Understanding Complications of Menopause

Menopause is a natural part of aging for people who have periods. It marks the end of reproductive years. While menopause is a normal change, this transition can affect the body in many ways.^1-4

These changes can lead to certain health issues or "complications." Knowing what to expect can help you manage your health.

Heart disease and stroke risk

Estrogen helps keep blood vessels flexible. Without estrogen, the blood vessels can become stiff, leading to high blood pressure. Estrogen also manages cholesterol levels. When estrogen levels go down during and after menopause, the risk for heart disease and stroke goes up.^1-3

It is important to monitor your heart health. Heart disease is a leading cause of death for men and women. The earlier that you reach menopause, the higher your risk is for heart disease. Talk to your doctor about your blood pressure and cholesterol numbers, so that you can stay within a healthy range.^1-3

Weight gain

Many people find it harder to maintain their weight during and after menopause. The metabolism slows down as we age.^1-3

Changes in hormones can cause the body to store more fat around the abdomen. This is sometimes called "belly fat." This type of weight gain can increase the risk of type 2 diabetes and heart disease. Staying active and eating a balanced diet can help manage these changes.^1-3

Osteoporosis

Osteoporosis is a condition that makes bones weak and brittle. Estrogen plays a major role in keeping bones strong. During the first few years after menopause, bone density can decrease quickly. Up to 20 percent of bone loss can happen at this time. This makes bones more likely to break or fracture. Half of all post-menopausal women will develop osteoporosis. ⁴

Common areas for fractures include the hip, wrist, and spine. Your doctor may suggest a bone density test to check your bone health. You can improve your bone health before perimenopause by taking calcium and vitamin D supplements, as well as adding weight-bearing activities like walking and lifting weights. Stability and balance exercises can also help prevent falls.^4,5

Painful sex

The walls of the vagina can become thinner and drier after menopause. This is called vaginal atrophy. It happens because there is less estrogen to keep the tissues healthy. This change can make sex feel uncomfortable or painful. These changes can be reversed by using vaginal estrogen creams.^1,2

It can also lead to more frequent urinary tract infections (UTIs). This is because a drop in estrogen thins and dries the vaginal walls, so the urethra actually can become more exposed, resulting in increased UTIs.^1,2

Sleep problems

Many people have trouble sleeping during menopause. You may find it hard to fall asleep or stay asleep. Hot flashes and night sweats are common causes of sleep loss. These are sudden feelings of heat that can wake you up at night.^1,2

Poor sleep can make it hard to focus during the day. It can also affect your mood and energy levels.^1,2

Cognitive issues

Some people describe "brain fog" during the transition to menopause. This can include minor memory gaps or trouble focusing on tasks. These cognitive issues are often linked to hormonal shifts and lack of sleep.^1,2

Most of the time, these issues are mild. If you feel very confused or have major memory loss, you should contact a healthcare professional.

Decreased fertility

Fertility begins to decline well before the actual start of menopause. During perimenopause, ovulation becomes irregular. This means the ovaries do not release an egg every month.^1,2

While pregnancy is still possible during perimenopause, it is much harder to achieve. Once you have gone 12 months without a period, you have reached menopause and can no longer get pregnant naturally.^1,2

Urinary incontinence

Menopause affects the connective tissue of the vagina/pelvic floor, so people can experience urinary incontinence (from loss of urethral support). This is a sudden, strong urge to urinate. It can also cause leaking when you cough, laugh, or lift heavy things. Menopause may also lead to pelvic organ prolapse from general loss of pelvic floor support. Strengthening the pelvic muscles can often help manage both of these issues.^1,2

When to see a doctor

You should talk to a doctor if menopause symptoms make daily life hard. Seek medical help if you have heavy bleeding, bleeding that lasts more than 7 days at a time, or periods closer than 21 days apart.^1,2

You should also see a doctor if you have bleeding after menopause has finished. A healthcare provider can check for other causes of irregular bleeding and for underlying health issues like heart disease or bone loss. They can also help you find treatments for sleep loss, painful sex, or mood changes.^1,2