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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


  • I am soon to be 55 and last year I had my hormones tested and my doctor told me to be careful as I am ovulating like a 20 year old! Nice to know this equates with a long life. My auntie lived until 97 yrs old and lived on her own until 95.

    Cynthia on

  • I am 55, will be 56 in November. I still get my period. I was really happy to read this article. All my friends have gone through menopause even my friends who are younger.. From what I saw them go through..I’ll wait lol

    Lisa on

  • Elaine, if you are now having bleeding, it is likely a period, which means you have ovulated and need birth control protection. But at age 54 the likelihood of having regular periods is very low. Using a condom over the next few months for protection is advisable until you have a better understanding of what to expect. The Mirena has no influence on hormone production, it only affects the lining of the uterus (thinning the lining-leading to less/no bleeding). Now that it is out the uterus will respond to the hormone production of the ovaries and may result in periods if ovaries are ‘still on board’.

    Dr Barb on

  • I am 54 I had a Merena Coil fitted for years. Having had no periods at all whilst having it was like a godsend. I had it removed about two-three months ago.

    It had embedded itself into my cervix which was pleasant on removal, my GP said
    I might bleed afterwards but it should settle.

    I was worried about periods and pregnancy to which my GP said as the coil had been left over its time, the estrogen would have run out so in effect, having unprotected sex.

    After a few months i started having what looked like a period but dark dark brown and clotted. This went on for a week and half ish, then it started getting heavier and heavier. Have had to wear sanitary pads which I haven’t done in years.

    Elaine on

  • Shell, it is true that late menopause is an increased risk factor for breast cancer, but so is aging all by itself. It can be frustrating to navigate mammograms with dense breast tissue. Have you and your doctor discussed breast tomosynthesis, also known as 3-D Mammograms? We have more information about this tool on our podcast, which may help you and your provider make a screening plan for you. https://middlesexmd.com/blogs/the-fullness-of-midlife/finding-out-you-have-an-increased-risk-empowers-you

    Dr Barb on

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