How Long Does The Transition To Menopause Last
Perimenopause, the transition to menopause, can last between two and eight years before your periods stop permanently. For most women, this transition to menopause lasts about four years. You will know you have reached menopause only after it has been a full year since your last period. This means you have not had any bleeding, including spotting, for 12 months in a row.
When Should I Contact My Doctor
Contact your healthcare provider if you experience vaginal bleeding:
- More than a year after your last menstrual period.
- More than a year after starting hormone replacement therapy .
A note from Cleveland Clinic
Its normal to have irregular vaginal bleeding in the years leading up to menopause. But if you have bleeding more than a year after your last menstrual period, its time to see your healthcare provider. It could be the result of a simple infection or benign growths. But in rare cases, bleeding could be a sign of uterine cancer.
Last reviewed by a Cleveland Clinic medical professional on 05/26/2021.
Calcium And Vitamin D
A combination of calcium and vitamin D can reduce the risk of osteoporosis, the bone loss associated with menopause. The best sources are from calcium-rich and vitamin D-fortified foods.
Doctors are currently reconsidering the use of calcium and vitamin D supplements. The U.S. Preventive Services Task Force advises that healthy postmenopausal women don’t need to take these supplements. According to the USPSTF, taking daily low-dose amounts of vitamin D supplements , with or without calcium supplements , does not prevent fractures. For higher doses, the USPSTF says there is not enough evidence to make a recommendation. In addition to possible lack of benefit, these supplements are associated with certain risks, like kidney stones.
However, calcium and vitamin D are important nutrients. Supplements may be appropriate for certain people including those who do not get enough vitamin D through sunlight exposure and those who do not consume enough calcium in their diet. They are also helpful for people who have been diagnosed with osteoporosis. Talk with your doctor about whether or not you should take supplements.
The National Osteoporosis Foundation recommends:
Vitamin D is necessary for the absorption of calcium in the stomach and gastrointestinal tract and is the essential companion to calcium in maintaining strong bones.
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The Most Important Part Of Post
Along with the physical changes that occur after menopause, women may need to improve their health care routines.
Postmenopausal women are at greater risk for heart disease, so redirect your diet toward low-fat foods and lower your salt intake this reduces the risk of heart attack and atherosclerosis, a condition in which plaque builds up on the insides of the arteries.
As part of your routine check-ups, you should have a blood test at a minimum of every five years until age 50, and then at regular intervals. Your doctor will recommend what that interval should be based on how high your cholesterol is, if you are on cholesterol treatment, and on other cardiovascular risk factors that you may have, such as hypertension or obesity.
Women also should have their bone density checked once every two years to spot early signs of osteoporosis, a weakening of the bones. Postmenopausal women are particularly at risk for this condition: Research shows that up to 20 percent of bone loss can occur in the first five years of menopause.
Estrogen is one of the best stimulators of bone growth, Audlin says. The risk of osteoporosis is very low before menopause, but post-menopausally, fractured hips and problems related to bone density are very likely.
Women ages 50 and up should consume at least 1,200 milligrams of calcium every day to maintain bone health. This can be accomplished with supplements, by consuming calcium-rich foods like milk, or a combination of the two.
How Do You Know The Cause Of Postmenopausal Bleeding
- Identifying the cause of the bleeding can include the following:
- Exam by your provider of the vagina and cervix.
- Pap smear to check the cervical cells.
- Ultrasound, usually using a vaginal approach, which may include the use of saline to make it easier to see any uterine polyps.
- Biopsy of the endometrium or uterus. In this procedure, your healthcare provider gently slides a small, straw-like tube into the uterus to collect cells to see if they are abnormal. This is done in the office and can cause come cramping.
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Frequently Asked Questionsexpand All
Yes. Although its normal for periods to change as you near menopause, you should still talk with your obstetriciangynecologist about bleeding changes. Abnormal bleeding sometimes can be a sign of health problems. Its especially important to tell your ob-gyn if you have bleeding after menopause.
If you have any bleeding after menopause, or if you have any of the abnormal changes in your monthly cycle listed above, its important to see your ob-gyn to find out the cause. Many things can cause abnormal bleeding, including
Polyps are noncancerous growths that attach to the wall of the uterus. They also may develop on the endometrium . These growths may cause irregular or heavy bleeding. Polyps also can grow on the cervix or inside the cervical canal. Polyps on the cervix may cause bleeding after sex.
