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Women’s Health After Menopause — A diverse older woman living actively after menopause while calm health symbols suggest bone, heart, pelvic, sexual, sleep, and preventive health.
Book 30 of the series

Women’s Health After Menopause

A Practical Guide to Bone, Heart, Pelvic, Sexual, Sleep, and Preventive Health After 60

Menopause gets the pamphlet. The forty years after it get almost nothing. This is the missing briefing.

Three ways to have it

  • Paperback$13.99Not yet printable

    5.5 × 8.5 in, 120 pages, posted to you. ISBN not yet issued

  • Ebook$4.99

    EPUB, reads on any e-reader, phone or tablet. ISBN 979-8-90623-745-3

  • Audiobook$9.99

    About 2h 40m, narrated in full. ISBN 979-8-90623-746-0

Read the opening free Prices and delivery

What it is for

For women in their sixties and beyond who want to understand what changed, what still helps, and how to be heard at appointments.

What it will not do

It is not a diagnosis manual or treatment plan, gives no screening schedules or lab numbers, and does not tell you whether hormone therapy is right for you.

What this guide is about

You were told about hot flashes, mood swings, and periods stopping. A rough patch, framed as a passage, and then, implicitly, it was over. Nobody sat you down and explained that the same drop in estrogen behind the flashes also changes bone, blood vessels, the bladder, the vaginal tissue, the shape of your sleep, and where your body prefers to store fat. Nobody mentioned that a fair number of women are still having hot flashes in their late sixties and quietly assume something must be wrong with them.

This book fills that gap in the briefing. Ten chapters on what actually comes up: building a personal health baseline, heart and metabolic health, bone and muscle and the honest business of not falling, the bladder and the pelvic floor, sexual comfort and intimacy, sleep and mood and the memory worries, the hormone therapy conversation, preventive care and being taken seriously, cancer screening as a shared decision rather than an order, and a one-page dashboard so all of it stops living in your head at three in the morning.

About 25,000 words, with chapter illustrations, a 30-day plan, questions for your doctor, a symptom log, a script for being taken seriously, a support circle worksheet, a quick-reference card, a glossary, and plain-language sources.

It sets no screening schedules and lists no lab thresholds. Hormone therapy is presented as an individualized decision to make with a clinician who knows your history, recommended neither for nor against. Symptoms you have adapted to still count, because adaptation is not treatment. And any bleeding after menopause should be checked by a doctor, promptly, every time.

Inside the book

Every chapter, with the sentence it opens on.

The chapters

  1. The Postmenopausal Health BaselineDoreen Whitcomb drove a school bus in western Nebraska for twenty-six years and retired at sixty-two with a good pension, a bad knee, and a manila folder she'd been adding to since her fifties.
  2. Heart and Metabolic HealthAna Beatriz Ferreira, who everyone calls Bea, was sixty-seven and still working four days a week supervising housekeeping at a hotel in Miami when she started feeling wrong in the afternoons.
  3. Bone, Muscle, and FallsHere is a small fact that reorganizes how most people think about bone.
  4. Pelvic and Urinary HealthLet's start with the sentence that ought to be printed on a card and handed out: leaking urine is common, and common is not the same as normal, and neither of those means untreatable.
  5. Sexual Comfort and IntimacyMargit Halvorsen was widowed at sixty-eight after forty-one years of marriage, and at seventy-three, to her own considerable surprise, she found herself seeing a man from her cross-country ski club in northern Minnesota.
  6. Sleep, Mood, and CognitionPriya Raghunathan was sixty-two, still working as a software tester from a spare bedroom in Seattle, and had not slept a full night in three years.
  7. Hormone Therapy and Other TreatmentsIf you want to understand why women your age are confused about hormone therapy, look at what they've been told over the course of one adult lifetime.
  8. Preventive Care and Self-AdvocacyFern Deloria drives ninety minutes each way from her home on the reservation in South Dakota to the clinic where she can be seen, and she does it in a truck with a heater that works when it feels like it.
  9. Cancer Screening and Shared DecisionsWinnie Cheung spent thirty-four years as an accountant in San Francisco and came to her seventies with a professional discomfort about being told what to do without seeing the working.
  10. Build a Personal Postmenopausal Health DashboardBy now you may be feeling something this book didn't intend, which is that your health has turned into a second job.

And at the back

  • When It Feels Hard: Troubleshooting the Real Barriers
  • Common Myths, Gently Corrected
  • Your 30-Day Plan
  • Worksheets, Scripts, and Reusable Frames
  • Quick-Reference Card
  • A Small Glossary
  • Sources and Further Reading
  • A Closing Word

The thirty days

Thirty small things, one a day, none of them taking more than about fifteen minutes. They're arranged so the early ones build the record, the middle ones build the body and the habits, and the later ones turn it all into something that continues. Nothing here is a test. Skip what doesn't apply, repeat what helps, and if you lose a fortnight to a family emergency, start again at the day you'd reached.

