How Long Do You Have To Go Without A Period To Be In Menopause
This is where it gets a bit confusing. In some circumstances, you’re told that you’re through the menopause when you’ve not had any periods for 12 months. In our experience, we find that quite a lot of women will go that year or year and a bit, and then get a single period back or they restart for a little while.
So our consensus here is that just to be on the safe side, we say that you are through the menopause after not having had any periods for 2 years . But this timescale, this is only really to do with saying that you’re post-menopausal and that you are safe from pregnancy.
A lot of women think that at this point all their symptoms will disappear and they will feel fine, and everything will be back to normal. So this two years without a period really has nothing to do with the symptoms that you’re getting, the symptoms you may be experiencing. So for some women, again, after the two years, they will find their symptoms start to ease off, but for other women, this symptom phase can go on for quite a bit longer.
Now, in all these circumstances, I have posted other video blogs that go into these particular circumstances in a lot more detail, so if you want to know more on this, please just click the link. But I just wanted to do one video blog on periods in general as you go through the menopause.
When To See A Doctor About Perimenopause Symptoms
You should see a doctor as soon as possible if:
- youre having very heavy periods, theyre happening more often than every 3 weeks, youre bleeding after sex or you have any bleeding after the menopause
- you have any symptoms of a UTI that dont get better after 2 days
- you feel pain deep inside when you have sex
- you feel low, depressed or anxious and these feelings dont go away, even after youve tried self-care measures
- you have joint pain with swelling or redness
- you have night sweats with weight loss or swollen glands
- you lose weight without trying to
- youre worried about any side effects from menopause medication you may be taking, like hormone replacement therapy
Be sure to see a doctor too, if:
- youre under 45 and are getting menopausal symptoms
- you have any menopausal symptoms that are upsetting your daily life or worrying you
- your symptoms arent getting better with self-care measures, or they keep coming back
How To Manage Irregular Periods During Perimenopause
Treatment for irregular or frequent bleeding depends very much on whats causing it. If youre bleeding frequently, you may need some tests to see if there’s any other underlying medical reason for your bleeding. For example, a doctor may want to do an ultrasound scan to check the thickness of your womb, some blood tests or a test for STIs.
If an underlying cause is found, this may need medical treatment that a doctor will advise you on. But, if your bleeding problems are caused by the perimenopause alone, there are some things you can do to manage them yourself.
For example, if you have short, unpredictable periods, consider wearing daily protection such as panty liners, pads or period pants .
Painful or heavier periods can be treated with some non-steroidal anti-inflammatory drugs , including ibuprofen that you can get in a pharmacy or supermarket, or with stronger NSAIDs that you would need to get from a doctor. Speak to a pharmacist or doctor first about how to safely get and use these medicines.
Hormonal medications like the combined oral contraceptive pill or HRT can also sometimes be used to regulate bleeding, depending on your age and other underlying medical conditions. HRT may be especially helpful if you have other menopausal symptoms.
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Is It Normal To Bleed For 3 Weeks During Perimenopause
As you go through perimenopause, your periods may last longer and become further apart. Evidence shows that having periods that last 8 days or longer is common when youre going through this natural stage in your life.
You may also bleed more heavily if youre obese or have a fibroid, and as you approach the time when your periods stop altogether.
So, for some people, it may be normal to bleed for 3 weeks during the perimenopause, but its best to see a doctor for their advice, as they may want to do some tests to make sure there’s nothing else causing your longer periods, and that youre not losing too much blood and becoming anaemic. Read below for when else to see a doctor about periods in perimenopause.
Lifestyle Factors To Support You During The Menopause
There are a number of easy self-help tips that you can try at home to help keep the symptoms of menopause under control:
- Diet During the menopause even very small changes in lifestyle factors can make a big difference for better or for worse! Try to reduce refined carbohydrates and sugary sweet treats as you can risk throwing your hormones off further, exacerbating cravings and encouraging weight gain. Eat plenty of fresh fruit and vegetables rich in vitamins and minerals, opt for whole grain sources of carbohydrates, up your intake of omega-3 with lots of oily fish and include a source of protein in every meal
- Think about drinks Its not just what you eat, but also what you drink that matters. Ensure you drink at least 1.5 litres of plain, still water a day to keep you hydrated and your bowels moving regularly. Also, try to avoid sugary drinks, alcohol and caffeine as much as possible as these can put a strain on the endocrine system and make you feel anxious or jittery
- Stress Stress can be exacerbated during the menopause so its important to not let it get on top of you. Practice breathing exercises, or try taking part in a yoga class after work, above all else make sure you take time out to do things you enjoy and take your mind off the stresses of modern life
- Exercise – Regular moderate exercise can help with many of the symptoms of menopause. It can help support your mood, sleep, body weight and often helps to keep pesky food cravings under control too!
