The Upside of Menopause: What Women Should Know
Menopause is a transition—not a permanent state of symptoms. Dr. Karen Horst explains how many menopause-related changes, including shifts in mood and memory, can stabilize over time as the brain adapts to a new normal. Dr. Horst discusses symptoms that may continue after menopause and offers an encouraging perspective on what women can look forward to in the years post-menopause.
Transcript:
Jamie Forward: Well, Dr. Horst, we often hear about the negative effects of the menopause transition, but what are the positive?
Is there something that women have to look forward to?
Dr. Karen Horst: Yeah, so my favorite thing is a lot of these symptoms, you do stabilize, and women cognitively in their 70s, and that’s usually 10 years out from menopause – or 60s, actually. It depends. The average age of last menstrual period in the US is 51, which means that the diagnosis of being in post-menopause is at age 52. Does that make sense? So, post-menopause means you have not had a period for a year.
Jamie Forward: That’s right. Okay.
Dr. Karen Horst: For the rest of a woman’s life, they are in post-menopause. In the beginning, they’re in early post-menopause, which can still involve a lot of hormone fluctuation and change, and so there’s more going on during that time.
Late post-menopause is with when parts of the body like the brain have stabilized. And that’s true for a lot of parts of the brain. Where it’s not true, where women can be symptomatic late post-menopause, is if they are not on any kind of hormone therapy and they are having genitourinary syndrome, which is basically the vagina loves estrogen and when there’s no estrogen, the vaginal tissue gets very thin, and that can cause infections, painful intercourse, and frequent UTIs.
So, that is the one big bad thing for late post-menopause. Everything else really gets better.
[00:43:01] The brain stabilizes, memory stabilizes for most women, and mood stabilizes. So, we do get to a new normal. And so, I really want to say menopause is a transition state. The problem is it can last a long time, longer than we used to say. But eventually, you get to stable and women usually feel better. And we can all turn to relatives who weren’t on hormone therapy who seem fine, and be reassured there is a stability at the end.
The other thing I like to talk about is that nature chose to preserve the lives of women and have women in particular live long, longer than men because of specifics that we bring to our tribe, our family, our community.
Estrogen produces a brain that is pro-social. And also, estrogen during the reproductive lifespan, women have greater verbal memory and sort of some cognitive superpowers that come from living with a lot of estrogen early on. And so, late in life nature has preserved older females who know a lot, have a lot of wisdom, and are not selfish.
