When Does Menopause Occur
Menopause occurs between 45 and 55 years of age for almost all women, with an average age of 51. Menopause that happens between the ages of 40 and 45 is known as early menopause and the menopause that happens before the age of 40 is called premature menopause.
Around 1 % of Australian women possess spontaneous premature menopause. Premature menopause may also take place if your ovaries are removed surgically, or in case you have certain kinds of chemotherapy or radiotherapy for cancer problems that can harm your ovaries. At times when dealing with these cases menopause occurs suddenly instead of slowly and steadily which can be upsetting for those who have not prepared themselves.Criteria associated with early and premature menopause include: being a smoker
- Family history
- Metabolic disorders
Perimenopause And Irregular Bleeding
During perimenopause a womans menstrual cycles may be shorter or longer, and the flow may vary from light to heavy. As ovarian function is declining, ovulation may not occur. The ongoing release of estrogen may cause the uterine lining to thicken while the production of progesterone slows down. As a result, the lining continues to build up and may cause irregular bleeding. The thickening of the endometrium may represent a benign change, such as a polyp, or hyperplasia. Most hyperplasia is not a problem but some forms can be precancerous. The bleeding can also represent endometrial . Fortunately, this is the least likely possibility.
Uterine polyps and uterine fibroids, both of which are benign, may also cause changes in bleeding pattern. Polyps are benign growths composed of the endometrial glands and contain no muscle tissue. A fibroid is a fibromuscular type of tumor that often grows within the muscular layer of the uterus. If the fibroid juts out into the endometrial cavity, abnormal bleeding can result. Both fibroids and polyps can cause extra bleeding due to their location within the interior of the uterus.
Can I Still Get Pregnant During Perimenopause
Yes. You may be less likely to get pregnant during perimenopause, but it’s still possible. As long as you have a period, you can still get pregnant. If you want to expand your family during this time, speak with your healthcare provider about your health, fertility and possible fertility treatment options.
When your periods are irregular, you may be more likely to get pregnant unexpectedly. If you dont want to expand your family at this age, continue using birth control until your healthcare provider tells you its safe to stop. Continue to practice safe sex to prevent sexually transmitted diseases throughout your life.
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Do You Know The 34 Signs Of Menopause
Hot flashes, sleepless nights, and topsy-turvy emotions are well-known signs that youre approaching menopause. In actuality, there are dozens of primary menopause symptoms, and while every woman may not experience each one, they can leave you with a whole lot of questions. Menopause is manageable, and knowing whats happening to your body is an important tool in feeling more control while you experience changes. If youre curious about the symptoms youre currently observing, take this quiz to learn about what phase of menopause youre experiencing. Keep scrolling to learn about the wide range of possible signs youll encounter as you approach the big change.
What Are The Symptoms
Common symptoms include:
- Irregular periods. Some women have light periods. Others have heavy bleeding. Your menstrual cycle may be longer or shorter, or you may skip periods.
- Vaginal dryness.
Some women have only a few mild symptoms. Others have severe symptoms that disrupt their sleep and daily lives.
Symptoms tend to last or get worse the first year or more after menopause. Over time, hormones even out at low levels, and many symptoms improve or go away.
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What Are The Major Causes Of Irregular Periods
“Irregular periods can be caused by many underlying health problems like general health issues or hormonal issues like Thyroid. Anovulatory cycles such as polycystic ovarian syndrome are also one of the reasons for irregular periods. Irregular cycles if left untreated for a longer period can cause endometrial hyperplasia,” explained Dr. Milind Tiwale, Consultant Gynaecology and Obstetrics, Aster Aadhar Hospital, Kolhapur.
Further emphasizing the point on how PCOS leads to irregular periods, Dr.Tanuja Paipuru, Counsultant- Obstetrics & Gynaecology, Aster Prime Hospital, Hyderabad said, “PCOS is a major cause of irregular periods studies shows that more than 50% of patients develop prediabetes or diabetes, and there is an increased risk of myocardial infarction , dyslipidemia, hypertension, anxiety, depression, endometrial cancer, and sleep apnea. Moreover, pregnant women with PCOS should be informed of the increased rates of miscarriage, gestational diabetes, pre-eclampsia, and premature delivery.”
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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When Should I Be Worried
You should see your gynecologist regularly at least once a year, particularly during this period of your life. Yearly checkups are vital to your health because these changes can mask problems like polyps, fibroids, thickening or thinning of your uterus walls .
You should see your doctor as soon as possible if the bleeding is unusually heavy, prolonged, or more frequent, as this can cause anemia. This kind of bleeding is not a normal perimenopausal issue.
