Menopause does not end when hot flushes stop, and the hormonal changes that accompany it can shape a woman’s health for the remainder of her life, a Pretoria-based clinician has warned. According to Dr Juanri Jonck, commonly highlighted symptoms such as hot flushes and irregular bleeding may ease, but the underlying drop in ovarian hormone production is permanent and its long-term consequences require ongoing attention.
Postmenopause can span decades
Dr Jonck explained that the language commonly used — phrases such as “the other side of menopause” — risks creating the false impression that women eventually revert to pre‑menopausal hormone levels. She said:
“I think we need to be careful with the phrase ‘the other side of menopause’, because it suggests that menopause eventually ends. It doesn’t. Your ovaries unfortunately don’t suddenly start producing their previous levels of oestrogen and progesterone again once your periods and hot flushes stop.”
Current recommendations from the International Menopause Society describe postmenopause as the life stage following the final menstrual period, and its later phase extends across the remainder of a woman’s life. For a woman who reaches menopause around 50 years of age, that may mean living another 30 or 40 years in a low‑oestrogen state, Dr Jonck said — a span that makes preventive health management essential rather than optional.
Health consequences extend beyond hot flushes
Dr Jonck highlighted that while obvious vasomotor symptoms (hot flushes and night sweats) may improve, other systems remain vulnerable in the long term. She identified several areas of concern:
- Bone health — Loss of oestrogen increases the risk of osteoporosis and fractures; bone loss affects not only hip and spine but also craniofacial bones.
- Cardiovascular system — A decline in protective hormones can influence heart and vessel health over time.
- Muscles and metabolism — Changes in body composition and metabolic rate may increase cardiometabolic risk.
- Skin — Reduced hormone levels affect skin quality and structural support.
- Genitourinary health — Vaginal and urinary tissues may become drier and more fragile, with implications for sexual and urinary health.
She emphasised that many of these changes are gradual and may not attract the same public or clinical attention as acute menopausal symptoms, yet they have profound implications for quality of life and long‑term illness prevention.
What this means for clinical care
Viewing postmenopause as a new stage of life shifts the clinical focus from symptom relief to long‑term prevention. Dr Jonck said menopausal care should incorporate strategies to protect bones, support cardiovascular health, preserve muscle mass and address genitourinary changes. She framed menopause not as an episode to recover from but as a durable endocrine environment requiring attention:
“Menopause is not something you recover from. The change in ovarian hormone production is permanent.”
That perspective supports routine assessment of fracture risk, discussions about cardiovascular risk factors, lifestyle interventions (nutrition, physical activity, tobacco cessation), and consideration of targeted therapies where appropriate. The article source did not provide specific treatment recommendations; patients should consult their clinician to discuss individual risks and options.
Practical takeaways for readers
While every woman’s experience of menopause is different, clinicians and public‑health programmes can reduce long‑term harm by treating postmenopause as a stage for preventative care. Key actions include:
- Regular health reviews after the final menstrual period to assess bone, heart and metabolic risk;
- Early lifestyle measures to preserve bone and muscle strength (exercise, adequate calcium and vitamin D where advised);
- Discussing genitourinary symptoms with a provider instead of assuming they are untreatable;
- Seeing a healthcare professional rather than self‑diagnosing or relying solely on over‑the‑counter remedies.
| System | Potential long‑term effect |
|---|---|
| Bone | Increased bone loss and fracture risk |
| Cardiovascular | Altered risk profile for heart disease |
| Muscle & metabolism | Loss of muscle mass, metabolic changes |
| Genitourinary | Vaginal atrophy, urinary symptoms |
Readers should remember that management must be individualised. If you have concerns about menopausal symptoms or long‑term risks, consult your doctor, clinic or a specialist in women’s health for an assessment and tailored advice.
This report is based on comments attributed to Dr Juanri Jonck and referenced International Menopause Society guidance in the original reporting.