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What Is Hormone Replacement Therapy
Hormone replacement therapy is a treatment for menopause symptoms. It involves taking synthetic hormones . HRT can involve taking estrogen alone or estrogen combined with another hormone, progestin. Some people have found that HRT can relieve menopause symptoms. These symptoms include hot flashes, vaginal dryness, and some urinary problems. However, HRT is not for everyone. Recent studies suggest that for most people, the risks of using HRT may outweigh the benefits. Talk to your doctor about the risks and benefits of HRT.
The American Academy of Family Physicians recommends against the use of combined estrogen and progestin for the prevention of chronic conditions in postmenopausal women. The AAFP also recommends against the use of estrogen for the prevention of chronic conditions in postmenopausal women who have had a hysterectomy.
According to the AAFP, This recommendation applies to postmenopausal women who are considering hormone replacement therapy for the primary prevention of chronic medical conditions. It does not apply to women who are considering hormone therapy for the management of menopausal symptoms, or to women who have had premature menopause , or surgical menopause.
What Medications Are Used To Treat Postmenopausal Symptoms
Hormone therapy could be an option, although healthcare providers often recommend using it for a short amount of time and in people under the age of 60. There are health risks associated with hormone therapy like blood clots and stroke. Some healthcare providers do not recommend using hormone therapy after menopause has ended or if you have certain medical conditions.
Some medications your healthcare provider may consider helping with postmenopausal symptoms are:
- Antidepressants for mood swings or depression.
- Vaginal creams for pain related to sexual intercourse and vaginal dryness.
- Gabapentin to relieve hot flashes.
Oftentimes your provider will recommend lifestyle changes to help manage your symptoms.
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How Does Menopause Affect Bone Health
The older a person is, the greater their risk of osteoporosis. A persons risk becomes even greater when they go through menopause. When your estrogen level decreases during menopause, you lose more bone than your body can replace. This makes your bones weaker and more likely to break. To keep your bones strong, its important to get enough calcium and vitamin D in your diet. These help your body absorb calcium. Your doctor can suggest ways to get more calcium through food, drink, and, possibly, a calcium supplement. They may also suggest that you take a vitamin D supplement to help your body process calcium. Ask your doctor what amount of daily calcium and vitamin D is right for you.
Are There Any Health Risks Associated With Postmenopause
People in postmenopause are at an increased risk for several conditions:
Estrogen helps protect against cardiovascular diseases like heart attack, heart disease and stroke. It is also common for people in postmenopause to become more sedentary, which contributes to high cholesterol and high blood pressure. These factors combined can increase a womans risk for cardiovascular diseases after menopause. A healthy diet, not smoking and getting regular exercise are your best options to prevent heart disease. Treating elevated blood pressure and diabetes as well as maintaining cholesterol levels are also ways to lower your risk.
People lose bone more rapidly after menopause due to decreased levels of estrogen. You may lose up to 25% of your bone density after menopause . When too much bone is lost, it increases your risk of developing osteoporosis and bone fractures. The bones of the hip, wrist, and spine are most commonly affected. Bone mineral density testing, also called bone densitometry, can be done to see how much calcium you have in certain parts of your bones. The test is used to detectosteoporosis and osteopenia, a precursor to osteoporosis.
Mental health issues
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What Is Perimenopause
The stage leading up to the menopause is called perimenopause. There are usually 2 stages to the perimenopause: the early transition where your periods are mostly regular and the late transition where you may have periods less often, leading up to your final period. Menopause is the time in your life when your periods have stopped and you havent had 1 for 12 months.
Changing levels of the hormones oestrogen and progesterone during perimenopause mean you may have irregular, heavier, lighter, shorter or longer periods. Other symptoms may include hot flushes, fatigue and mood swings.
Many people dont need treatment for perimenopause symptoms, but if you do have symptoms that are upsetting your day-to-day life, there are lots of ways to deal with them. Lifestyle changes and medical treatments like hormone replacement therapy can help relieve your symptoms in the run up to menopause.
Risk Of Heart Disease
Women who have not gone through the menopause have a lower risk for heart disease than men of the same age. This is because oestrogen helps to lower a womans cholesterol levels and improve the flow of blood through the blood vessels. But this advantage disappears after menopause when women stop producing oestrogen and their risk of coronary heart disease increases. While heart and blood vessel disease generally remains uncommon among women in their 50s, it becomes more common after the age of 60 years.
Because of the results of some studies which suggest that HRT may increase the risk of heart disease in some women, HRT is not currently recommended to help prevent heart disease in menopausal women. However, short-term HRT given in standard doses and started within 10 years of menopause or in women younger than 60 years has not been shown to significantly increase the risk of cardiovascular disease, and may perhaps even help protect against heart disease.