After menopause, the uterine lining may become too thin. This can happen when a woman has low levels of estrogen. The condition is called endometrial atrophy. As the lining thins, a woman may have abnormal bleeding.
The risk factors for endometrial cancer include
early age when periods started
older age at menopause
long-term use of medications containing high doses of estrogen
treatment with a drug called tamoxifen
certain tumors of the ovaries
Are Women Who Arent Experiencing Menopausal Symptoms Still Fertile
No matter when you experience natural menopause, your chances of getting pregnant after the age of 40 are low, says Faubion. But you can still become pregnant as youre transitioning to menopause, and you still need to use if you don’t want to conceive, she adds.
Streicher confirms, saying, and menopause are not the same thing there are plenty of women who are pumping out and menstruating and are not fertile. If youre sexually active, its important to consult with your doctor before making any decisions about birth control to avoid unwanted pregnancy.
On the other hand, dont assume that just because you are still menstruating that you can . Women who are concerned that they may have trouble conceiving or think they may experience menopause early and still want children should discuss options such as egg freezing with their doctor, says Streicher.
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Body Image And Menopause
Some of the things that may contribute to your body image around menopause include:
- social attitudes Western culture rarely portrays older women as sexual or desirable. These ingrained social attitudes may make you feel less attractive. Some women wrongly believe that sex is only for young people. If you feel this way, it may cause your sexual interest and activity to wane
- possible weight gain you may find your body fat increases at this time, especially around your abdomen. This is due to hormonal changes and other age-related factors
- changes to body hair growth.
Its Best Not To Ignore Any Changes That Cause You Distress
You may cringe at the thought of talking to your gynecologist about sex. But rest assured, there is no reason to feel awkward. If you’re dealing with these changes and are very much unhappy with them, talk to your doctor. Right now, this may be a conversation that needs to take place via telehealth due to the pandemic. If you feel dismissed, then Dr. Rowen encourages you to consider switching to another provider if at all possible. Go find someone who will listen to you and take your problems seriously, Dr. Rowen says. Together, you can come up with a treatment plan that may help you have a more fulfilling sex life, even after menopause.
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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
At What Age Do Most Women Reach Menopause
The medical definition of menopause is no menstrual bleeding for a year, according to Lauren Streicher, MD, a clinical professor of obstetrics and gynecology and the medical director of the Northwestern Center for Menopause and the Northwestern Center for Sexual Medicine in Chicago.
Most women experience menopause between age 40 and 58, and the average age at menopause is 51, according to the North American Menopause Society.
Many women are surprised when they go through menopause in their forties because they think theyre too young, but its not unusual, says Dr. Streicher.
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Pros & Cons Of Replacing Hormones
Since menopause is caused by a decrease in estrogen and progesterone, why not just replace them and continue on? Hormone replacement therapy is an option for many women who wish to combat the health risks that increase during their postmenopausal years. But this therapy may have its own risks.
Benefits: Estrogen therapy may relieve hot flashes, night sweats, vaginal dryness and protect against bone loss.
Risks: Estrogen-only therapy may increase your risk of breast and uterine cancer, stroke, heart disease, and deep vein thrombosis. Combine hormone therapy could cause an increased risk of breast cancer, stroke, heart disease, deep vein thrombosis, and gallbladder disease.
Talk to your doctor about the right approach to managing your health changes after menopause.
What Can I Do To Prevent Osteoporosis
Osteoporosis isnt entirely preventable, but you can take steps to strengthen your bones. Eating foods high in calcium like cheese, yogurt, spinach or fortified cereals can help boost calcium intake. Adding a calcium supplement can also help. Some people also need a vitamin D supplement because it helps their body absorb calcium.
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What Other Factors Influence When Perimenopause Starts Or When A Woman Reaches Menopause
New research published online on April 12 in Menopause, the journal of NAMS, looked at the various factors that may affect the age when natural menopause occurs.
They found that there are factors that do seem predictive of when a woman will approach menopause, such as higher and follicle-stimulating hormone levels, which weve known for a while,” says Streicher. Irregular menstrual bleeding and hot flashes were also indicators of earlier menopause, she adds.
