Postmenopause: 5 Common Symptoms and What to Expect After Your Period Stops

As you age, menopause happens naturally when your body stops making estrogen and your menstrual period has gone away for at least a year. Many women spend at least a quarter of their lives in the menopausal stage. This time of life can be exciting. But there may be some troublesome symptoms you can experience during postmenopause due to the decline in hormones.

Let’s take a closer look at what postmenopausal symptoms you can expect and how to best manage them.

What is postmenopause?

The years after menstruation ends are called the postmenopause years. The average age of menopause is 52 years old. There’s a wide range though: Anyone between the ages of 45 and 55 would be at a “normal” age range for menopause. 

This change is signaled by a lack of hormone production by the ovaries. This can cause a variety of symptoms. And some people may experience no symptoms at all.

Let’s take a look at five postmenopause symptoms you might have and what you can do about them. 

1. Hot flashes (vasomotor symptoms)

When the estrogen level drops in menopause, you may notice vasomotor symptoms, such as hot flashes and night sweats. Hot flashes often feel like a sudden rush of heat in your body that can make you sweat. When they happen at night, you could notice that your clothes and bedding are soaking wet. This can often make you wake up frequently at night and have ongoing tiredness.

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These symptoms can sometimes be severe enough to interrupt your daily life. The good news is that there are lifestyle changes and medical treatments that can help you manage these symptoms. 

Lifestyle strategies for hot flashes can include:

• Dressing in layers that you can remove if you feel hot during the day 

• Wearing cooling pajamas and using cooling sheets, mattresses, and fans at bedside during the evening

• Staying hydrated throughout the day

• Avoiding triggers like spicy food, alcohol, and caffeine

• Adding soy products to your diet, such as tofu, soy milk products, and edamame 

Common medication treatments for hot flashes include:

• Menopausal hormone therapy (MHT): These medications help to add back estrogen and are effective against hot flashes in some people. Examples include Premarin and estradiol patches.

• Neurokinin 3 (NK3) receptor blockers: These medications work in the area of the brain responsible for temperature control. Veozah is a nonhormone-based treatment that’s approved by the FDA for hot flashes.

• Antidepressants: Brisdelle is the only FDA-approved antidepressant medication for vasomotor symptoms. Other antidepressants like venlafaxine have also been used off-label for treating vasomotor symptoms. 

Some dietary supplements may also help with hot flashes from menopause. These include:

• Black cohosh

• St. John’s wort

• Omega-3 fatty acids

Talk with a healthcare professional to see which approach for managing your hot flashes is right for you.

2. Mood changes

Changes in mood are common in menopause. These are more likely to happen during the transition and in the first few years after your period stops. 

Research is ongoing to understand exactly why postmenopausal mood changes happen. One theory is that the drop in estrogen affects how the body responds to certain chemicals in the brain. This can directly affect your mood. 

Mood symptoms you may notice in menopause include: 

• Irritability

• Fatigue (tiredness)

• Anxiety

• Depression

People with severe premenstrual syndrome (PMS) and prior episodes of depression may be at higher risk of mood changes in menopause. 

Make sure to let a healthcare professional know if you think you have symptoms of depression or an inability to cope with your daily activities. There are useful treatments available. Common treatments for most cases can include psychotherapy or antidepressant medication.

3. Sexual dysfunction and urinary issues

Estrogen and testosterone are both important hormones for the vagina and bladder. The decrease in these hormones during menopause can lead to genitourinary syndrome of menopause (GSM). This is a condition where the tissues of the vagina become thin due to the drop in estrogen. It can lead to symptoms like:

• Vaginal dryness

• Painful sex

• Having a strong urge to pee

• Having to pee more often

• Decreased libido or sexual desire

There are treatment options that can help with these vaginal symptoms, such as:

• Low-dose hormone therapy inserted vaginally (creams, inserts, or rings)

• Pelvic floor physical therapy

• Sexual therapy

• Vaginal lubricants and moisturizers 

4. Weight gain

Since menopause most often occurs in midlife, many people also notice weight gain during this time. This may be a combination of many factors. But a decreased metabolism linked with aging seems to play a major role.

Maintaining a comfortable weight as you age is important in decreasing your risk of other conditions. If you notice rapid weight gain, speak with a healthcare professional. They can help you figure out the cause and offer a treatment plan for you. They may suggest strategies to manage weight gain through diet and exercise plans and other weight-loss therapies.

5. Brain fog

Many people in menopause describe having a “brain fog.” This may feel like: 

• Not being able to process information as quickly 

• Forgetting names of people or words

• Feeling slightly “out of sorts” 

It’s not clear why this happens. But it may be due to the drop in estrogen levels leading to certain changes in the brain.

There aren’t any good treatments for brain fog specifically. But things that can help include:

• Eating a well-rounded diet 

• Staying physically active 

• Getting enough rest 

• Maintaining close relationships 

The good news is that the brain fog of menopause isn’t a predictor of your risk of dementia or severe cognitive decline. And it tends to get better over time.

Brain fog can sometimes be a sign of a serious underlying condition, so you never want to take these symptoms lightly. Talk with a healthcare professional to make sure there’s nothing else causing your symptoms.

How long can postmenopausal symptoms last?

Most postmenopausal symptoms last a few years, but it’s different for everyone. In some people, symptoms may last up to 15 years. It’s hard to know where you’ll land. Black women tend to have more severe symptoms that last for longer periods of time.

When do you need to see a doctor about postmenopausal symptoms?

If you find that your symptoms are disruptive, talk with a healthcare professional to decide if therapy would be helpful during this time. Many women with moderate or severe symptoms tend to feel better with some form of treatment.

You’ll also want to see a healthcare professional right away if you notice any postmenopausal bleeding. It’s common to have irregular bleeding leading up to menopause. But any bleeding more than 12 months after your last menstrual period is abnormal and should be checked.

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Written by:

Kimberly Turner, MD

Kimberly Turner, MD, is an OB/GYN physician who has been in clinical practice for over 30 years. She graduated from Duke University medical school and currently practices gynecology in the state of Maryland.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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