Menopause affects half of the world’s population, yet there remains a lot of uncertainty and misinformation about it. This is especially true for postmenopause, the period following menopause. Thankfully, recent published research provides us with new insights into how the body changes and on supporting postmenopausal health.

What is menopause?

Menopause is a normal part of aging and is a natural transition that all females experience. It occurs when the ovaries stop producing eggs and the reproductive hormones decline. This marks the end of menstruation and fertility. For most, this begins between the ages of 40 and 55, and experiences vary greatly between individuals.

The three stages of menopause

Menopause is split into three stages:

1. Perimenopause/premenopause: During this phase, mostly beginning in a woman’s 40s, hormone levels (particularly oestrogen and progesterone) begin to fluctuate. This is often accompanied by mood changes, irregular menstrual cycles, and other menopausal symptoms. This phase usually lasts from 3 to 5 years.
2. Menopause: This refers to the absence of menstruation for 12 months without other causes. This means a woman can no longer become pregnant.
3. Postmenopause: This refers to a woman’s entire life after menopause. Generally, symptoms of menopause tend to reduce over time, but low levels of oestrogen and progesterone can increase the risk of conditions like heart disease and osteoporosis.

Postmenopause can last for decades and be a defining factor of a woman’s quality of life, yet there remains a general lack of awareness and even a stigma around discussing it. Sometimes, symptoms are dismissed as a regular part of aging.

Common symptoms and risks of Postmenopause

As the amount of oestrogen, a key chemical messenger, decreases, women are at a higher risk for a range of symptoms and conditions. Here are some examples:

• Osteoporosis;
• Cardiovascular disease;
• Elevated cholesterol;
• Blood sugar anomalies;
• Urinary tract infections;
• Painful intercourse;
• Hot flushes/night sweats;
• Insomnia;
• Depression and anxiety;
• Thyroid disease;
• Weight fluctuation and body composition changes.

Because experiences vary so greatly from women to woman, it can be hard to pinpoint whether these symptoms are connected to postmenopause. Moreover, these symptoms interact with other key changes that occur as people age, including decreased physical activity and sun exposure and stressful experiences, such as losing family members.

Therefore, postmenopause is a complex and interactive experience that can interact with, trigger, and exacerbate other symptoms of aging. It is a period in which healthy habits and behaviours become paramount for mitigating the worst effects of postmenopause.

Supporting postmenopausal health

We suggest that you speak to a medical professional if you have concerns that your postmenopausal symptoms are harming your quality of life. Keep up regular visits with your doctor also for preventative health care, including screening tests.

Additionally, see whether you would benefit from hormone replacement therapy (HRT), which is also known as hormone therapy, menopausal hormone therapy, and oestrogen replacement therapy. This can help mitigate the effects of menopause.

Here, however, we’ll discuss what scientific research suggests about supporting postmenopausal health through lifestyle changes and supplementation.

Physical activity during postmenopause

MDPI have published several works on how physical activity is integral to mitigating the negative effects of postmenopause.

An article published in Journal of Functional Morphology and Kinesiology describes how regular physical activity can serve as a vital foundation for preventing chronic ailments during postmenopause. The authors estimate that postmenopausal women who do not perform regular physical activity are 1.18 times more likely to have very high disease risk.

So, how can physical activity help support health during this period?

Strength exercises

A review in JCM looks at how strength exercises can reduce the symptoms of menopause.

Generally, the authors explain, strength training has a range of benefits including increasing muscle strength and bone mineral density and improving motor control and muscle coordination.

These are particularly beneficial for aging women as they help increase lean mass. During and after menopause, women are prone to unfavourable changes in body composition and fat deposition. This can result in an increase in abdominal fat and a decrease in lean mass.

The findings of the review favour high-volume exercises. This means many repetitions of exercises, usually using lower weights. This helps increase muscle performance and lean mass. The authors note it must be performed regularly, recommending 2‒4 times a week, for supporting postmenopausal health.

