Postmenopause is the last stage in the menopausal process in a woman’s life. Chronologically the other three previous stages are premenopause, perimenopause, menopause and postmenopause. This stage starts from the time when menopause occurs till the death of the woman.
Technically a woman is considered to attain menopause when there is stoppage of menstrual blood loss for 12 consecutive months; hence menopause is defined as a particular point of a time. However the remaining days in the woman’s life after that particular point of time is considered to be included in the postmenopause period.
Menopause is a normal biological phenomenon which occurs in every woman so is postmenopause. However the age at which one will attain menopause is different in different woman; usually menopause sets in either in the late 40’s or in the early 50’s. Thus postmenopausal age is also variable from woman to woman; usually postmenopausal period starts between late 40’s to early 60’s.
During perimenopause ands menopause numbers of troubling symptoms may arise like hot flashes, night sweats, mood swings, extreme irritability, excessive tearfulness etc especially due to change in the circulating female hormones (estrogen and progesterone) in the body. In some women these symptoms may not be significant whereas in many they become so much bothering that leading normal routine life becomes almost impossible.
During the postmenopausal years the women gradually become adjusted to these new altered level of circulating hormones hence all the above mentioned symptoms gradually become less severe and after few years disappear altogether. However not all the women are lucky in many the above mentioned symptoms persist and continuous fluctuation of the circulating hormone level may lead to some other uncommon symptoms.
Common symptom include
1. Dryness of the vagina: fall in the circulating estrogen level leads to shrinkage of the normal elastic walls of the vaginal canal (atrophy); hence there is dryness of vagina. Now this dryness may lead to other symptoms like excessive vaginal itching, painful intercourse etc
2. Vaginal discharge: many woman experience thin watery discharge with slight blood tinge. Although it is as such not worrisome but one should immediately seek professional advice if there is frank bleeding or change in the frequency and amount of the vaginal discharge.
3. Weight gain; in order to compensate for the low circulating estrogen levels body tends to accumulate large number of fat cells so that estrogen production can be increased. This is one of the most distressing symptoms and occurs without any change in the diet. Psychological factors like stress may also have an important role.
4. Urinary incontinence: leakage of urine occurs especially in women after sneezing, coughing, weight lifting etc. As estrogen is the hormone responsible for maintenance of normal bladder tone fall in its level leads to this symptom
Urinary tract infection: repeated attacks of urinary tract infection are very common in women of this age group. Estrogen is essential to maintain acidity in the vaginal canal and this acidity keeps growth of harmful bacteria at bay. Fall in estrogen level leads to alteration in pH balance and frequent urinary tract infection.
5. Altered sleep pattern leading to insomnia is also a common symptom
Uncommon symptoms include
1. Vaginal bleeding: it may occur in women having hormone replacement therapy to tackle menopausal symptoms but other than this, vaginal bleeding must be investigated thoroughly to rule out other serious underlying health conditions like cancer
2. Hot flashes: these are more common in perimenopause and during menopausal period however in postmenopausal life hot flashes may also occur
Other than the above mentioned symptoms certain other health conditions may arise due to fall in eth circulating hormone level; these are
1. Osteoporosis: in this condition the bones become weak and tend to break with minimal or no trauma. Usually the vertebral bones, hip, wrist and neck of the femur bone are affected.
2. Cardiovascular diseases: estrogen protects women from various heart conditions. Thus when estrogen level falls in the postmenopausal years women become vulnerable to number of heart conditions which were more common in men during earlier years of life. These conditions include high blood pressure, heart failure, heart attack (myocardial infarction), atherosclerosis etc
Fluctuation in the circulating hormones is the main cause of postmenopausal symptoms. These hormones include estrogen, progesterone and testosterone.
Other than fluctuating hormone level some other external causes are also responsible; these are adopting certain life style pattern which include chronic smoking and consumption of alcohol, prolonged periods of stress, surgery like removal of ovaries as for treatment of ovarian cancer, undergoing radiation and chemotherapy which may damage the ovaries etc.
There are mainly three approaches to treat postmenopausal symptoms; these include
1. Change in life style habits: like quitting smoking and alcohol intake, regular exercise, reducing stress through yoga, breathing exercises, consulting a counselor and changing eating habits like consuming diet rich in soy, fruits, legumes, nuts etc
2. Alternative therapy which include phytoestrogenic and non estrogenic herbs
3. Drug therapy which include hormone replacement therapy (HRT)