Feeling better after the menopause: how long the symptoms last, what mood and memory do, and what a hormone scan measures

In this article you can read what feeling better after menopause means in numbers: how long menopausal symptoms usually last, how mood, memory and bone move around the final menstrual period, what has been measured about exercise, and which signals belong with your GP. That matters, because much of what feels permanent in the middle of menopause has a measured end, and knowing where that end lies has an effect on what you expect from the coming year. The BioProfile hormone scan measures how much you notice of these symptoms, and gives you an indication of where you stand today in this area, as the first of the 11 health areas that the full scan assesses. This is not a diagnosis. It is insight, to see where you stand today, and to help you make better choices in your food and your way of living. This scan does not point to a cause. It is not a diagnosis. Only a doctor can do that.

How you notice that menopause is behind you

Thuisarts gives the calendar. Menopause begins somewhere between the ages of 40 and 60, the average age of the last period is 51, 1 in 100 women reach menopause before the age of 40, and symptoms usually ease about 5 years after the last period. 8 in 10 women get hot flushes and about 3 in 10 get vaginal symptoms such as itching or dryness; a hot flush usually lasts a few minutes.⁠⁴

The long-term measurement is more precise about how long that tail can last. Among 1,449 women with frequent hot flushes and night sweats, followed at 7 sites in the United States over 17 years of visits between February 1996 and April 2013, the median total duration was 7.4 years; among the 881 whose last period could be identified, symptoms lasted a median of 4.5 more years after it. When the symptoms began mattered more than when periods stopped: starting in premenopause or early perimenopause went with a median total duration of more than 11.8 years and 9.4 years of symptoms after the last period, while starting after the last period went with a median total duration of 5.66 years.⁠¹

So the date of your last period is not the day the symptoms stop. An early start points to a long tail, a late start to a short one.

Feeling better after menopause: what women notice after the final menstrual period

1,582 women of different backgrounds, average age 46.2 years at the start, were followed for an average of 10.85 years over up to 11 visits in the 10 years around the last period. The 360 who came in with many depressive symptoms (CES-D 16 or higher) fell 1.04 points per year up to 4 years before the last period and 0.50 points per year from that moment until 18 months after it, a cumulative change of -3.42 points over 10 years. The 1,222 who came in low rose 0.21 points per year up to 1 year before the last period and fell 0.06 points per year after that, with an average CES-D of 6.94 at the last period, below the screening threshold throughout the whole window.⁠²

In plain words: the average mood score in this cohort moved towards better across menopause, and the women who came in with the most depressive symptoms are the ones whose scores fell the furthest.

Dutch figures show where the weight of the symptoms sits. In a national survey of 4,010 female employees aged 40 to 67, carried out in 2021 as a follow-up to the Nationale Enquête Arbeidsomstandigheden 2020, almost a fifth were perimenopausal (n = 743), and 80% of that group reported menopausal symptoms: 27.5% ‘often’ and 52.5% ‘sometimes’. Having symptoms went together with lower work ability, worse perceived health and more emotional exhaustion, most clearly in perimenopausal women who reported symptoms ‘often’.⁠⁵ The heaviest burden in that survey sits in the phase you are leaving.

Can your character change during menopause?

What was measured is mood and thinking. In 2,362 women aged 45 to 57, average age 50 at the first cognitive test, followed over 4 years, processing speed climbed with repeated testing in women before the menopause (slope 0.94, p = 0.0008), in women in early perimenopause (slope 0.54, p < 0.0001) and in women after the menopause (slope 0.63, p < 0.0001), while women in late perimenopause showed no improvement (slope 0.26, p = 0.2). Delayed verbal memory climbed in the premenopause (slope 0.14, p = 0.01) and in the postmenopause (slope 0.13, p < 0.0001) but stayed flat through the early and late perimenopause. The authors read that as a cognitive difficulty of the menopause that is limited in time.⁠³

For you that means: the searching for words and the slower thinking that so many people describe sit concentrated in the menopause itself, and after the last period the scores climbed again with practice, just as in the groups on either side. The rest of the list is in the sister article on which menopause symptoms belong to it and how long they last.

