Your hormone levels will have stabilised, and most menopausal symptoms will have gone away, but you may still be left with:

• Hot flushes and sweats at night caused by a drop in oestrogen levels
• Vaginal dryness and pain during sex
• Changes to your libido
• Depression
• Insomnia or other sleep disorders
• Dry or flaky skin
• Weight gain
• Hair loss
• Urinary incontinence

After the menopause, your hormone levels have changed such that your ovaries won’t release any new eggs, so you won’t be able to get pregnant naturally.

If you experience postmenopausal bleeding from your vagina, you should contact your GP immediately, even if it’s only happened once or there is only a small amount of blood.

The change in your body’s hormone levels after menopause can put you at greater risk of certain conditions, so it’s important to focus on staying healthy after the menopause – both physically and mentally.

Cardiovascular disease

As your body’s oestrogen levels drop during and after menopause, your coronary arteries can narrow, which increases the risk of developing coronary heart disease or stroke.

Eating well and exercising regularly can help you to maintain a healthy weight and lowers the risk of developing heart disease.

Osteoporosis

Lower oestrogen levels can also cause bones to weaken and break more easily. This is known as osteoporosis. A healthy diet, rich in calcium and Vitamin D can help keep your bones strong, as can regular weight-bearing or resistance exercises.

Urinary tract infections (UTIs)

UTIs are common as you get older and your oestrogen levels decrease, causing thinness and dryness of the vaginal walls and urinary incontinence or pain when you try to pass urine.

But UTIs can be a serious condition, causing confusion or slow thinking, delirium or hallucinations and agitation. It may cause you to become withdrawn and depressed, so it’s important that you see your GP as soon as possible if you think you may have a UTI.

There are ways to prevent recurrent infections post-menopause, including wiping back to front, urinating after sex and taking showers rather than baths.

Urinary incontinence

If you suffer with frequent urine leaks when you cough, sneeze, laugh or exercise you’re not alone. Urinary incontinence affects almost 35% of women and can have a real effect on your quality of life.

Have you ever wondered why some women develop stress incontinence after menopause? It can be due to hormone changes that weaken the pelvic floor – but also, in women, the tube that carries urine from the bladder is shorter and more prone to leaks.

Thankfully, bladder problems can often be easily treated. Jan Chaseley, our Clinical Nurse Specialist in Continence Care -  along with her expert team of nurses - treat stress incontinence, overactive bladder syndrome prolapse and many other bladder issues.

Vaginal pain, dryness or thinning of the vaginal walls

Some postmenopausal women and those who have undergone some cancer treatments may suffer from low oestrogen levels, which can cause the walls of the vagina to become thin and dry. This is known as vaginal atrophy.

Treatment is available in the form of Hormone Replacement Therapy or, if HRT doesn’t resolve your vaginal dryness, a procedure called MonaLisa® Touch which delivers low-powered laser energy to your vaginal wall to stimulate the production of collagen and new blood vessels.

Pelvic, uterine or vaginal prolapse

The organs within your pelvis are held in place by ligaments and muscles known as the pelvic floor. If these tissues are weakened, the pelvic organs can bulge (prolapse) into the vagina. You may experience a feeling of heaviness in your pelvic area, a bulge in the back of your vagina, urinary incontinence, and discomfort during sex.

Prolapse isn’t a life-threatening condition but it can cause a lot of stress and discomfort. If you think you have a prolapsed pelvic organ, you should speak to your GP to discuss your options. This may include pelvic floor exercises, hormone treatment or pessaries or surgery such as a hysterectomy, colporrhaphy or sacrospinous fixation.

Drop in libido

After the menopause, you may find that your libido – or sex drive – decreases. This is due to a drop in both oestrogen and testosterone, which can cause vaginal pain as well as urinary incontinence, trouble sleeping and depression or anxiety. All these conditions can really affect how you feel about sex or intimacy.

If you’re concerned that this is affecting your relationship or your own mental health, you should speak to your GP. They can arrange tests to check your hormone levels and advise on the best treatment for you.

Depression

Although the risk of depression is lower after the menopause, you may still experience mood swings due to changes in hormone level. This can leave you feeling anxious about your health, relationship, or work or because of difficulties navigating this new phase of your life.

Keeping active, eating well, and developing a reliable support network of friends and family can all boost your mood and self-confidence -  but if you’re struggling to cope, it’s crucial to seek help from your GP or other mental health professional.