Postmenopause it is assumed that many of the previous hormonal symptoms will be a thing of the past.

But as a result of several factors, including continuing oestrogen dominance, stress and anxiety, postmenopausal women can still be at risk for a number of health conditions, such as osteoporosis, cancer and heart disease.

When are you postmenopausal?

A woman is considered to be postmenopausal when she has not had her period for an entire year or longer. It can vary as some women’s periods cease due to stress, illness or medication and so can sometimes restart after a year.

What changes can there be?

Once you are postmenopausal, there can be positive changes in terms of your attitude and approach to life as often you discover a more relaxed way of life.

However it does mean you may also be at higher risk for certain conditions and changes to your body.

1. An increase in anxiety and stress is common but whether this is due to being post menopause or just getting older is debatable.

Certainly more anxiety occurs and depression is not uncommon as you have to deal with a new phase of life so if unsupported and untreated this can be very debilitating. This leads to higher stress levels and we know this impacts so many of our bodily functions and may be why women report hot flushes returning.

2. Continued oestrogen dominance from either long term HRT use, or increased body fat particularly on the stomach. Oestrogen is still being produced in the fat cells once the ovaries cease production so if overweight this can contribute to oestrogen dominance.

3. Diabetes hits women hard, and if you began menopause before age 46 or after 55, you’re even more likely to develop type 2 diabetes, according to the Women’s Health Initiative

High blood pressure during pregnancy (preeclampsia), diabetes during pregnancy (gestational diabetes), or polycystic ovary syndrome raise the risk even more.

Keep an eye on it and have regular checks over the age of 45.

4. Higher risk of osteoporosis and fracture as some 20 to 30 percent of bone loss in women occurs in the first five years after menopause. The risk of osteoporosis is very low before menopause, but post-menopause fractured hips and problems related to bone density are very likely

If you have any family risk, or are concerned then take steps to safeguard those bones by eating a calcium-rich diet, performing weight-bearing exercises and strength-training.

Limit too much salt as well as those drinks like alcohol, carbonated drinks and coffee that all leach calcium from bones. If at risk look for a good Osteoporosis supplement and check your progesterone levels as that is the hormone that build bone.

5. Vaginal discomfort is certainly experienced by many women as oestrogen levels overall drop, and the vaginal wall starts thinning so atrophy may also be an issue. If vaginal atrophy is the case then local additional oestrogen will be needed but if just dryness then a combination cream with both progesterone and oestrogen can help.

Libido too can suffer so you might benefit from progesterone as that is the hormone behind sex drive in women

6. Gum disease can also become evident as the same process that leads to bone loss in the spine and hips can lead to the loss of the alveolar bone of the jaws. The result: loose teeth, tooth loss, and periodontal disease, which women are more susceptible to after menopause

So regular dental checkups are essential, and don’t ignore any bleeding from your gums.

7. Sleep apnoea is pretty common for postmenopausal women but, unfortunately, nearly 90 percent of women are not diagnosed.

Unlike men, women may not have the hallmark signs of the sleep disorder—snoring, pauses of breath, and excessive daytime sleepiness, for instance. Instead, they may experience such atypical symptoms as insomnia, morning headache, fatigue, tiredness, depression, and anxiety

8. Heart disease is the number one risk for women at menopause, though not often recognised as such by them.

Good hormone balance is essential so you have sufficient oestrogen and enough progesterone to balance it as it is excess oestrogen linked to increased risk. T

One in eight women between the ages of 45 and 64 has some form of heart disease, and this increases to one in four women over 65, according to the National Heart, Blood, and Lung Institute.

The answer lies in being proactive by quitting smoking, eating a plant-based diet, exercising 30 minutes a day and reducing stress all have big preventative pays-offs.

9. Breast cancer is more likely to strike postmenopausal women than younger women. By age 60, the risk jumps to one in 28 women, according to the National Cancer Institute.

The biggest factor for breast cancer that you can reverse is weight gain after menopause and that is helped by our old favourites, hormone balance, healthy diet and exercise.

10. Autoimmune disorders surprisingly perhaps women account for more than 75 percent of those living with autoimmune disorders and if you’re postmenopausal, you’re particularly vulnerable.

Although the reasons are unclear, researchers found that the risk of developing autoimmune diseases such as lupus, rheumatoid arthritis, Graves’ disease, scleroderma, and thyroiditis all rise after menopause according to a study in the journal Expert Review of Obstetrics and Gynaecology.

Because stress affects hormone levels and autoimmune disease puts a lot of stress on the body, people with autoimmune disease are especially susceptible to hormone imbalance.

11. Urinary infection and incontinence is particularly common after menopause. This is likely due to the thinning of the urethra (caused by declining oestrogen) as well as weakened pelvic floor muscles

UTI’s become more common as oestrogen helps keep bacteria out so very low levels will be implicated in frequent attacks. Some simple preventative steps: drink plenty of fluids, and pee both before and after sex.