postmenopausal

Postmenopausal refers to the stage of life that follows menopause, the permanent end of menstruation resulting from diminished ovarian function. Menopause is diagnosed retrospectively after 12 consecutive months without a period; postmenopause begins the day after the final menstrual period. The duration and experience of the postmenopausal period vary among individuals.

During postmenopause, estrogen and progesterone levels remain low and follicle-stimulating hormone stays elevated. Vasomotor symptoms such as hot flashes and night sweats commonly lessen over time, but may persist for years in some people. Urogenital atrophy can cause vaginal dryness, itching, dyspareunia, and urinary symptoms. Sleep disturbance and mood changes may also occur.

Health risks increase with advancing age and reduced estrogen. Osteoporosis and fracture risk rise due to lower bone density, and cardiovascular risk profiles may change. Regular bone density screening, healthy lifestyle, adequate calcium and vitamin D, regular exercise, not smoking, and limiting alcohol are recommended to mitigate risks.

Management is individualized. Treatments focus on symptoms and risk balance. Options include nonhormonal approaches for vasomotor symptoms; topical estrogen for vaginal atrophy; systemic hormone therapy is considered for select individuals after careful evaluation of risks and benefits, using the lowest effective dose for the shortest duration. Treatments for osteoporosis include bisphosphonates, denosumab, or anabolic agents as indicated. Fertility ends with menopause; pregnancy is not expected in postmenopause, though assisted reproduction using donor eggs may be possible in some cases.