  1. Write your medication list. Everything you swallow in a normal week, prescription and otherwise, copied off the container with the strength and how often. Fold it into your wallet.
  2. Add your surgeries and major illnesses with rough years, and note whether you still have your uterus and your ovaries.
  3. Write what you know of your family history: hearts, strokes, cancers, broken hips, diabetes, and the ages if you have them. Leave gaps.
  4. Fill one gap. Call the relative most likely to know something you don't.
  5. Find out your blood pressure. If you don't know it and can't remember the last check, get it done free at a pharmacy or senior center this week.
  6. Write four honest lines about what your body has actually been doing lately, including the thing you'd rather not write down.
  7. Put it all on one page. Name and date at the top. This is your health summary, and you'll use it for years.
  8. Stand behind a chair and time how long you can balance on one leg. Write the number and today's date inside a cupboard door.
  9. Do ten sit-to-stands from a dining chair without using your hands, or as many as you manage. While the kettle boils is the traditional slot.
  10. Walk for fifteen minutes at a pace where talking takes a bit of effort. Notice how you feel afterward rather than during.
  11. Look at one meal and add protein to it. Eggs, beans, fish, yogurt, whatever you'll actually eat. Breakfast is where most women are short.
  12. Do the rug walk. Go through your home and deal with one tripping hazard: tape a rug, move a cord, clear a stair.
  13. Put a light where you can reach it from bed, or a nightlight along the path to the bathroom.
  14. Rest, and read back over your one page. Circle the item you'd most like sorted out this year.
  15. Write the single sentence you'd most like to say to a clinician, in your own words, on a card. Put it in your wallet next to the medication list.
  16. Book something. An overdue appointment, a check you've been putting off, or a call to ask when you're next due for anything.
  17. Ask the pharmacist one question you've been carrying. They're free, they're there, and they know a great deal.
  18. Ask for a medication review, or write the request on your card for the next appointment.
  19. Find out whether there's a pelvic floor physical therapist available to you, by asking your clinic or searching your area. Just find out.
  20. Tell one person something true about your health that you've been keeping to yourself. A friend, a sister, a daughter, a neighbor.
  21. Rest. Notice whether anything in the last fortnight has already shifted.
  22. Start a three-day bladder diary, or a symptom log for whatever you're currently chasing.
  23. Fix your wake-up time and keep it fixed for the rest of the month, including after bad nights.
  24. Get outside within an hour of waking, even for five minutes, and see what it does to your sleep by the weekend.
  25. Cut one thing that's working against your sleep. The evening drink, the after-lunch coffee, or the four o'clock nap. Choose one, not all.
  26. Do a second strength session this week. Add heel raises at the counter and wall push-ups to the sit-to-stands.
  27. Read one thing about hormone therapy from a reputable medical body rather than a product website, and write down the two questions it raises for you.
  28. Find your team's gaps. List everyone you see medically, and note who's missing. For many women it's a gynecologist, or someone to come to appointments.
  29. Ask one person to come to your next appointment, and tell them what you want out of it.
  30. Put your one page in an envelope with your name and the year on it, take a photograph of it or ask someone to, and mark a date in next year's calendar for the annual review. You're set up.

Pages from this book

Real pages, at the size they print. In the paperback these are black and white; the cover keeps its colour.

An older adult naming emotions and choosing support, shown with calm body language and non-stigmatizing symbolism.
An older adult naming emotions and choosing support, shown with calm body language and non-stigmatizing symbolism.
A calm thirty-day progression as four weekly clusters and two review days, simple shapes, no readable text.
A calm thirty-day progression as four weekly clusters and two review days, simple shapes, no readable text.
Concentric support rings — self, trusted people, community, professionals — shown through people and symbols, no words.
Concentric support rings — self, trusted people, community, professionals — shown through people and symbols, no words.
A four-stage decision path shown as visual stations with a calm older adult moving through them, no words.
A four-stage decision path shown as visual stations with a calm older adult moving through them, no words.

