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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


  • Arundhati, you should contact your doctor. Follow-up is necessary whenever there is unexpected bleeding.

    Dr Barb on

  • I am 51yrs. I did not have periods after 2016. Recently in Nov 2020, i am experiencing periods again. Please help. Am very much tensed.

    Arundhati on

  • Sonia, any dramatic changes to your cycle or health should be evaluated by your physician. Many are providing more virtual visits in this time. Please reach out to your office and share this with your provider.

    Dr Barb on

  • I am 56.. From 2013, I am having periods off and on, with real periods and spotting and sometimes slimy mucus type bleeding, from heavy to scant, sometimes more days and sometimes few..I had my last period before 7 months in Feb 2020, now in Oct 2020 and again after 10 days it showed up again with very scanty spotting type and little bright red blood. This time feeling tired, headache and stomach cramps…Please help.

    Sonia on

  • I am going to be 55 years old in 3 months. I started with sleeplessness at 48 years old which moved to joint pain, head aches, hot flashes, dry skin, break outs, extreme breast pain and swelling, mood swing, anxiety etc. the list goes on. I have had almost every symptom on the list. It is a living hell. I had EASY pregnancies and births. Never had PMS and was lucky to only have periods every 6 weeks before the start of all of this. I miss a couple of months and sometimes 3 months but I have many symptoms listed the entire time. There is no break with or without a period. The only difference is I have more symptoms when I get my period and all the symptoms that stick around when I don’t have a period only intensify when I do get it. At this point the earliest I could go through menopause is 56 years old. My mom and sister were done by 50 and I smoked up until 3 years ago so reading that you follow your mother’s pattern and smoking can lead to an earlier menopause isn’t true or at least in my case it’s not. I don’t wish this on anyone. Low sex drive is horrible to deal with and daily breast swelling and discomfort can really effect your mood horribly. I just want my life back. I want some energy. No aching when getting up etc. Im starting to feel like I may never feel normal again. I am extremely healthy. Never took medication. Perfect weight good blood pressure etc. I could care less about the extra estrogen. All that means is I’m increasing breast cancer risk and like I read on an earlier post go to a dermatologist for wrinkles. What good is the so called estrogen benefit if for the past 6 years I feel so horrible and can’t even enjoy my days as I should. I’d rather feel good now in my younger years then get a few extra later on in my geriatric years. Sorry ladies I have not one positive thing to say about going thru menopause on the later side. With that said I love how they say this is a natural process. There is nothing good about this and for some women their so called natural process sure doesn’t feel natural. I just want to add I am the furthest from a whiner or drama queen. I never go to a doctor unless I am practically dying. I had both children with no medication. I have a higher then normal tolerance for pain but this has really knocked me down physically and mentally. I wish you all the best during your journey and pray yours is nothing like mine

    Sue on

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