Q: What Causes Irregular Periods During Menopause
Short answer: Decreasing levels of estrogen and progesterone in the body lead to menstrual irregularities.
Long answer: The underlying reason that women experience irregular periods during menopause is hormonal change. When the transition to menopause begins, the body begins to produce less estrogen and progesterone, which directly affects the menstrual cycle. Thus, irregular periods are often a sign that the body is heading towards menopause.
How Often Do I Need To See My Doctor After Menopause
You should still see your healthcare provider for routine gynecological care even though you arent menstruating. This includes Pap tests, pelvic exams, breast exams and mammograms. You should continue to schedule annual wellness appointments. Since you are at an increased risk for osteoporosis, providers usually recommend bone density screenings as well. Talk to your healthcare provider to determine how often you should make check-up appointments based on your health history.
How Do I Stay Healthy After Menopause
It is important to maintain a healthy lifestyle, especially as you age and your risk for certain medical conditions increases. Some ways for people in postmenopause to stay healthy include:
- Exercising regularly. Walking, doing yoga or strength training can help lower your risk for many medical conditions.
- Weight-bearing exercises can strengthen your bones and muscles.
- Eating a healthy diet. Foods like fruits, vegetables, lean meats and whole grains should make up the bulk of your diet. Avoid lots of salt or sugar and limit your consumption of alcohol.
A note from Cleveland Clinic
Going through menopause can be uncomfortable and present new challenges and health concerns. Speak with your healthcare provider about any symptoms you feel or questions you have. They can help make sure you are supported through this time and get the care you need.
Last reviewed by a Cleveland Clinic medical professional on 10/05/2021.
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Why Might Periods Be Lighter During Perimenopause
Throughout perimenopause, the body’s natural production of the reproductive hormone estrogen begins to decline however, it is a gradual process. When there is a specific dip in estrogen, the lining of the uterus is thinner – meaning a lighter bleed during the period. Conversely, when estrogen levels are higher, this can lead to a heavier flow. As well as being light or heavy, these changes can also cause periods to be shorter or longer lasting.
When Are You Actually In Menopause How Is Menopause Calculated Defined Or Diagnosed
Menopause is defined as taking place 1 year after a woman’s last period. Once you have had a consecutive 12 months with no period you are officially declared to be in the menopause – congratulations! So you can find yourself putting the clock back to zero a few times if your period returns after a few months break.
Some women have a period even after a 1-year break with no period. So you see why menopause can drive some women crazy – it’s so different and unpredictable!
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When Does Menopause Usually Happen
Menopause happens when you have gone 12 months in a row without a period. The average age of menopause in the United States is 52. The range for women is usually between 45 and 58. One way to tell when you might go through menopause is the age your mother went through it.
Menopause may happen earlier if you:
- Never had children. Pregnancy, especially more than one pregnancy, may delay menopause.
- Smoke. Studies show smoking can cause you to start menopause up to two years earlier than women who dont smoke.
can also cause you to start menopause earlier.
Menopause usually happens on its own. However, you may enter menopause earlier than you normally would if you have had chemotherapy or surgery to remove both ovaries. Learn more about early menopause on our page.
How Long Will Menopausal Transition Symptoms Last
Menopause is technically one full year without bleeding, and perimenopause is the stage before the final menstrual period, also known as the menopausal transition. Puberty and perimenopause are similar in that they both involve hormonal changes, and the transitions can take place over several years. Some medical organizations, such as the American Osteopathic Association, refer to perimenopause as reverse puberty in women.
According to NAMS, this phase can last four to eight years, and it comes with symptoms caused by hormone fluctuations, such as mood swings, poor sleep, and hot flashes.
The age at which a woman begins perimenopause can help predict how long the transition to menopause will last, according to research published in the journal Menopause in February 2017. The authors found that perimenopause lasted longer in women who started the transition at a younger age, and the women had more symptoms, such as hot flashes.
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Q: When Do Irregular Periods Usually Start
Short answer: It depends, but irregular periods during menopause usually begin between ages 45 and 55.
Long answer: Though irregular periods can occur at any time, they are often the first sign that a woman has begun the transition into menopause. Women in their mid-forties to mid-fifties often begin to have irregular periods, as the body begins to decrease its production of estrogen and progesterone in preparation for the cessation of menstrual periods.
Read below to find out how long irregular periods usually last during the menopause transition.
