The Basics of Menopause

The Basics of Menopause (<i>cont'd</i>)

Everybody's menopause is unique

Just as every woman's body is unique, your menopause experience will be a highly personal one. For example, 15 to 20 percent of women experience no physical symptoms at all, except the end of their menstrual periods.

Some women go through menopause before age 51 and some experience it a bit later. Early menopause is defined as occurring at any age younger than age 40 or 45. Early menopause can occur naturally, but premature menopausal symptoms may signal an underlying condition, so it is important to discuss any symptoms with your health care professional. Menopause can occur as early as your 30s and, rarely, as late as in your 60s. However, there is no correlation between the time of a woman's first period and her age at menopause. In addition, age at menopause is not influenced by race, height, the number of children a woman has had or whether she took oral contraceptives for birth control.

What does influence the time of menopause? Genetics are a key factor. And, women who smoke cigarettes experience menopause two years earlier, on average, than nonsmoking women.

About six years prior to natural menopause, typically in a woman's late 40s, menopause-related changes begin. Physical changes triggered by hormonal fluctuations during this time frame include irregular menstrual patterns.

One of the most common and annoying symptoms you may notice during your 40s is that your periods become irregular. They may be heavy one month and then very light the next. They may get shorter or last longer. You may even begin to skip your period every few months or lose track of when your periods should start and end. These symptoms are caused by irregular estrogen and progesterone levels. Levels of hormones vary erratically and may be higher or lower than normal during any cycle. For example, if you don't ovulate one month — which is common for women in their late 40s — progesterone isn't produced to stimulate menstruation and estrogen levels continue to rise. This can cause spotting throughout your cycle or heavy bleeding when menstruation does start.

One note of caution: although irregular menstrual periods are common as you get closer to menopause, they can also be a symptom of uterine abnormalities or uterine cancer. If your periods stop for several months and then start again with heavy bleeding or if you start bleeding after menopause, consult with an obstetrician/gynecologist as soon as possible for an evaluation. Irregular bleeding can also be a symptom of cervical cancer which should be picked up by a Pap test (see screening recommendations below). Be sure to mention any menstrual irregularities during regular check-ups. A uterine biopsy or vaginal ultrasound are the only ways to evaluate if irregular symptoms are abnormal.

Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)