Its important to remember though that HRT is not suitable for women who have known cardiovascular disease. In addition, HRT may increase the risk of cardiovascular disease in older women, and it increases the risk of stroke in all women.
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Can You Get Pregnant During Menopause
Yes, even if youre not having periods. Fertility naturally declines with age, meaning youre less likely to become pregnant the older you get. Even so, until youre sure that youve gone through menopause, its very important to continue to use birth control if youre sexually active and dont want to get pregnant.
If youre under 50 years old, reliable contraception should be used until you havent had any periods for 2 years. If youre over 50 years old, you should use contraception until its been at least 12 months since your last period. Generally, 55 is thought to be the cut-off age for needing contraception, even if youre still having periods. After this time, you will become menopausal and you wont be able to get pregnant.
Unintended pregnancies can still happen in the perimenopause even though fertility decreases and menopausal symptoms such as vaginal dryness and mood changes can affect how often you have sex.
After the age of 40, a higher proportion of pregnancies are unplanned. Pregnancies that do occur are at a higher risk of complications, including miscarriage or chromosomal abnormalities, which is when your child is born with a genetic conditionsuch as Downs syndrome.
How Can I Treat The Symptoms
There are a bunch of ways.
Lifestyle changes. A healthy diet and regular exercise program will help manage your symptoms and boost your health. This is a great time to finally kick any old, unhealthy habits like smoking or drinking too much alcohol. To help with hot flashes, dress lightly and in layers. Avoid triggers like caffeine and spicy foods. And if you stay sexually active, that may help preserve your vaginal lining.
Prescription medication for hot flashes. If you still have your uterus, your doctor might prescribe treatment with estrogen and progesterone. This is called combination hormone therapy or hormone replacement therapy . It helps with hot flashes and night sweats, and it may help prevent osteoporosis. If you donât have a uterus, you might get estrogen alone.
Hormone therapy isnât for everyone. Donât take it if you’ve ever had breast cancer, uterine or “endometrial” cancer, blood clots, liver disease, or a stroke. Also don’t take it if you might be pregnant or you have undiagnosed vaginal bleeding.
If you can’t or don’t want to take hormones, other medications can ease symptoms. They include antidepressants, antiseizure drugs, or blood pressure medications to help with hot flashes and mood swings.
Prescription and OTC medication for vaginal dryness and sleep problems. You can try topical estrogen, lubricants, and non-estrogen prescriptions for dryness and painful sex. OTC or prescription sleep aids can help if you have trouble falling asleep.
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Q When Should I Call A Doctor About My Perimenopausal Symptoms
If you have not had a period for 12 months and then experience vaginal bleeding, contact your doctor. It is not normal for bleeding to recur after this period of time. Read our article about when you should see your OBGYN.
Remember, perimenopause and menopause are natural and normal transitions, but they can be stressful. Many symptoms can be managed which can help you regain a sense of control, well-being, and confidence to thrive in your next stage of life.
We want you to feel supported, heard, and cared for as you go through this change.
Sometimes, the biggest help is simply confirmation that what youre experiencing is normal!
Dr. Ashley Durward has been providing healthcare to women in Madison since 2015 and joined Madison Womens Health in 2019, specializing in high and low risk obstetrics, contraception and preconception counseling, management of abnormal uterine bleeding, pelvic floor disorders, and minimally invasive gynecologic surgery.
Should I Be Worried About Late
Posted4 years agobyAndreas Obermair
At what age do you expect menopause to occur? How does it affect your health and cancer risk?
Menopause occurs when a womans ovaries stop releasing hormones. Naturally, a womans production of estrogen and progesterone hormones decrease in her late forties, which may cause menstrual periods eventually stopping. The age where most women become menopausal is between 50 and 54 years. In this context menopause is defined as not having a menstrual cycle for 12 consecutive months. As the hormone levels decrease, this may come with symptoms such as hot flushes, headaches, insomnia, mood swings and depression. Some women dont have symptoms at all. Others may have symptoms at varying severity for 5 to 10 years.
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Are There Any Tests For Menopause
The most accurate way to tell if it’s happening to you is to watch your menstrual cycles for 12 months in a row. It helps to keep track of your periods and chart them as they become irregular. Menopause has happened when you have not had any period for an entire 12 months.
Your doctor can check your blood for follicle stimulating hormone . The levels will jump as your ovaries begin to shut down. As your estrogen levels fall, youâll notice hot flashes, vaginal dryness, and less lubrication during sex.
The tissue in and around your vagina will thin as estrogen drops, too. The only way to check for this is through a Pap-like smear, but itâs rarely done. As this happens, you might have urinary incontinence, painful sex, a low sex drive, and vaginal itching.