Vaginal And Sexual Symptoms
Vaginal dryness, atrophy and associated symptoms such as dyspareunia and urinary symptoms, are common in the postmenopause, affecting between 1/3 to 1/2 of women or more. Symptoms may also arise in the perimenopause. These symptoms, collectively, are termed genitourinary syndrome of menopause and are associated with decreased vaginal collagen and elastin content, thinned epithelium, and increased vaginal pH related to decreasing estrogen. Vaginal dryness and its effect on quality of life, particularly its impact on sexual function, is of significant import to patients. Cross-sectional studies have suggested that increased pain during sexual intercourse may occur earlier in the transition, while decreases in desire may occur later in a womans transition. The SWAN cohort noted a decrease in reported sexual functioning starting at around 20 months prior to the FMP, with the greatest rate of decline in the late transition and a slower decline in postmenopause. Of women reporting vulvovaginal symptoms, 40% also reported overall sexual dysfunction. However, the most important factors influencing sexual function were not hormonal determinants, but rather prior, premenopause transition level of sexual function and relationship satisfaction. While many perimenopausal symptoms such as VMS and mood tend to improve with time, ongoing targeted treatment is required for improvement in vaginal symptoms .
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Hot Flashes & Night Sweats
Hot flashes and night sweats are common symptoms of perimenopause and menopause, with over 85% of women reporting hot flashes. Hormone changes affect your bodys internal thermostat. A hot flash feels like a wave or sensation of heat across your face, neck, and chest. It can last for several minutes. Hot flashes can happen a few times a day, a few times a week, or less often.
Hot flashes that happen at night are called night sweats, which can cause women to wake up drenched in sweat and disturb sleep. Women are more likely to report hot flashes at night.
Irregular Periods In Your 40s Is It Perimenopause Or Something Else
If youre in your mid- to late 40s and your periods are becoming irregular, you may be in the menopausal transition, or perimenopause. This is the natural stage your body goes through as you approach menopause.
This stage lasts about four years on average, although some women may experience only a few months or many more years of symptoms. It is characterized by fluctuations in hormones as your ovaries are nearly out of eggs. Your estrogen levels drop and you may have markedly irregular menstrual cycles. On top of irregular periods, hormonal changes can lead to weight gain, hot flashes, trouble sleeping, vaginal dryness, mood changes, and depression.
Perimenopause ends with menopause, at which point you have not had a period for 12 months.
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The Link Between Irregular Periods And Heart Disease
Dr Shashidar, Director- Interventional Cardiology, Fortis Hospital, Bannerghatta Road, Bangalore said, “Irregular period by itself is not a risk factor for heart diseases but if it is an indication of perimenopause period, then it becomes a risk factor. Generally, women are protected from heart diseases till menopause which is because of a hormonal effect. Once they reach menopause, they are prone to heart-related problems and have equal chances of being affected by a heart condition as men.”
Other Causes For Period Changes
The regular monthly period is not the only reason why people may bleed.
Because a persons periods are often irregular during perimenopause, they should pay extra attention for any abnormal symptoms particularly as some uterus-related conditions are more common during and after perimenopause.
People may bleed because of:
- Endometrial atrophy. Low estrogen in perimenopause and menopause can cause the tissue of the uterus to get very thin, which can cause irregular bleeding.
- Uterine polyps. These are benign growths that can grow inside the uterus and cervix. Polyps do not always cause symptoms, but some people notice bleeding after sex.
- Endometrial hyperplasia. Hormonal shifts can cause the lining of the uterus to thicken in perimenopause. When the body has too much estrogen without enough progesterone, this thickness may cause bleeding. Bleeding is its most common symptom. Endometrial hyperplasia is treatable but can increase a persons risk of cancer.
- Uterine Cancer. Uterine cancer happens when abnormal or atypical cells progress into cancer. Though rare, it generally presents with heavy bleeding or postmenopausal bleeding.
Perimenopause is not a disease and does not require treatment. It can, however, increase peoples risk of developing certain diseases. Moreover, the menstrual cycle can change for reasons other than perimenopause.
Anyone experiencing changes in their menstrual cycle should see a doctor for a diagnosis.
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Charlottes Heavy Periods And Potential For Flooding Are Scary And Embarrassing Once She Was
I remember having sort of heavy periods but they might have been more clotty periods early on and them being difficult to manage and not very nice but certainly this potential for flooding is scary. Its scary. And Ive been caught out. Ive been in a situation where I drove to the Trafford Centre shopping with my daughter and I had tampons and pads on and I stepped out of the car and there was this woosh and fortunately my daughters a doctor so shes quite comfortable, she wouldnt have been embarrassed or anything by that. But I was terribly embarrassed. I couldnt move, I couldnt walk forward or backward and of course I had to send her into Marks & Spencer to get me some clothing, all of that. So it could be as bad as that standing up from sitting down somewhere at work and then realising your skirts or your trousers and got to deal with that kind of thing. Being kind of anxious about that possibility. Yeah, so yeah it can impinge on what you do. I tried not to let it impinge on things. I said I liked walking I try not to let it impinge on things like that but Id be talking about stacks of supplies going round here there and everywhere with me that kind of thing. So, yeah, I think you perhaps know that other people struggle like that but you almost dont say anything, sort of feel Ive got to manage it, Ive got to cope with it. I cant say Im going home now, Im having a terrible day of it. Youve got to just keep going.
