Postmenopause is the time after you've been without a menstrual period for 12 months. During this stage, menopausal symptoms, such as hot flashes, get milder or go away. People in postmenopause are at increased risk for osteoporosis and heart disease. Medication or healthy lifestyle changes may reduce the risk of these conditions.
Postmenopause is a term to describe the time after someone has gone through menopause. When you're in postmenopause, your menstrual period has been gone for longer than 12 consecutive months. At this stage in life, your reproductive years are behind you and you're no longer ovulating (releasing eggs). The menopausal symptoms you’ve experienced in the past may become milder or go away completely. However, some people continue to experience menopausal symptoms for a decade or longer after menopause.
There are three stages of menopause: perimenopause, menopause and postmenopause.
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Once you enter postmenopause, you're in this stage for the rest of your life. Your hormone levels will remain low and you'll no longer have a monthly period. You can’t get pregnant because your ovaries have stopped releasing eggs.
Your ovaries are making very little of both estrogen and progesterone by the time you're in postmenopause. Some people still experience side effects from low hormone levels.
There is not an age at which that you are automatically in postmenopause. Once your period has been absent for more than one year, you're in postmenopause regardless of age. On average, people go through menopause around 51 years of age.
Most people in postmenopause feel lingering symptoms from menopause. The symptoms are less intense. In some cases, they almost disappear. Lingering symptoms are caused by low levels of reproductive hormones.
People in postmenopause can feel symptoms such as:
If your symptoms become more intense or interfere with your daily life, talk with your healthcare provider. They may want to rule out any underlying condition causing these symptoms.
Vaginal bleeding during postmenopause isn't a normal side effect of decreasing hormone levels. In some cases, the dryness in your vagina could cause some light bleeding or spotting after sex. In other cases, it could indicate a condition like endometrial hyperplasia or uterine fibroids, infections like endometritis, or cancer. Contact your healthcare provider if you experience any vaginal bleeding so you can be evaluated.
Some people still experience hot flashes after menopause. Postmenopausal hot flashes are caused by decreased estrogen levels. It is not uncommon to experience a random hot flash for years after menopause. If your hot flashes are bothersome or intensify, speak with your healthcare provider to rule out other causes.
Your healthcare provider will be able to tell you if you're in postmenopause based on your symptoms and how long it's been since your last menstrual period. In some cases, your healthcare provider will take a blood sample and check your hormone levels to confirm you've gone through menopause. Remember, you're not considered to be through menopause until it's been over one year since you’ve had a period.
Hormone therapy could be an option, although healthcare providers often recommend using it for a short amount of time and in people under the age of 60. There are health risks associated with hormone therapy like blood clots and stroke. Some healthcare providers do not recommend using hormone therapy after menopause has ended or if you have certain medical conditions.
Some medications your healthcare provider may consider helping with postmenopausal symptoms are:
Oftentimes your provider will recommend lifestyle changes to help manage your symptoms.
Certain lifestyle or at-home changes can help you manage symptoms of postmenopause. Some of these include:
People in postmenopause are at an increased risk for several conditions:
Estrogen helps protect against cardiovascular diseases like heart attack, heart disease and stroke. It is also common for people in postmenopause to become more sedentary, which contributes to high cholesterol and high blood pressure. These factors combined can increase a woman’s risk for cardiovascular diseases after menopause. A healthy diet, not smoking and getting regular exercise are your best options to prevent heart disease. Treating elevated blood pressure and diabetes as well as maintaining cholesterol levels are also ways to lower your risk.
People lose bone more rapidly after menopause due to decreased levels of estrogen. You may lose up to 25% of your bone density after menopause (approximately 1% to 2% per year). When too much bone is lost, it increases your risk of developing osteoporosis and bone fractures. The bones of the hip, wrist, and spine are most commonly affected. Bone mineral density testing, also called bone densitometry, can be done to see how much calcium you have in certain parts of your bones. The test is used to detect osteoporosis and osteopenia, a precursor to osteoporosis.
Decreased estrogen levels cause the tissues in your vagina to thin and deteriorate, making your vagina dry. People in postmenopause may continue to struggle with vaginal dryness for years after their last period. Using vaginal lubricants can help ease any discomfort caused by sex. Decreased estrogen levels can also impact the urinary tract and bladder and make leaking urine a problem for some people. Persistent dryness and painful intercourse should be evaluated by your healthcare provider to rule out other conditions. Using lubrication and topical creams or getting laser therapy to the vagina can help with vaginal dryness.
Many people in postmenopause experience moodiness, anxiety and depression. This could be caused by stress, sexual tension or other life challenges that occur during this time. Some people feel sad that their reproductive years are over. Mood symptoms can also be caused by decreased hormone levels. It might help to talk with a therapist or counselor about what you are feeling.
Osteoporosis isn’t entirely preventable, but you can take steps to strengthen your bones. Eating foods high in calcium like cheese, yogurt, spinach or fortified cereals can help boost calcium intake. Adding a calcium supplement can also help. Some people also need a vitamin D supplement because it helps their body absorb calcium.
The best ways to prevent cardiovascular diseases are to eat a healthy diet, exercise regularly and avoid smoking. Conditions such as high cholesterol, high blood pressure and having obesity are usually related to poor diets and lack of physical activity.
Once your menstrual period has been absent for over a year, you are unlikely to get pregnant. Until your healthcare provider has confirmed you are no longer ovulating and can’t get pregnant, continue to use birth control if you don't want to become pregnant.
No, not all people lose interest in sex after menopause. Vaginal dryness and discomfort during sex can make sex less pleasurable. Using a vaginal lubricant can help with dryness. Some people are less interested in sex because of other symptoms like depression or feeling tired. If your feelings about sex have changed, ask your healthcare provider for help.
You should still see your healthcare provider for routine gynecological care even though you aren't menstruating. This includes Pap tests, pelvic exams, breast exams and mammograms. You should continue to schedule annual wellness appointments. Since you are at an increased risk for osteoporosis, providers usually recommend bone density screenings as well. Talk to your healthcare provider to determine how often you should make check-up appointments based on your health history.
If any of your postmenopause symptoms bother you or prevent you from living your daily life, contact your healthcare provider to discuss possible treatment. They can confirm you have completed menopause and are in postmenopause.
Some questions you might ask are:
If you experience any vaginal bleeding during postmenopause, contact your healthcare provider to rule out a serious medical condition.
Some people continue to feel symptoms of menopause for years after their last menstrual period. It's common to have hot flashes or feel depressed about getting older. Speak with your health care provider if you are still suffering from symptoms so they can offer support or treatment.
It is important to maintain a healthy lifestyle, especially as you age and your risk for certain medical conditions increases. Some ways for people in postmenopause to stay healthy include:
A note from Cleveland Clinic
Going through menopause can be uncomfortable and present new challenges and health concerns. Speak with your healthcare provider about any symptoms you feel or questions you have. They can help make sure you are supported through this time and get the care you need.
Last reviewed by a Cleveland Clinic medical professional on 10/05/2021.
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