How Do You Know Youre In Postmenopause
Your healthcare provider will be able to tell you if youâre in postmenopause based on your symptoms and how long itâs been since your last menstrual period. In some cases, your healthcare provider will take a blood sample and check your hormone levels to confirm youâve gone through menopause. Remember, youâre not considered to be through menopause until itâs been over one year since youve had a period.
Chances Of Getting Pregnant During Perimenopause And Postmenopause
If you hope to become pregnant during perimenopause, and you have not conceived even after six months of trying, you should consult a doctor. The below measures can increase your chances of getting pregnant:
- Intercourse during ovulation: Observe the signs of ovulation such as breast tenderness, abdominal bloating, increased sex drive, slight cramping, and white discharge. Ovulation time is the most fertile time in the menstrual cycle.
- Diet and exercise: Have a balanced diet and exercise to stay fit and healthy. These will improve the chances of conception.
- In vitro fertilization : Getting an IVF treatment during perimenopause or menopause could help. In this case, you may have to use the eggs that were frozen in the past or donor eggs. You might also need hormone therapy to prepare your body for implantation and pregnancy. However, this might not be the case for all women .
With lifestyle changes and medical help, you might get pregnant during the perimenopausal stage. But is it safe for you and the baby?
Postmenopause And In Vitro Fertilization
When you reach postmenopause, your hormone levels are no longer suitable for ovulation and natural pregnancy, and birth control isnt necessary anymore. However, there is still a chance you could get pregnantthrough in vitro fertilization .
IVF after menopause has proven to be successful in many cases. It can be done using your own eggs that you had frozen earlier in life, or by using a donors eggs . This process will require you to undergo hormone therapy to prepare your body for the implantation process and to carry the baby to term.
However, be aware that postmenopausal women are much more likely to experience minor to major complications of pregnancy after IVF compared to premenopausal women.
IVF after menopause isnt an option for everyone. It depends greatly on your overall state of health and a doctor should be able to tell you whether or not its an option for you.
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Ovulation In A Postmenopausal Woman
- Aimee SeungdamrongCorrespondenceReprint requests: Aimee Seungdamrong, M.D., New Jersey Medical School, UMDNJ, Department of Obstetrics, Gynecology, and Womens Health, 185 South Orange Avenue, MSB-E506, Newark, NJ 07101 .AffiliationsDepartment of Obstetrics, Gynecology, and Womens Health, New Jersey Medical School, University of Medicine and Dentistry New Jersey, Newark, New Jersey
- Gerson WeissAffiliationsDepartment of Obstetrics, Gynecology, and Womens Health, New Jersey Medical School, University of Medicine and Dentistry New Jersey, Newark, New Jersey
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When Will Menopause Occur
During perimenopause, hormone levels may be low one day and within the normal range or high the next. So, there is currently no test that can determine when menopause will occur for you. The best way to tell if you are close to menopause is to pay attention to the symptoms you have. Keep a record of your menstrual cycle to see if your periods are irregular or have stopped for some time. If youre experiencing typical menopausal symptoms such as hot flushes and erratic periods, its likely you are going through perimenopause, and menopause is approaching.
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How Can You Tell If You Are Pregnant During Perimenopause
Pregnancy and menopause share some similar symptoms, from the classic missed period, to fatigue and night sweats. So how can you tell if you are pregnant during perimenopause, or if your symptoms are the result of further transitioning in the process?
Pregnancy symptoms may differ from one woman to the next, but there are some symptoms seen in both pregnancy and menopause, while others are unique to pregnancy. Pregnancy symptoms like sensitive or swollen breasts, nausea, constipation, and food sensitivity should be followed up by an at home pregnancy test, and a trip to the doctor if warranted. While anyone can experience these symptoms, they are more often associated with pregnancy and a test with your doctor can confirm this.
Symptoms unique to menopause include irregular ovulation, vaginal dryness, and loss of bone mass. Although many of these can only be investigated with the help of your doctor, its important to understand the difference in symptoms so you can figure out what you are experiencing.
Do People In Postmenopause Lose Interest In Sex
No, not all people lose interest in sex after menopause. Vaginal dryness and discomfort during sex can make sex less pleasurable. Using a vaginal lubricant can help with dryness. Some people are less interested in sex because of other symptoms like depression or feeling tired. If your feelings about sex have changed, ask your healthcare provider for help.
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Can Women Conceive After Menopause
Yes. With the help of IVF, women who have gone through menopause can still get pregnant, whether menopause came early or at a more expected time. You will need to use donor eggs, but chances are that you can still carry and deliver a healthy baby. A study carried out at the Columbia University Medical center and published in The American Journal of Perinatology followed 101 women over the age of 50 who underwent IVF with donor eggs and found that the outcomes for both mothers and babies were as good for the post-menopausal women as they were for women under the age of 42.