Why Are My Menopause Symptoms Getting Worse
Symptoms of perimenopause leading up to menopause may increase in frequency and intensity as hormonal shifts become more severe. Around the age of 35, estrogen and progesterone production enters a phase of gradual decline. You may notice any symptoms from these gradual shifts.
In your 40s, the ratios between estrogen and progesterone will be in flux. Ovulation may not happen with every period or your periods may become irregular. These shifts in your hormones can cause more noticeable symptoms.
Carolyns Periods Had Always Been Irregular So She Didnt Really Notice The Menopause Had Started
My periods had always been fairly irregular certainly as I got older, and so I didnt really think, I never really knew if I was going to have one or not it just happened, when they came they came. So the fact I hadnt been having any didnt really register either until eventually I began to think well it must be getting on for about a year which I know is the time that they say. And I was having some blood tests done for something else so they threw in the a hormone check as well and I was decreed that I was through it and I have to say I dont think Id had any adverse effects at all.
When To See Your Doctor
Heavy bleeding and unusual period cycles are common in women over 50. But if your symptoms interfere with your life and well-being, you should contact your doctor. You may be a good candidate for hormone therapy that helps balance your estrogen and progesterone levels, easing heavy bleeding and other perimenopausal symptoms.
Bleeding can occur in women over 50 after they experience menopause as well. Studies show that this postmenopausal bleeding is usually caused by conditions like uterine fibroids or polyps. It can also be a sign of endometrial cancer, which affects 2 to 3% of women and is most common among postmenopausal women.
Heavy bleeding could also be a symptom of another underlying health condition. Make sure to monitor your flow and see your doctor if you experience:
- Extremely heavy bleeding like soaking through a sanitary product hourly
- Consistent spotting between cycles
- Several cycles in a row that are shorter than 21 days or several days longer than usual
- More than three months between periods
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What Do You Need To Know About The Menopause
The menopause is the natural process women go through as they reach a certain age and signals the point when a womans monthly periods have come to an end.
Although reaching the menopause technically means you have had your last ever period, we often use this phrase to describe the lead up to your periods stopping. Periods rarely just stop suddenly, many women experience irregular periods for some time. This might include heavier, more painful periods or lighter, less frequent ones these patterns can go on for a number of years. Every woman is different but you are generally considered to be fully through the menopause after not having a period for at least two years.
Alongside the often irregular periods, many women often experience a whole number of symptoms in the lead up to the menopause as oestrogen begins to drop, this can be anything from hot flushes to joint pain.
On this page I give a quick overview of what the menopause involves and specifically the effects it can have on the menstrual cycle. Visit A.Vogel Talks Menopause for more in-depth information and video blogs from our menopause expert Eileen.
The Common First Signs Of Perimenopause: Irregular Periods Spotting Or Heavy Bleeding
Hormonal fluctuations in perimenopause usually cause changes to a womans periods.
One of the first signs that most women notice of the perimenopause is that their periods become shorter than normal or they experience spotting or heavy bleeding, says Dr Rosen. Thats linked to the decline in the hormone progesterone, which is produced by your ovaries.
Progesterone helps the endometrium the tissue inside the uterus stick to the walls of the uterus, which helps take care of a pregnancy. When the levels of this hormone decrease, the endometrium can no longer stick to the walls of the uterus, which is why women may experience such erratic bleeding.
There may also be heavy bleeding during womens periods before menopause because the level of oestrogen becomes increased before declining. The production of oestrogen and progesterone continues to decline to extremely low levels, which is when you reach menopause.
So, what are the symptoms of perimenopause, and what can help?
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Last Periods Before Menopause
So I hear people say “I haven’t had a period in over a year” or something similar when talking about entering menopause. But I’m wondering how sudden it was or whether there was a gradual decline. For years after having kids, I had very long heavy periods. Now I might have one heavy day and 2 days of spotting, and last month, I just spotted for a couple of days, and it looks like that might be the case this month. I’ve also had a couple of episodes where I suddenly got a flush of feeling really sweaty and hot, but not like the room was hot, more like my own internal furnace suddenly kicked in. I’ve been in perimenopause for years, but I’m wondering whether this is brave new territory. Thoughts?
When Does Menopause Occur
Most women reach menopause between 45-55 years of age, and the average age for women in Australia to reach menopause is 51-52 years. Some women will have a later menopause, at up to 60 years of age, especially if there is a family history of late menopause.
