What Happens After Menopause?

Will the hot flashes, mood swings, and other symptoms of menopause come to a halt when your periods are finally finished? Find out what to expect in the years after menopause.

By Jennifer Acosta Scott

Medically reviewed by Lindsey Marcellin, MD, MPH

Though you may have some idea of what’s in store for you as you head toward menopause, the stage of life when the ovaries stop producing eggs and menstrual cycles dwindle, you may not quite know what to expect when your periods are officially over.

A woman is medically defined as being in menopause when she has not had a menstrual cycle for at least 12 months, says Kevin Audlin, MD, a gynecologist at Mercy Medical Center in Baltimore. At that point, the transition into your non-child-bearing years is complete.

After Your Period Stops

The permanent end of menstrual periods doesn’t necessarily mean the end of bothersome menopause symptoms, however. The symptoms typically associated with menopause, like hot flashes and mood swings, can occur for some time both before and after that point.

“There’s a window of about eight years in which women can feel those flashes and sweats,” Dr. Audlin says.

Women who have reached menopause can expect menopause symptoms to become worse than they were during perimenopause, the three- to five-year stage leading up to the permanent end of menstruation. Experts don’t know exactly why this happens, but it’s believed to be related to the hypothalamus, the portion of the brain that regulates temperature.

“The hypothalamus is acutely responsive to estrogens,” Audlin says. “Leading up to menopause, your estrogen levels fluctuate. When they’re high, you don’t have symptoms. But when you go into menopause and there’s a complete lack of estrogen, you start to notice those symptoms more.”

Managing Menopause Symptoms

Replacing the missing estrogen in the body with medication can help relieve hot flashes and night sweats. However, women who take hormone replacement therapy usually find that their hot flashes will resume years later, when they go off the drugs.

“If you give a woman hormones until the age of 70, she’ll get hot flashes then, when she stops taking them,” Audlin says.

Some non-hormonal methods are available for relieving menopause symptoms. Certain antidepressants, such as Pristiq (desvenlafaxine) and Effexor ( venlafaxine), have been proven to be effective hot flash treatments.

But, Audlin says, the simplest way to take control of your physical symptoms is to stay in good health. Regular exercise, healthy eating habits, and getting enough sleep at night can all help a woman stay stronger, which makes her more able to withstand the changes that occur as estrogen levels drop.

“Women who do these things are less likely to be bothered by hot flashes, and they get less of them,” Audlin says.

The Most Important Part of Post-Menopause Life

Along with the physical changes that occur after menopause, women may need to improve their health care routines. Postmenopausal women are at greater risk for heart disease, so redirect your diet toward low-fat foods and lower your salt intake — this reduces the risk of heart attack and atherosclerosis, a condition in which plaque (cholesterol and other fats) builds up on the insides of the arteries.

As part of your routine check-ups, you should have a blood test at a minimum of every five years until age 50, and then at regular intervals. Your doctor will recommend what that interval should be based on how high your cholesterol is, if you are on cholesterol treatment, and on other cardiovascular risk factors that you may have, such as hypertension or obesity.

Women also should have their bone density checked once every two years to spot early signs of osteoporosis, a weakening of the bones. Postmenopausal women are particularly at risk for this condition.

“Estrogen is one of the best stimulators of bone growth,” Audlin says. “The risk of osteoporosis is very low before menopause, but post-menopausally, fractured hips and problems related to bone density are very likely.”

Women ages 50 and up should consume at least 1,200 milligrams of calcium every day to maintain bone health. This can be accomplished with supplements, by consuming calcium-rich foods like milk, or a combination of the two.

According to Audlin, proactive health habits like these can keep women happy and healthy in their post-menopause years.