What runs on quietly: bone

862 women (242 African American, 384 Caucasian, 117 Chinese, 119 Japanese) were followed for 10 years, 5 before and 5 after the last period. The loss of bone mineral density began 1 year before the last period and slowed, without stopping, 2 years after it. Lumbar spine density fell 10.6% over the 10 years, 7.38% of that within the transmenopausal window (2.46% per year); the femoral neck fell 9.1%, 5.8% of that within that window (1.76% per year).⁠⁶

Read simply: the fast phase sits around the final menstrual period and slows down after that, and slower still means downwards. That is why the everyday advice for this age still stands. Het Voedingscentrum advises women aged 50 up to and including 69 to take a daily supplement of 10 micrograms of vitamin D and everyone of 70 and older 20 micrograms a day, and states that vitamin D is needed to limit bone loss as much as possible and so reduce the risk of osteoporosis at a later age.⁠⁷

What was measured about exercise

A systematic review screened 954 records and pooled 8 randomised controlled trials with 882 women with menopausal symptoms. The pooled standardised mean difference was 0.89 for physical quality of life (95% CI -0.11 to 1.89) and 0.56 for mental quality of life (95% CI -0.04 to 1.15), with both intervals running through zero. The studies used yoga or yoga-like postures (4 studies, 10 to 18 weeks), pelvic floor muscle training (3 studies, 4 to 12 weeks), aerobic training (1 study, 24 weeks), walking (1 study, 16 weeks) and self-directed exercise (1 study, 12 weeks), without a pooled signal coming through on general, social or menopause-specific quality of life.⁠⁸ The honest reading of that is a possible gain rather than a certain gain.

A randomised controlled trial in Turkey enrolled 38 postmenopausal women aged 45 to 65, of whom 36 completed it. Twelve weeks of strength training twice a week plus walking three times a week produced a large change in the vasomotor MENQOL domain in the exercise group (eta squared = 0.81, p < 0.001), with improvement in the psychosocial and physical MENQOL domains (both p < 0.001) and in sleep quality measured with the PSQI (p < 0.01, eta squared = 0.435).⁠⁹ This small 12-week study does not predict your result.

What a hormone scan measures, and when you go to the doctor

The hormone scan asks how much of these symptoms you notice over the past few weeks. Your answers are given points, the points are added up and converted into a score, with the reading band the score falls in. What you get is a picture of how much you are carrying right now, and a starting value you can repeat in a few weeks.

What a set of questions cannot do is tell you what is causing a symptom. These symptoms can have more than one cause, and a questionnaire cannot determine which cause it is. The scan is not a diagnosis. Blood values and the tests a doctor can carry out are the layer that turns a picture of your symptoms into an explained picture.

Thuisarts names the moments to contact your GP: heavy menstrual bleeding, symptoms before the age of 40, vaginal bleeding after more than 1 year without a period, and hot flushes with symptoms that bother you.⁠⁴ That third signal has a page of its own. Make an appointment if you have vaginal bleeding after more than a year without a period, or pink or brown discharge from the vagina, even if it happens only once, is very little, or stops on its own. After bleeding that comes following the menopause, the cause is a polyp in 3 in 10 women and cancer of the womb or the cervix in 1 in 10; in more than half no cause is found, and the checks named are a smear test and an internal ultrasound of the womb and the ovaries.⁠¹⁰

In summary

Menopause symptoms have a measured length: a median of 7.4 years in total for women with frequent symptoms, and 4.5 years after the last period for the 881 of them whose last period could be identified.⁠¹ Over the same window, mood scores moved towards better, most strongly in the women who started highest.⁠² Processing speed stalled only in late perimenopause, and delayed verbal memory stayed flat through early and late perimenopause; after the last period, both rose again.⁠³ Bone keeps declining after the last period, more slowly than during the transition.⁠⁶ Exercise is the habit here with research figures behind it.⁠⁹ And a hormone scan gives you a starting point for how much you are carrying today. It is not a diagnosis.