How Long Does This Last
On average irregular periods, last 4 years, but again, every woman is different. For some, this can take a decade for others, just a few months before menstruation stops completely and you enter menopause.
As you approach full menopause , the time between two cycles can become longer. The women in our community report that they had a period after 9 months of no bleeding. I personally had two episodes of 8 months with nothing and then very painful and heavy bleeding. So do not measure what is happening to you by what happens to other women.
Do You Need Tests To Diagnose Menopause
You don’t need to be tested to see if you have started perimenopause or reached menopause. You and your doctor will most likely be able to tell based on irregular periods and other symptoms.
If you have heavy, irregular periods, your doctor may want to do tests to rule out a serious cause of the bleeding. Heavy bleeding may be a normal sign of perimenopause. But it can also be caused by infection, disease, or a pregnancy problem.
You may not need to see your doctor about menopause symptoms. But it is important to keep up your annual physical exams. Your risks for heart disease, cancer, and bone thinning increase after menopause. At your yearly visits, your doctor can check your overall health and recommend testing as needed.
Is Having A Hard Time Concentrating And Being Forgetful A Normal Part Of Menopause
Unfortunately, concentration and minor memory problems can be a normal part of menopause. Though this doesnt happen to everyone, it can happen. Doctors arent sure why this happens. If youre having memory problems during menopause, call your healthcare provider. There are several activities that have been shown to stimulate the brain and help rejuvenate your memory. These activities can include:
- Doing crossword puzzles and other mentally stimulating activities like reading and doing math problems.
- Cutting back on passive activities like watching TV.
- Getting plenty of exercise.
Keep in mind that depression and anxiety can also impact your memory. These conditions can be linked to menopause.
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What Causes Longer
During a regular menstrual cycle, your levels of estrogen and progesterone rise and fall in a relatively consistent pattern. However, while in perimenopause, your hormones dont follow a set pattern and your ovaries produce erratic and unpredictable perimenopause periods.
When youre about to enter menopause, youll ovulate less frequently, creating one of two possible scenarios. In the first scenario, your ovary doesnt release an egg, and the lining of the uterus doesnt shed, which causes a missed period.
In the second scenario, the lining of your uterus has grown extra thick and requires more time to shed. The excessive buildup of tissue means longer periods and intense menstrual flow.
Gradually, however, your periods will become less frequent and eventually stop altogether. Experts consider the transition to menopause complete once a woman has gone without having a period for at least 12 consecutive months.
Several uterine conditions become more prevalent during the perimenopausal phase. Be sure to pay close attention to any abnormal symptoms such as:
Have you noticed your menstrual symptoms growing more pronounced and uncomfortable during perimenopause? Consider the following remedies:
Hormone therapy is capable of reducing bleeding, shortening periods, and alleviating PMS by hindering the buildup of your uterine lining.
Over-the-counter pain relievers
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What Are The Long
There are several conditions that you could be at a higher risk of after menopause. Your risk for any condition depends on many things like your family history, your health before menopause and lifestyle factors . Two conditions that affect your health after menopause are osteoporosis and coronary artery disease.
Osteoporosis, a âbrittle-boneâ disease, occurs when the inside of bones become less dense, making them more fragile and likely to fracture. Estrogen plays an important role in preserving bone mass. Estrogen signals cells in the bones to stop breaking down.
Women lose an average of 25% of their bone mass from the time of menopause to age 60. This is largely because of the loss of estrogen. Over time, this loss of bone can lead to bone fractures. Your healthcare provider may want to test the strength of your bones over time. Bone mineral density testing, also called bone densitometry, is a quick way to see how much calcium you have in certain parts of your bones. The test is used to detectosteoporosis and osteopenia. Osteopenia is a disease where bone density is decreased and this can be a precursor to later osteoporosis.
If you have osteoporosis or osteopenia, your treatment options could include estrogen therapy.
Coronary artery disease
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What Causes Irregular Periods
There are several factors that can cause irregular periods but for women approaching menopause they are most likely brought on by fluctuating hormone levels. This will typically happen between the ages of 45 to 55.
Estrogen and progesterone both play an important role in menstruation estrogen is responsible for thickening the uterine lining before ovulation and progesterone acts as a trigger to discard the uterine contents after ovulation if fertilization has not occurred.
Production of these hormones starts to decrease during peri-menopause, their levels often fluctuating wildly before they settle to a constant low. It is this fluctuation that creates irregular periods in menopausal women.
However, all women of reproductive age can experience cycle irregularities at some stage in their lives, that are not related to menopause. These can be the result of health conditions or lifestyle triggers so if in doubt professional health advice should be sought.