Words this book makes plain

Bone density scan (DEXA)
A low-dose imaging test that measures bone mineral density, usually at the hip and spine. The result is reported as a score compared with a reference; what it means for you depends on your history, and whether and when to have one is an individual decision.
Cardiovascular risk
An estimate of your chance of a heart attack or stroke over a given period, calculated from several factors together rather than any one number.
Deprescribing
A deliberate review of everything you take, asking for each whether it's still needed and whether the dose is still right.
Estrogen
The hormone whose decline after menopause drives most of the changes in this book, with effects on bone, blood vessels, and the tissues of the vagina and urinary tract.
Genitourinary syndrome of menopause (GSM)
The collection of changes to vaginal, vulvar, and urinary tissue caused by lower estrogen: dryness, irritation, pain with sex, urgency, and more frequent urinary infections. Progressive if untreated, and treatable.
Hormone therapy (HT or MHT)
Prescription treatment with estrogen, with a second hormone added if you still have a uterus, taken to treat menopausal symptoms. Given throughout the body or applied locally, which are different propositions.
Local (vaginal) treatment
Prescription treatment applied directly to the vagina, which behaves differently in the body from treatment taken throughout it.
Osteopenia and osteoporosis
Terms describing degrees of reduced bone density, with osteoporosis meaning bone weak enough to raise fracture risk substantially.
Overdiagnosis
Finding a condition through screening that meets the definition of disease but would never have caused symptoms or harm in your lifetime, leading to treatment you didn't need.
Pelvic floor
The sling of muscle supporting the bladder, bowel, and uterus. It can be weak, or too tight, and the treatment differs.
Pelvic floor physical therapy
A specialty that assesses and retrains those muscles. Under-referred, and often the most useful treatment for leaking and pelvic pain.
Pessary
A fitted device placed in the vagina to support a prolapse, avoiding surgery for many women.
Postmenopause
Everything after the twelve-month mark since your last period. For most women, decades.
Prolapse
When a pelvic organ drops lower than it should, often felt as heaviness or a bulge.
Sarcopenia
Age-related loss of muscle mass and strength. Responds to resistance training and adequate protein at any age.
Screening
Testing someone who feels well, to find disease early. Distinct from testing someone who has symptoms, which is not optional.
Shared decision making
Choosing between reasonable options based on your values as well as the evidence, rather than receiving an instruction.
Sleep apnea
Repeated pauses in breathing during sleep. Under-diagnosed in women, more common after menopause, and can present as insomnia or fatigue rather than snoring.

The words to use

Copy these out, print them, or keep them in a note on your phone. They are yours to use.

The Self-Advocacy Script: being taken seriously

Open with the agenda. "I have three things today. The most important is ______."
> Describe, don't diagnose. "It started ______. It's ______ [constant, comes and goes, worse at night]. It's worse when ______ and better when ______."
> Name the cost. "Because of it, I've stopped ______."
> If you're brushed off, ask these, calmly, in this order.
"I understand it may well be that. What else could it be?"
"What would need to change for you to want to investigate further?"
"If it doesn't improve, what's the next step, and when should I come back?"
> Ask for the record. "Would you note in my chart that I raised this today and what we decided?"
> If you need to escalate. "I'd like a second opinion, please. Can you refer me, or tell me who does this regularly?"
"I would like my heart evaluated before I go home."

Use the parts you need. The order matters more than the wording.

For an emergency setting, when you're not being believed about cardiac symptoms:

Say it plainly, once, and then repeat the same sentence if needed. Escalating the volume tends to work against you; repeating the identical sentence tends to work.

The Symptom Log

Keep it two to three weeks, not forever. One line per episode.

| Date and time | What I felt, in my words | How bad (1–10) | What I was doing before | How long it lasted | What helped | |---|---|---|---|---|---| | | | | | | |

At the bottom, note anything unusual you ate, drank, or took, and any pattern you've spotted yourself. Bring the whole thing, don't summarize it.

For bladder symptoms, swap the columns: time, roughly how much, urgent or not, any leak and what you were doing, and what you drank and when.

Your One-Page Health Summary

Handwrite it. Keep it to a single side. Update it twice a year and before every appointment.

Who I am, medically Name, date of birth, emergency contact and phone. Conditions I've been told I have: ______ Allergies: ______ Uterus: yes / no. Ovaries: yes / no. Year of last period: ______ Health care power of attorney held by: ______

What I take (copy off the bottles: name, strength, how often) Prescriptions: ______ Vitamins, supplements, herbal products: ______

My numbers and dates (write the date beside every one) Blood pressure: ______ Cholesterol: ______ Blood sugar: ______ Weight: ______ Last bone density conversation: ______ Screenings and tests, with dates and one-line results: ______

My history Surgeries and years: ______ Pregnancies, and any high blood pressure or diabetes during them: ______ Family: heart disease and strokes, with ages: ______ Cancers, with ages: ______ Fractures: ______

What I'm watching now (two or three things, in my own words, with when they started) 1. ______ 2. ______ 3. ______

My team Primary care: ______ Gynecology: ______ Pharmacy: ______ Eyes: ______ Dental: ______ Specialists: ______ Who comes with me: ______

Questions Worth Asking About Any Test or Treatment

  1. What are we looking for, and what will we do differently depending on the result?
  2. What's the chance this helps someone with my history specifically?
  3. What are the downsides, including the common annoying ones as well as the rare serious ones?
  4. What happens if I wait, or decline?
  5. How long would I be on this, and what would make us stop?
  6. What should make me call you before the next appointment?

