Medically speaking, menopause is the 12-month span when your menstrual period completely stops and thus ends your reproductive years. The build-up to that 12-month span — when women may first experience these hormonal changes — is known as perimenopause. But it’s what comes after menopause — postmenopause — that many women say is when the hormonal wallop hits them the hardest.
Here are five things about being post-menopausal that may surprise you.
No, those pesky hot flashes don’t just go away overnight.
Don’t retire that brow-mopping handkerchief simply because you donated your last box of tampons to your daughter. Hot flashes aren’t going to disappear as fast. These vasomotor symptoms — the sudden sensations of heat in the chest, face and head followed by flushing, perspiration and sometimes chills — generally occur at the most inopportune times and for many women are a cause of discomfort, embarrassment and interrupted sleep.
Common wisdom — call it hope? — had many of us believe that the menopause-related hot flashes and night sweats would fade six to 24 months after our last menstrual cycle. Bad news: They regularly last for another seven years; in some cases, as many as 11 years after menopause, according to a Harvard Medical School study.
Your thermostat does more than overheat; it also dips down to freezing.
Scientists believe that cold flashes — think hot flashes but the complete opposite — are likely caused by the hormone havoc going on in your head. As estrogen levels drop, the hypothalamus — the part of your brain responsible for regulating body temperature — gets overactive, releasing chemicals that alert your body that it’s overheating. So the body sheds heat, whether you want it to or not, and there you have it: a cold flash that leaves you physically shivering and hogging all the bed covers. Although cold flashes are rarer than the hot flashes that 80 percent of women experience, they are no less disruptive. Now if you could only get back all those turtleneck sweaters you tossed out when you were perimenopausal.
Your bladder develops a mind of its own.
When our estrogen levels drop in menopause, the tissue around the bladder and urethra thin and weaken, which can lead to incontinence. The two most common types of urinary incontinence in postmenopausal women are stress incontinence and urge incontinence. The first one is when you leak a bit of urine when you sneeze, cough or laugh too hard. The second occurs when you
have the urge to urinate and your bladder squeezes at the wrong time. In either case, many postmenopausal women opt to “put up and pad up,” as the expression goes, referring to wearing either an adult diaper or a sanitary pad. There are many other options, so having a talk with your doctor isn’t a bad idea.
Your libido that went MIA may return, but you’ll need to get ready for it
.Sometime around perimenopause, there’s a fairly good chance your sex drive evaporated. Even women who enjoyed robust sex lives before the start of menopause report that with a drop in their hormones, their desire for a roll in the sheets simply vanished.
But that desire will likely return. The issue becomes: Are you physically ready to have sexual intercourse again? The short answer: Probably not. But you can be.The problem is postmenopausal atrophic vaginitis or vaginal atrophy, something that 40 percent of
postmenopausal women experience, according to the American Association of Family Physicians. The walls of your vagina have thinned because of the lower levels of estrogen you are producing. Thin vaginal walls can make sex painful, plus women with this condition have a greater chance of urinary function issues and chronic vaginal infections. The solution is pretty easy. Start with a vaginal moisturizer or water-based lubricant and consult your doctor about using a topical estrogen.
You will no longer be friends with parts of your body.
Talk about betrayal! All those diets and trips to the gym suddenly don’t count for squat because estrogen loss redistributes fat to your abdomen, erasing your waistline and causing you to look six months pregnant, which of course would no longer be possible. And then there is the brain fog you walk around in after decreasing progesterone and estrogen levels make your cortisol levels erratic. Dwindling hormones also can cause insomnia or bouts where you feel like sleeping all day.Oh! And does your tongue burn? About 40 percent of postmenopausal women experience a tingling tongue or metallic taste in their mouths. Personally, I spent about a year thinking my taste buds had taken an acid trip because flavors weren’t the same anymore. And then, of course, there is the loss of hair — to the point of baldness — and brittle nails caused by an increase in male hormones (androgens).
Need more? Yeah, me neither.
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Cristina Spano