Maintaining metabolic health

A review in Nutrients discusses postmenopausal metabolic health. Metabolic health refers to how well your body is processing fats and sugar and how it responds to insulin. Poor metabolic health is associated with a range of conditions like type 2 diabetes and hypertension.

Oestrogen provides protection against metabolic dysfunction, meaning this protection is lost after menopause. Moreover, this is often paired with lifestyle changes and changes in body composition that can further reduce metabolic health.

The authors explain that exercise remains the best therapeutic option available to mitigate menopause-associated metabolic dysfunction. Their review found that supporting regular exercise with diet boosts the positive effects and that combining this with HRT may make it even more beneficial.

Exercise can help to reduce inflammation, maintain immune and mitochondrial function, and reduce the risk of central obesity, insulin resistance, and hypertension. The benefits are broad and apply to essentially all bodily systems.

Furthermore, the authors cited that alternative forms of exercise confer similar benefits, including resistant band training paired with balance and agility exercises, tai chi, and yoga.

Vitamin D and bone health

Postmenopausal women are at high risk for vitamin D deficiency. This is due to various risk factors:

• Hormonal fluctuations, particularly the decrease in oestrogen.
• Excessive clothing covering.
• Sunscreen use.
• Changes in body fat composition.
• Vitamin D-deficient diet.
• Sedentary lifestyles and lack of sun exposure.

Furthermore, deficiency is linked to many menopausal symptoms, including osteoporosis, vasomotor symptoms, and sexual dysfunction. Accordingly, a systematic review in Nutrients explores vitamin D supplementation for postmenopausal women.

The authors studied experiments on solving vitamin D deficiency caused by menopause by supplementation. They cited that supplementing with high doses of vitamin D levels helped women’s vitamin D levels return to baseline after three months.

However, levels did not remain adequate after the supplementation finished. Therefore, the authors recommended a period of high dose supplementation to return to baseline, followed by regular maintenance doses and checkups to ensure levels remain sufficient.

Having sufficient vitamin D in the body is essential to supporting postmenopausal health. It helps maintain the immune system, reduce symptoms of depression, and sustain healthy bones. Supplementing very high doses of vitamin D for longer periods can pose health risks, so always speak to a medical professional when beginning a supplementation plan.

We covered vitamin D supplementation in a recent article if you want to learn more.

Vitamin E and sleep

Chronic insomnia disorder is one of the most common problems for postmenopausal women. It is associated with a greater risk of mortality, morbidity, and accidents. And it can lead to reliance on sedative drugs.

An article in Nutrients analyses the effects of supplementing vitamin E on chronic insomnia disorder in postmenopausal women. The authors separated 160 postmenopausal women with the disorder in two groups: one taking vitamin E and the other a placebo. They followed up with by providing the women with questionnaires.

They found that a one-month vitamin E prescription can improve sleep quality and reduce sedative drug use, describing it as an “excellent alternative treatment”. Furthermore, they cited it can help reduce hot flushes and support bone formation too.

Vitamin E can be found in fish and a range of plant-based food items, including almonds, sunflower seeds, pine nuts, avocado, peanut butter, and red bell peppers. It helps the body’s immune response and can prevent age-related cell damage that is linked to many chronic diseases, like cancer.

Supporting postmenopausal health

Half the population goes through menopause, and postmenopause affects women for decades of their lives. Despite this, there is a lot of uncertainty about its symptoms. Thankfully, awareness is increasing within the scientific literature.

Here, we discussed how, during postmenopause, maintaining health is very important and how lifestyle changes can support this. We explored scientific research that describes how physical exercise has shown positive effects for mitigating the negative effects of postmenopause. Also, supplementing vitamin D and E can help support bone health and relieve chronic insomnia disorder, respectively.

MDPI publishes a variety of research on women’s health. If you’re interested in publishing research on the topic, we have journals that may interest you. Please see our full list of journals if you are considering submitting your work.

If you’d like to learn more about women’s health, why not start with Women’s Health.