If you think that you may be undergoing menopause early and are hoping to have a baby, it is a good idea to get professional advice as soon as possible. Your fertility team can run a series of tests to find out whether you are in fact going through menopause, and which treatment options make sense for your situation. If you decide to try IVF with donor eggs, you can use eggs from a known donor or go with a donor from an egg donation program, where you can choose to know the identity of the donor or proceed anonymously.
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When Does Perimenopause Occur
Perimenopause usually happens in a womans 40s and on average lasts 4-6 years, but can be as short as one year, or as long as 10. When you have had no period, spotting or staining for 12 months, you have reached menopause and are then considered postmenopausal. However, symptoms may continue for months or years after menopause every woman is different.
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Breast Cancer And Hrt
Women over 50 years of age who use combined oestrogen and progestogen replacement for less than five years have little or no increased risk of breast cancer. Women who use combined HRT for more than five years have a slightly increased risk. Women on oestrogen alone have no increased risk up to 15 years of usage.
There is no evidence to suggest that a woman with a family history of breast cancer will have an added increased risk of developing breast cancer if she uses HRT. The risk with combined oestrogen and progestogen is greater than with oestrogen alone, or with newer HRT agents such as tibolone , and may also depend on the type of progestogen used. Studies suggest that medroxyprogesterone acetate and norethisterone have higher risks than dydrogesterone and progesterone.
Hormone Replacement Therapy For Menopause Symptoms
Hormone replacement therapy , also called hormone therapy, is sometimes prescribed during or after the menopausal transition to help relieve certain symptoms, like hot flashes, night sweats, and vaginal dryness. HRT involves taking synthetic or âbioidenticalâ forms of estrogen and often synthetic progesterone. âSystemicâ HRT goes throughout the whole body and can be taken in several forms, like pill, patch, gels, creams, and sprays. For people who are only experiencing vaginal symptoms, âlocalâ HT used inside the vagina in the form of a cream, ring, or tablet may be recommended .
Also, data suggest that systemic HRT lowers the risk of osteoporosis, coronary heart disease and overall mortality in people who take it around menopause, particularly for those who have had a hysterectomy and use estrogen-only HRT, but more information is needed (39.
Systemic HRT also carries risks, including an increased chance of developing breast cancer, stroke, and blood clots . Risks vary by whether your form of HRT contains a progestin or not . Also, the risk of negative effects increases when people begin taking it after menopause, particularly 10 or more years from menopausal onset . The U.S. Federal Drug Administration currently recommends that people who choose HRT take it âat the lowest dose that helps and for the shortest timeâ .
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Can I Tell If Im Approaching Menopause
The frustrating reality is that there is great variation among women. Some women have few if any symptoms at age 50 and may be 1-5 years away from menopause. Other women have hot flashes at age 45 and may still be 1 7 years away from menopause. So the simple answer is noyou cant predict when youll be menopausal. But the question is thisdoes it matter?
I know it sounds like a ridiculous question but the truth is that menopause isnt treated according to whether or not you still have eggs left or estrogen is still being produced by the ovaries. Menopause is primarily treated because of symptoms that a woman experienceshot flashes, night sweats, palpitations, insomnia, etc. Whether or not youre still having periods and still producing estrogen these symptoms can still be addressed. You dont need to be officially menopausal to get relief of these symptoms.
A word about definitions
So the bottom line is this: avoid the confusion in trying to define exactly where you are in the menopause process. After all, menopause is just another aging processin this case the aging of the reproductive organs. Instead of trying to define where you are in the aging process, focus on whether or not youre feeling well, having symptoms or concerned about other aspects of menopause including the loss of skin elasticity, bone health, vaginal dryness or other menopause-related issue.
Abnormal Bleeding After Menopause
In some cases, bleeding continues after menopause. It is easy to mistake this type of bleeding for symptoms of perimenopause, which may mislead someone to think they have not reached full-menopause when they actually have.
Any spotting or bleeding after menopause is abnormal and should be checked out by a healthcare provider . Spotting or bleeding after menopause can be caused by a medical condition, such as uterine polyps . Uterine polyps are growths on the inside lining of the uterus , and become more common with age .
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Health Risks For Pregnancies Later In Life
Health risks in pregnancy increase with age. After age 35, the risks of certain problems rise in comparison to younger women. These include:
- Multiple pregnancy, especially if you have IVF. Multiple pregnancies can result in early birth, low birth weight, and difficult delivery.
- Gestational diabetes, which can cause health problems for both mom and baby.
- High blood pressure, which requires careful monitoring and possibly medication to ward off complications.
What Can I Do About Hot Flashes
Hot flashes occur from a decrease in estrogen levels. In response to this, your glands release higher amounts of other hormones that affect the brain’s thermostat, causing your body temperature to fluctuate. Hormone therapy has been shown to relieve some of the discomfort of hot flashes for many women. However, the decision to start using these hormones should be made only after you and your healthcare provider have evaluated your risk versus benefit ratio.