Menopause sometimes occurs earlier than expected as a result of cancer treatment, surgery or unknown causes. This is discussed further in ‘Causes of menopause’.
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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.
Factors Influencing Hormone Levels
BMI and race impact hormones. Obesity is associated with lower LH, FSH, estradiol and progesterone secretion, as well as marked decreases in urinary hormone metabolite excretion. Women with obesity have a lower rise in FSH and a less steep decline in estradiol as they traverse the FMP. African American and Hispanic women had higher FSH and lower testosterone compared to other ethnic groups based on an analysis of 2930 women from the SWAN Study.
In addition to BMI and race, which account for variability in hormones over time, there are cycle to cycle changes that may impact the menopause and symptom experience. For example, women who experience the cycle irregularity of the early menopause transition at a younger age than the median of 47 are more likely to have a longer, and more symptomatic transition than those whose onset is later in life. Women who have more variable hormone levels over time are also more likely to have a symptomatic menopause transition.
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What You Can Do
Consider keeping a journal to track your periods. Include information such as:
- when they start
- whether you have any in-between spotting
You can also log this information in an app, like Eve.
Worried about leaks and stains? Consider wearing panty liners. Disposable panty liners are available at most drugstores. They come in a variety of lengths and materials.
You can even buy reusable liners that are made of fabric and can be washed over and over again.
A skipped period can also cause the lining to build up, leading to heavy bleeding.
Bleeding is considered heavy if it:
- soaks through one tampon or pad an hour for several hours
- requires double protection such as a tampon and pad to control menstrual flow
- causes you to interrupt your sleep to change your pad or tampon
- lasts longer than 7 days
When bleeding is heavy, it may last longer, disrupting your everyday life. You may find it uncomfortable to exercise or carry on with your normal tasks.
Heavy bleeding can also cause fatigue and increase your risk for other health concerns, such as anemia.
How Long Are Normal Perimenopause Periods
Ordinarily, your menstrual cycle occurs every 21 to 35 days and lasts from 2 to 7 days. However, perimenopause periods can last much longer. Some months, the ovaries might not produce sufficient levels of estrogen and progesterone, preventing menstruation altogether. Other months, the imbalance might cause the uterine lining to become overly thick, which means it will take longer to be shed by your body to shed.
Excessive bleeding and long periods are fairly common during perimenopause. Many women experience an increased flow and extended perimenopause periods before entering menopause.
If youve had periods that are several days longer or more frequent or heavier than usual, its a good idea to see your doctor.
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Higher Risk Of Heart Disease
The end of menopause means that your age becomes solid. It causes certain health problems and heart disease is one out of the list of when is menopause over. This problem also derives from low levels of estrogen and so, induces various complications from the part of the cardiovascular system. Commonly, this issue can be averted if you follow a healthy lifestyle. Its vital to consult a specialist in this field to define the necessary preventive measures.
Of The Reproductive Journey
We usually diagnose menopause in hindsight, after that full year of absent periods. Ive found that most women know theyve reached menopause when they get there.
Even if your irregular periods turn out to be something else, youll face menopause eventually. Talk with your ob-gyn about what youre experiencing. Together we can work through this part of your health journey.
The views expressed in this article are those of Dr. Eisenberg and do not reflect the views of the National Institutes of Health, the Department of Health and Human Services, or the United States government.
Copyright 2021 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.
This information is designed as an educational aid for the public. It offers current information and opinions related to women’s health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOGs complete disclaimer.
Dr. Esther Eisenberg
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Lorna Could Set The Clock By Her Periods When Her Periods Became Irregular She Knew The
Menopause. I think the first time I was aware was about when I was about 51, 52. 51 probably. When my periods started to not be as regular as they were. Now you could set a clock by my periods. Okay. Twenty eight days more or less to the hour, almost to the minute I mean it was amazing, and just as regular as clockwork. And they started to not be the regular twenty eight. And there were delays, the period extended. So I knew that this was the start of the menopause because Id been so incredibly regular for so many years.
What Happens At Menopause
Women are born with about a million eggs in each ovary. By puberty about 300,000 eggs remain, and by menopause there are no active eggs left.
On average, a woman in Australia will have 400-500 periods in her lifetime. From about 35-40 years of age, the number of eggs left in your ovaries decreases more quickly and you ovulate less regularly until your periods stop. Menopause means the end of ovulation.
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