Late Postmenopause
- Estrogen at stable low postmenopausal levels
- FSH stabilised at elevated levels
- Ongoing androgen decline
Menstrual Changes
No periods
Primary Symptoms
- • GSM continues and worsens without treatment
- • Osteoporosis risk significant (silent disease)
- • Cardiovascular disease risk elevated
- • Cognitive changes — estrogen's neuroprotective effects absent
Clinical Protocol
- DEXA bone density scan if not done in past 2–3 years
- Full cardiovascular risk assessment
- Cognitive health monitoring
- Ongoing genitourinary symptom review
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