To learn more about women’s health, and specifically hormone therapy, the National Heart, Lung, and Blood Institute of the National Institutes of Health launched the Women’s Health Initiative in 1991. The hormone trial had 2 studies: the estrogen-plus-progestin study of women with a uterus and the estrogen-alone study of women without a uterus. Both studies ended early when the research showed that hormone therapy did not help prevent heart disease and it increased risk for some medical problems. Follow-up studies found an increased risk of heart disease in women who took estrogen-plus-progestin therapy, especially those who started hormone therapy more than 10 years after menopause.
The WHI recommends that women follow the FDA advice on hormone therapy. It states that hormone therapy should not be taken to prevent heart disease.
Practical suggestions for coping with hot flashes include:
General Recommendations For Ht
Current guidelines support the use of HT for the treatment of severe hot flashes that do not respond to non-hormonal therapies. General recommendations include:
- HT may be started in women who have recently entered menopause.
- HT should not be used in women who have started menopause many years ago.
- Women should not take HT if they have risks for stroke, heart disease, blood clots, and breast cancer.
- Currently, there is no consensus on how long HT should be used or at what age it should be discontinued. Treatment should be individualized for a womans specific health profile.
- HT should be used only for menopause symptom management, not for chronic disease prevention.
Before starting HT, your doctor should give you a comprehensive physical exam and take your medical history to evaluate your risks for:
- Heart disease
- Breast cancer
While taking HT, you should have regular mammograms and pelvic exams and Pap smears. Current guidelines recommend that if HT is needed, it should be initiated around the time of menopause. Studies indicate that the risk of serious side effects is lower for women who use HT while in their 50s. Women who start HT past the age of 60 appear to have a higher risk for side effects such as heart attack, stroke, blood clots, or breast cancer. HT should be used with care in this age group.
Do You Still Need Contraception During Perimenopause And Menopause
Although you are less likely to get pregnant during the perimenopausal and menopausal stages, it is advisable to use contraceptives. There is a possibility to ovulate, even if the periods are irregular. Contraceptives, such as condoms, not only prevent unplanned pregnancy but also help you avoid sexually transmitted infections .
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Fertility In The Aging Male
Unlike the early fertility decline seen in women, a mans decrease in sperm characteristics occurs much later. Sperm quality deteriorates somewhat as men get older, but it generally does not become a problem before a man is in his 60s. Though not as abrupt or noticeable as the changes in women, changes in fertility and sexual functioning do occur in men as they grow older. Despite these changes, there is no maximum age at which a man cannot father a child, as evidenced by men in their 60s and 70s conceiving with younger partners. As men age, their testes tend to get smaller and softer, and sperm morphology and motility tend to decline. In addition, there is a slightly higher risk of gene defects in their sperm. Aging men may develop medical illnesses that adversely affect their sexual and reproductive function. Not all men experience significant changes in reproductive or sexual functioning as they age, especially men who maintain good health over the years. If a man does have problems with libido or erections, he should seek treatment through his primary care provider and/or urologist. Decreased libido may be related to low levels of testosterone.
How To Protect Against Unplanned Pregnancy
To prevent a baby bump on your road to menopause, use an effective, safe and appropriate method of birth control until your menopause is confirmed.
Natural family planning is not recommended for perimenopausal women because irregular periods make predicting ovulation difficult.
Many contraception options exist. Dr. Bembry says vasectomy is the most effective form of birth control, as long as post-procedure care is followed, but admits a lot of men just dont go there.
When considering birth control options, talk to your physician. She can discuss risks, effectiveness rates, perimenopausal symptom relief and even which methods can protect against certain cancers.
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Women After 50 Can Have Safe Pregnancy
But They Have More C-sections, Diabetes, High Blood Pressure
Nov. 12, 2002 â As the years pass and technology improves, the barrier to pregnancy gets pushed farther and farther back. It used to be thought that women shouldnât get pregnant over the age of 40. Today, 50-something women and their doctors wonder if it is safe to push that barrier even farther.
âThere is no medical reasonâ not to, said Richard J. Paulson, MD, in a news conference today. Chief of the division of reproductive endocrinology and fertility at the University of Southern California Keck School of Medicine, he is also the lead investigator on a study that appears in the Nov. 13 issue of The Journal of the American Medical Association.
The study of women aged 50 to 63, all of whom were postmenopausal, revealed an increased number of complications, but nothing that cannot be handled by close monitoring and quality healthcare.
After menopause, a woman no longer produces eggs and thus cannot become pregnant naturally. But although eggs succumb to this biological clock, pregnancy is still possible using a donor egg. Therefore, all of the women in the study had an egg from a younger woman implanted into her uterus.
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