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Late-Onset Menopause: Should I Be Worried?

Late-Onset Menopause: Should I Be Worried?

by Dr. Barb DePree MD


Maybe you were that girl. The last one to get her period. Maybe it’s déjà vu all over again as you wait… and wait… to cross the reproductive finish line. Menopause. It’s certainly been a thing for your girlfriends, but you only know about it secondhand.

Do not fret. Recent studies confirm a few educated guesses about women who begin menopause late, and most of it is good news for you.

Most women reach menopause between 45 and 55; the average age is 51. Menopause officially occurs one year after your last period. Late onset is considered anytime after age 55, at which point, a woman has been producing estrogen for at least 40 years, depending on when she began menstruating.

Factors that affect when a person begins her reproductive years and reaches menopause have a little to do with heredity and occasionally may be related to do with environmental factors. Those who smoke or live at high altitudes, for example, tend to begin menopause early. Most often, it occurs… well, when it occurs.

As any menopausal woman knows, estrogen is an important hormone that regulates lots of systems in your body, from your brain to your skin to your reproductive organs and keeps them running smoothly. That’s why the absence of estrogen in menopause sends you into such a tailspin and requires several years to adjust to.

 

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We know that estrogen has protective effects on our bones and our heart. Two large-scale, recent studies confirm that women who reach menopause late, and thus are exposed to estrogen for longer, also tend to have fewer cardiovascular problems, such as strokes or heart attacks.

For example, one very recent study looked at longitudinal data for over 3,000 women, specifically examining the reproductive years—the total number of years from first menstruation to menopause—in women age 60 or over. They determined that “every one-year increase in reproductive duration… was associated with a 3% reduction in a woman’s risk of angina or stroke.”

Women with more reproductive years are also at lower risk for osteoporosis and have fewer fractures. Since estrogen keeps skin smooth and supple, late menopause tends to keep your skin smooth and your vagina lubricated.

If you are still menstruating at 55, please continue your diligence with regular gynecological exams and screenings, while you enjoy your supple skin and healthy heart. I’ve seen more vulvar cancers in the last three months than in the previous 15 years, and these were among women who hadn’t had a pelvic exam in years.

Overall, you’ll probably live longer, according to two large-scale studies. A 2005 study followed 12,134 Dutch women for 17 years and found that, when all the risk and protective factors were considered, “the net effect was an increased life span.”

Another study examined the effect of late menopause on the chances of living to age 90. These researchers selected a diverse group of post-menopausal women from the Women’s Health Initiative, the massive study of 16,251 women that ran from 1993-1998, and followed them until 2014. Of the 55 percent of women who reached age 90, odds of survival for those with over 40 reproductive years were 13 percent higher.

Neither lifestyle, weight, reproductive factors, contraception use, nor hormone therapy nor significantly altered these survival rates. The determining factor was the number of reproductive years.

“Later age at menopause is associated with better health, longer life and less cardiovascular disease,” said Ellen B. Gold, a professor emeritus in public health at the University of California, Davis, School of Medicine in this article.

So buckle up, late bloomers, it might be a smoother, longer ride than you thought. 


151 comments


  • Lovelyn: Pregnancy tests are highly accurate. Repeating another now could be further confirmation of no pregnancy. We do recommend some form of BC until the full 12 months of time has passed since the last period, you can have a rare ovulatory event. If you ovulate later in perimenopause it isn’t preceded by a period so you cannot use any method or rhythm or calendaring. On the other hand, the quality of egg formation/ovulation in late perimenopause is very poor so the likelihood of conception even if you were to ovulate is very low.

    Dr Barb on

  • I am so glad to have found this site. The information I have read on the internet is confusing and disheartening. It says once you have gone 1 full year without a cycle, then you can consider yourself in ‘menopause’, Then it turns right around and tell you if you go 6 months without a cycle, and then start your cycle, then you need to be seen my a GYN. Which is it? :-/

    Sheila on

  • I am 53. I think I have entered the perimenopausal stage. I have hot flushes at night, less or disturbed sleep, dry vagina and less interest in sex. My last period was in September 2019. In February 2020, I had sexual intercourse with my husband and considered it safe since I did not have periods for consecutive four and a half months. I somehow felt a little uneasy with anxiety about the possibility of pregnancy since we didn’t use contraceptives. To ensure myself that I am not pregnant I took a home pregnancy test in April 2020. It showed a negative for pregnancy with only C having a pink line. Can I be sure that I have not conceived? I don’t want any pregnancy at this age. Please tell me doctor if the test result can be trusted. I am fine and strongly think that I am not pregnant. Would greatly feel relieved if you share your views Doctor and assure me that I am not pregnant. Thanks.

    Lovelyn on

  • On my 50th b day, the anatomy check ultrasound revealed me in the middle of ovulating and on the dude I told her I’m due to ovulate. My question is this. Sinner now I’m 50.5 abs have an extremely predictable 29 day cycle, the amount of bleeding is same since was 13, n my tests show all normal hormone levels, can I still get pregnant?

    Karenwslp on

  • I’m glad I am not the only one in this boat! I am 57 and have gone 3-6 months between periods. This last episode I have gone 6 months and then bam – now bleeding again and sore breasts. Previous to this episode, I have gone from bleeding regularly for 3 months, then stop for 3-4 months and then nothing for another 3-4 months.

    I did have an ablation in 2017, but after a couple months continued to have regular monthly cycles until the last year or so.

    I don’t have family history to compare this to since my mom, my aunt and my younger sister all had hysterectomies before the age of 50. I figured with the hot flashes I have that the end was in sight, but after reading this site and the comments, I will hang on for the ride. I just hate how it interferes in our active sex life and having to be prepared for the unexpected/untimed bleed when we travel.

    Dawn on

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