D, low vitamin B12, diabetes, and also, heart disease. These can all cause hot flushes and night sweats.

So, if you're more than three or four years past your last period, you're still getting hot flushes or night sweats and they're not easing or they're getting worse, then it's really worth asking your doctor for a general health check to rule out all these health conditions. These are ones that can be sorted and treated. And if that's the case, then you're likely to feel so much better once you've had some kind of medical intervention.

If hot flushes and night sweats suddenly appear maybe three or four years down the line, you're suddenly thinking, "Oh, wait a minute. I'm getting hot flushes and night sweats," they are nearly always due to lifestyle.

What I usually recommend here is to look back at the point when these suddenly appeared, look at what was going on in your life. Have you been extra stressed? Have you gone on a strict diet? Have you started to exercise? Has anything else changed, maybe you're moving home, maybe family disruptions are going on, so all sorts of things?

Even tiny little things can impact your nervous system and trigger flushes and sweats. So, this would be the point where you need to look at what was going on and you may find a clue, and that could make it much easier to address.

The other thing you can do is keep a diary. I'm a great believer in doing diaries. Do a hot flush or night sweat diary. Write down everything you're eating and drinking during the day, how you're feeling emotionally, and you may find, again, that something pops up. You may think, "Oh, wait a minute, I've started having a cup of coffee after my dinner every night." That could be enough to trigger the night sweats. So, sometimes, it can be just something very tiny that you've changed in your daily life that can be enough to put stress on the body that triggers the sweats or the flushes.

So, I hope you found this one useful. Look out for part two next week. And if any of you have any symptoms that suddenly appeared, if you have any questions, then please do ask me your questions in the comment section below or you can ask me your question privately.

Until next week, take care.