One new finding uncovered in the research was around alcohol consumption. The authors observed that participants tended to increase their alcohol consumption when approaching menopause, making it a potential clue that the change was coming.
That makes sense, says Streicher. This can be a time of added stress for women, and we know that any can cause someone to drink more, she says.
Although this study didnt find a strong association with smoking, other research has indicated that smoking is related to early onset of menopause, says Streicher.
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.
Getting To The Bottom Of It
Postmenopausal bleeding can range from light spotting that is pinkish-gray or brown, all the way to a heavy flow, like a regular period. Most of the time, there is no pain with the bleeding. No matter your exact symptoms, youll want to get in touch with your ob-gyn right away if this happens to you.
Any evaluation should start with a detailed conversation, either in person or via telehealth . Your ob-gyn should ask questions such as:
- When did you go through menopause? The longer its been, the greater cause for concern and the more testing we might need to do.
- Are you taking any new medications? Some drugs, such as blood thinners and some mental health medications, can have vaginal bleeding as a side effect.
- What else is going on with your health? Other medical conditions could be relevant.
A pelvic exam usually is needed when were talking about unexplained vaginal bleeding. During the exam, your ob-gyn may look at your vagina and cervix and feel the size of your uterus.
The next steps will depend on your age, how long it has been since you reached menopause, and how much bleeding youre experiencing. Your ob-gyn might suggest a pelvic ultrasound to look at your uterus more closely or a biopsy to take a tissue sample from the lining of your uterus. You might even need both.
What Causes The Menopause
The menopause is caused by a change in the balance of the body’s sex hormones, which occurs as you get older.
It happens when your ovaries stop producing as much of the hormone oestrogen and no longer release an egg each month.
Premature or early menopause can occur at any age, and in many cases there’s no clear cause.
Sometimes it’s caused by a treatment such as surgery to remove the ovaries , some breast cancer treatments, chemotherapy or radiotherapy, or it can be brought on by an underlying condition, such as Down’s syndrome or Addison’s disease.
Page last reviewed: 29 August 2018 Next review due: 29 August 2021
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How Do You Get Rid Of Menopause Cramps Fast
According to the American College of Obstetricians and Gynecologists , over-the-counter pain relievers like ibuprofen, naproxen, and aspirin are effective treatments for cramps.
If you are looking for nonmedicinal help, try using a heating pad or a heated patch or wrap on your abdomen to help relax the muscles of your uterus. Heat can also boost circulation in your abdomen, which may help reduce pain.
When To Seek Help
Its common and normal to experience irregular periods when youre perimenopausal.
- suddenly experience very heavy periods or periods with blood clots
- have periods lasting longer than usual
- spot or bleed after sex
- spot or bleed after your period
- have periods close together
Osteoporosis and heart disease are long-term health risks associated with menopause. Thats because estrogen plays a significant role in protecting your bones and your heart. Without estrogen, youre at an increased risk for both diseases.
Youre also at an increased risk of urinary tract infections because menopause can cause your urethra to become dry, irritated, or inflamed. Vaginal infections can also occur more frequently because your vagina has become dryer and thinner.
Report menopausal symptoms when visiting the doctor. Get assessed by your physician if you continue to have menopausal symptoms that are unbearable or last more than five years after your last menstrual period.
Although menopause can cause uncomfortable symptoms for some women, this natural process has possible upsides, too. There are several potential benefits of menopause to consider:
You will still need to protect yourself from sexually transmitted diseases.
Other Symptoms Of Surgical Menopause
There are a number of other symptoms of surgical menopause, although some of them are believed to also be caused by increasing age.
These symptoms include:
- Mood changes, like depression and anxiety
- Weight gain, especially around the waist
- Dry skin and hair loss
- Increased urinary problems, especially urinary tract infections and urinary incontinence
Menopausal symptoms tend to be more intense for people who have undergone surgical removal of their ovaries than for those who experience menopause naturally. However, menopausal symptoms vary widely and in degree from person to person.
This greater intensity of menopausal symptoms is attributed to the abrupt removal of the ovaries, which are a primary source of estrogen. In natural menopause, the ovaries gradually lose their ability to produce estrogen, so the body can adjust more easily.