Signs Menopause Is Ending: Transitioning to Postmenopause

Menopause is a major physiological transition, yet for many women, the uncertainty surrounding its duration remains a significant concern. The Australian Menopause Society states that the average age of menopause is 51, but symptoms can persist for years beyond that milestone. While menopause itself is defined as the cessation of menstrual cycles for 12 consecutive months, the symptoms that accompany this transition vary widely between individuals.

Many women ask, how do you know when menopause is over and at what age does menopause finish? Understanding the end of menopause involves recognising specific physiological markers, hormonal stabilisation, and shifts in symptom patterns.

Functional medicine offers a holistic, evidence-based approach to navigating menopause by addressing hormonal imbalances, metabolic changes, and lifestyle factors that influence the length and severity of symptoms. Rather than relying solely on hormone replacement, it focuses on optimising long-term health outcomes through nutrition, stress management, and personalised care.

When Do Menopause Symptoms Stop?

The intensity and duration of menopausal symptoms vary based on factors such as genetics, lifestyle, and medical history. Research indicates that for most women, the most severe symptoms persist for an average of 4–7 years, though some may experience lingering effects for a decade or more.

Common symptoms such as vasomotor instability (hot flushes and night sweats), mood fluctuations, and fatigue typically decline as the body adapts to a new hormonal baseline. However, other changes, particularly those affecting bone density, cardiovascular health, and metabolic function, may persist postmenopause.

You can also read more about menopause including, the symptoms of the beginning of menopause and key symptom information like can menopause make you tired?

What Are the Signs of Coming to the End of Menopause?

Several indicators suggest a woman is transitioning from menopause to postmenopause:

Reduced Frequency of Vasomotor Symptoms

Hot flushes and night sweats occur less frequently and with lower intensity.

Research from The Lancet shows that 50% of women experience a significant reduction in hot flushes within 5 years postmenopause.

Stabilisation of Mood and Sleep Patterns

As hormone fluctuations subside, sleep disruptions and mood swings become less severe.

Improved melatonin regulation leads to better sleep quality.

Absence of Menstrual Activity for Over a Year

While perimenopause involves irregular periods, postmenopause is marked by their complete cessation for 12 months or more.

Hormonal Stabilisation

Oestrogen and progesterone reach a new baseline.

Blood tests can confirm the permanent decline of reproductive hormones.

Metabolic Adjustments

Weight fluctuations stabilise, and the body adapts to a lower metabolic rate.

Insulin sensitivity may shift, influencing blood sugar regulation.

Why Do Some Women Experience Prolonged Menopause Symptoms?

While some women experience relief within 2–5 years postmenopause, others continue to experience symptoms well into their 60s or 70s. So when do menopause symptoms stop? Several factors contribute to this variability:

  • Early or Surgical Menopause – Women who undergo hysterectomy or oophorectomy often experience more severe and prolonged symptoms due to a sudden loss of oestrogen.
  • Genetic Predisposition – A family history of extended menopause symptoms can indicate a similar trajectory.
  • Chronic Stress and Elevated Cortisol – Persistent stress impacts the hypothalamic-pituitary-adrenal (HPA) axis, prolonging hormonal imbalance.
  • Underlying Medical Conditions – Thyroid disorders, metabolic syndrome, and autoimmune diseases can amplify menopausal symptoms.

    • Functional Medicine and the Management of Late-Stage Menopause

    A functional medicine approach goes beyond symptom management, focusing on optimising long-term health through nutritional, hormonal, and lifestyle interventions. At Evergreen Doctors, we integrate comprehensive assessments and evidence-based strategies to support women through menopause and beyond.

    1. Hormonal Testing and Targeted Interventions

    • Comprehensive hormone panels assess oestrogen, progesterone, testosterone, and cortisol levels.
    • Bioidentical hormone therapy (BHRT) may be considered for individuals with persistent symptoms.
    • Adaptogenic herbs such as ashwagandha and rhodiola support adrenal function.

    2. Nutritional Strategies to Support Hormonal Balance

    • Phytoestrogen-rich foods (soy, flaxseeds) help modulate oestrogen activity.
    • Anti-inflammatory diets, incorporating omega-3 fatty acids, turmeric, and cruciferous vegetables, support metabolic stability.
    • Vitamin D and calcium supplementation counteract bone density loss.

    3. Stress Reduction and Sleep Optimisation

    • Mindfulness practices regulate the autonomic nervous system and lower cortisol.
    • Magnesium supplementation aids in muscle relaxation and sleep regulation.
    • Cognitive behavioural therapy (CBT) is beneficial for managing anxiety and sleep disturbances.

    4. Exercise for Long-Term Postmenopausal Health

    • Weight-bearing exercises preserve bone mineral density and prevent osteoporosis.
    • Cardiovascular fitness reduces postmenopausal cardiovascular risks.
    • Resistance training enhances muscle mass and metabolic function.

    Postmenopause: What Comes Next?

    Once menopause symptoms subside, the focus shifts to maintaining long-term health. Postmenopausal women face an increased risk for osteoporosis, cardiovascular disease, and cognitive decline due to reduced oestrogen’s protective effects.

    Key considerations include:

    • Bone Health – Regular DEXA scans assess bone density, and strength training is crucial.
    • Heart Health – Lipid profile monitoring and adherence to a heart-healthy diet support cardiovascular function.
    • Cognitive Function – Research suggests that oestrogen influences neural plasticity, making brain health interventions essential.

    How to Navigate the End of Menopause with Expert Support

    Menopause may mark the end of reproductive cycles, but it is not the end of a woman’s health journey. Recognising what the signs are of coming to the end of menopause, managing long-term risks, and implementing functional medicine strategies can help women maintain vitality, cognitive function, and metabolic balance well into later life.

    At Evergreen Doctors, we provide individualised menopause care, integrating hormonal testing, nutritional interventions, and lifestyle medicine to ensure that women transition into postmenopause with confidence.

    If you are experiencing prolonged menopausal symptoms or want to optimise your postmenopausal health, schedule an appointment with Sydney's trusted menopause doctors. 

Ebony Tosch