The Raising-It-Again Script

"I brought this up about a year ago and we left it. It hasn't gone away, and it's been affecting ______. I'd like to look at it properly this time. What would that involve?"

For a symptom you've mentioned before and let drop.

No apology needed at the start of that sentence. Many women put one there. It's the one edit worth making.

Support Circle Worksheet

Fill in at least one name per ring. Gaps are the point of the exercise.

  • You. What's the one thing you've decided to handle this season? ______
  • Your close people. Who knows what's actually going on with your health? ______ Who would come to an appointment if you asked? ______ Who has a key, and your emergency contact's number? ______
  • Your community. Senior center, library, faith community, walking group, exercise class, transport service, a friend doing the same thing at the same time: ______
  • The professionals. Primary care, gynecology or women's health, pharmacist, physical therapist, mental health support if you need it: ______

If a ring is empty, that's your next task, and the community ring is usually the easiest one to fill.

Questions worth asking before you buy

Who is Women’s Health After Menopause for?
For women in their sixties and beyond who want to understand what changed, what still helps, and how to be heard at appointments.
What does it not do?
It is not a diagnosis manual or treatment plan, gives no screening schedules or lab numbers, and does not tell you whether hormone therapy is right for you.
How long is it?
About 25,300 words across 10 chapters, with 13 full-page illustrations. In paperback that is about 120 pages. The audiobook runs about 2h 40m.
Can I read some of it first?
Yes. The foreword and the whole introduction are on this site, free, with nothing to sign up for.
What languages is it in?
The books exist in five: English, German, Spanish, French and Dutch, each localised properly — its own illustrations with the labels drawn in that language, and its own country's institutions named in the text. This shop can sell you the English and the Spanish today; the other three are finished books waiting on their paperwork.
What does the complete set include?
All thirty guides in print, in one box, and the ebook and the audiobook of every one of them at no extra charge.

Free to read

What is in it, chapter by chapter

All 10 chapters: what each one opens on, the questions it answers, and the one small thing to do when you have finished it. About 25,300 words in the book itself.

Every chapter

Where it sends you next

The book’s own sources, printed here in full.

No statistics or study findings have been invented for this book. Where the text refers to general patterns, they reflect long-standing findings that are widely reported by the organizations below; where a specific number would have been needed, the book deliberately declines to give one, because the right number depends on you and because guidance changes.

These are reasonable, non-commercial places to look things up, all of which publish plain-language material for the public:

  • Your own clinician and pharmacist. The most important sources on this list, because they're the only ones who know your history.
  • The North American Menopause Society / The Menopause Society, for menopause-specific guidance including hormone therapy, and for finding clinicians with menopause expertise.
  • The American College of Obstetricians and Gynecologists (ACOG), for gynecologic and postmenopausal health.
  • The American Heart Association, particularly its material on heart disease in women and on recognizing symptoms.
  • The U.S. Preventive Services Task Force, for current screening recommendations and the reasoning behind them.
  • The National Institute on Aging and the Office on Women's Health, for accessible overviews across most topics in this book.
  • The Bone Health and Osteoporosis Foundation, for bone and fracture prevention.
  • The National Center for Complementary and Integrative Health, for evidence on supplements and non-conventional treatments.
  • Outside the United States, your national health service or equivalent public health body, and your country's menopause society, since recommendations and terminology differ.

Be wary of any source that is selling the treatment it recommends, that promises hormone balance, that offers a single answer for every woman, or that uses "natural" as a claim about safety.

A Note on Review

This book was developed with primary-care and gynecology-informed review. Two areas require verification against current guidance near the time you act on them: hormone therapy, where recommendations have changed repeatedly and continue to be refined, and cancer screening, where recommended ages, intervals, and stopping points differ between expert bodies, differ between countries, and are periodically updated. Nothing here is a substitute for a conversation with a clinician who knows your history. If anything in this book contradicts what your own clinician tells you about your own body, ask them about the difference rather than assuming either of you is wrong.

This book in other languages

En español

The particulars

SeriesPractical Guides for Life After 60, book 30 of the series
ImprintThe Greenlight Guides Editorial Team
Length25,300 words, 10 chapters
Extentabout 120 pages (estimated from the manuscript, not a proof)
Size5.5 × 8.5 in (140 × 216 mm)
Illustrations13, full-page illustrations
Listening time2h 40m
ISBN, ebook979-8-90623-745-3
ISBN, audiobook979-8-90623-746-0
ISBN, paperbacknot yet issued
LanguageEnglish (en-US)

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