This article reviews what menopause is, its symptoms, the factors that affect timing, and when to notify your healthcare provider.
What Is Menopause?
Menopause occurs when women have not had a menstrual cycle (period) for 12 months in a row. It is considered the permanent end to menstruation. While menopause usually comes naturally, surgical removal of the ovaries, some medical treatments, and certain diseases can cause premature menopause.
During perimenopause, the time leading up to menopause, the levels of hormones produced by the ovaries decrease. The first symptom is typically a change in a woman’s menstrual cycle.
Signs of Late Menopause
Natural menopause is a gradual process that happens over several years. While most women reach menopause by 51 or 52 years old, this is an average—everyone’s timing is different. If you are a woman in your late 50s or early 60s who is wondering why you still have a period, you may be experiencing late-onset menopause.
For women who are experiencing signs of perimenopause, menopause may be just around the corner. The first sign is lighter or heavier, skipped, or irregular menstrual cycles. Other symptoms that occur in the later stages of perimenopause include:
Hot flashes Night sweats Vaginal dryness Decreased sex drive Weight gain Mood swings Trouble sleeping Fatigue Headaches
Insomnia (trouble sleeping), hot flashes, and vaginal dryness may last several years after menopause.
Causes
The following factors may affect the age a woman enters menopause:
Smoking: Smokers typically enter menopause a couple of years earlier than nonsmokers. Particles in cigarette smoke cause the ovaries to stop functioning and to produce less estrogen. Women who smoke more than 14 cigarettes per day enter menopause almost three years before nonsmokers. Alcohol consumption: Some studies show an association between drinking alcohol regularly and later menopause. More research is needed regarding amounts and types of alcohol that affect menopausal onset. Birth control: Research suggests a link between having used oral contraceptives (birth control) and a late start to menopause. It is unclear if the delay is because the pill helps mask symptoms or truly delays the process. Some healthcare providers believe the pill makes the transition easier or less noticeable rather than causing the delay. Food choices: Several foods can affect the timing of menopausal onset.
Risk Factors
If your mother experienced menopause later in life, there is a chance you will as well. Other factors include weight, menstrual cycle patterns, estrogen levels, and pregnancies.
Diets high in fruits, vegetables, and protein may cause delay. Meat-eaters are more likely to experience delay than vegetarians. High intake of oily fish and fresh legumes may delay onset by 3. 3 years. Higher intake of vitamin B6 and zinc may delay onset by about six months. Carbohydrates such as refined pasta and rice are associated with earlier menopause.
Genetics: Genetics determines the onset of menopause about half of the time. This factor is most relevant if your mother entered menopause naturally rather than from surgery or an illness. Obesity: Overweight and obese women have a 50% higher risk of late menopause than other women. Fat tissue produces and stores estrogen, which delays its depletion. Menstrual cycle patterns: Women who started menstruating late, had lifelong irregularities, or have naturally high estrogen levels may experience later menopause. Pregnancies: The timing and number of pregnancies you’ve had may delay onset.
When to See a Healthcare Provider
If you are still experiencing a menstrual cycle in your late 50s or early 60s, make an appointment with your healthcare provider. During your appointment, you may be asked about your menstrual cycle and symptoms. This will help your provider identify if you are in menopause.
Experiencing your first pregnancy later in lifeHaving one of your children later in life Having at least one child Multiple pregnancies
They may also check your blood for levels of follicle-stimulating hormone (FSH), which helps control the menstrual cycle, or estradiol, the main form of estrogen (primary sex hormone in women). FSH levels fluctuate, so these tests may need to be traced over time. FSH levels in blood fluctuate during perimenopause and decrease after menopause.
Summary
Menopause is when a woman stops having her period permanently, for 12 months in a row. While most women reach menopause by 51 or 52, this is an average and varies. Late menopause can occur in a woman’s upper 50s or early 60s. Genetics, lifestyle, menstrual cycle patterns, and medications are factors that affect timing.
A Word From Verywell
The timing of menopause is different for all women. If you’ve reached your late 50s or early 60s and are still having a period, you may feel concerned. If this is the case, talk with your healthcare provider. Together, you can discuss the possible reasons for the delay and your provider can order tests if needed. Ruling out concerns can help you feel more comfortable about late-onset menopause.
