Menopause Unveiled: Real Health Impacts You Need to Know

Menopause doesn’t just mean the end of your periods—it’s a hormonal rollercoaster that can mess with your health in ways you might not expect.

Sure, you’ve heard about the hot flashes, but what about the increased risk of heart disease, asthma, and even depression?

As oestrogen levels drop, your body goes through a serious shift that could leave you vulnerable to a whole new set of health challenges.

But instead of seeing menopause as the beginning of the end, experts say it’s a golden opportunity to take control and set yourself up for decades of better health.

What is menopause, anyway?

The most obvious impact of menopause is not having periods, but it triggers other changes too that may raise your risk for certain health problems.

Menopause happens – at least in part – because of a drop in levels of reproductive hormones, including oestrogen.

“Oestrogen has receptors and functions in many different tissues,” Australasian Menopause Society president Dr Sylvia Rosevear says.

“So oestrogen levels falling at menopause and the lead-up to it is one reason why a number of health risks increase for women at this life stage.”

WellFemme Telehealth Menopause Clinic founder Dr Kelly Teagle suggests viewing menopause as an opportunity.

“People often have negative thoughts about ageing and menopause, but women should instead view menopause as a signal that things are changing and see that as a golden window of opportunity,” Dr Teagle says.

“It’s a time when you can make a few small interventions which, done consistently, will make a huge difference to your health for decades to come.”

To help you look after yourself, here’s a list of postmenopausal health risks to have on your radar.

#1. Adult-onset asthma

Study findings published in The Journal of Allergy and Clinical Immunology suggest women are at a higher risk of adult-onset asthma during and after menopause.

Adult-onset asthma is harder to control than asthma that first occurs in childhood.

Hormonal fluctuations are one of the likely culprits, and symptoms include difficulty breathing, wheezing, chest tightness and coughing at night, during exercise or when laughing.

#2. Depression

As many as one in four postmenopausal women have symptoms of depression, such as feeling sad, hopeless, tired and unmotivated.

“When you consider that mood changes associated with premenstrual syndrome are linked to the drop in oestrogen that occurs just before menstruation, it makes sense that perimenopause and postmenopause can increase the risk of depression,” Dr Rosevear says.

Exercise is key in managing depression, with University of South Australia research suggesting physical activity can be more effective than counselling or the leading medications.

For mental health support, visit Beyond Blue.

#3. Disturbed sleep

More than 60 per cent of postmenopausal women experience symptoms of insomnia; and they are up to three times more likely to have sleep apnoea than premenopausal women.

Research shows lower levels of oestrogen could be partly to blame, perhaps because oestrogen helps produce neurotransmitters that influence the sleep-wake cycle.

Menopause can also affect melatonin levels, which may disrupt sleep.

“It’s important for women to make lifestyle choices that contribute to good sleep hygiene,” Dr Rosevear says.

“This includes exercising regularly and having an evening routine that supports sleep.”

#4. Heart disease

Heart disease risk increases significantly after menopause.

One explanation is that as oestrogen levels fall, blood pressure and cholesterol levels can rise.

But, Dr Teagle says, there are other factors at play too.

“Midlife is when women are often at the peak of their responsibilities at work, but they are also busy with family and are being pulled in many different directions, which can detract from the ability to prioritise their own health,” she explains.

“So, at a time when it’s never been more important to exercise and eat a Mediterranean diet, which we know is highly protective for women at this life stage, life can get in the way.”

Heart disease symptoms include chest pain, shortness of breath, heart palpitations, jaw pain, and swollen feet and ankles – but many women don’t know they have it until they have a heart attack.

That’s why, once you turn 45, you’re eligible for an annual Heart Health Check to help you understand what you can do to reduce your risk.

#5. Osteoporosis

As oestrogen levels drop, bone density starts to decrease, increasing the risk of osteoporosis.

It is a silent disease so often has no symptoms, but the most common symptom is a bone fracture.

Strength training and eating a calcium-rich diet can make a difference.

“Menopausal hormone therapy (MHT) can be used to prevent bone loss in postmenopausal women, as well as being the best way to treat debilitating hot flashes,” Dr Teagle says.

“MHT can also improve things like sleep and mood and offers protective benefits against heart disease and type 2 diabetes, on top of osteoporosis.”

#6. Sexual dysfunction

Vaginal dryness caused by falling oestrogen levels can make sex uncomfortable or painful, and hormonal changes can also trigger a loss of libido.

In addition, difficulty sleeping and mood changes may contribute to decreased sexual wellbeing.

A number of treatments are available, but their effectiveness varies between women.

Seeking advice from a healthcare professional is advised.

#7. Urinary incontinence

This can present as leaking urine when coughing, sneezing or exercising, but the most common symptom is an urgent and frequent need to wee.

With menopause, pelvic floor muscles weaken and the bladder becomes less elastic.

“This means the bladder is less tolerant of capacity, so you get increased urinary frequency,” Dr Rosevear explains.

Incontinence can often be prevented, better managed and even cured.

#8. Urinary tract infections (UTIs)

Oestrogen helps the tissues in the vagina and the urethra, through which urine leaves the bladder, stay supple.

“After menopause, these tissues become thinner and drier and the vagina also becomes more alkaline, increasing susceptibility to infection,” Dr Rosevear explains.

UTI symptoms include wanting to urinate more often and urgently, a burning sensation when urinating, and feeling like your bladder is still full after going to the toilet.

Strategies that may help prevent UTIs include drinking enough water; treating thrush, if it occurs, quickly; and emptying your bladder after sex.

#9. Weight gain

It’s not uncommon to gain weight after menopause. This is mainly due to a loss of muscle mass, which slows the metabolism.

Weight distribution can also change, with lower oestrogen levels causing body fat to collect around the waist, increasing the risk of heart disease, type 2 diabetes, breast cancer and dementia.

The 2018 CSIRO Protein Balance Report highlights the importance of eating at least 25g of protein at each meal to maintain muscle mass and support sustainable weight loss.