Diminishing levels of progesterone and estrogen, which are the two hormones ovaries produce for controlling the menstrual cycle, can result in changes in periods. These changes are an indication of the impending menopause. Most women in their mid-30s or early 40s don’t anticipate the symptoms of menopause transition which include menstrual bleeding that become unpredictable with each passing day and hot flashes that seem like fever. The period changes after 40 can manifest slowly and seem more like PMS whose signs are anxiety, weight gain, depression, crankiness, exhaustion and sleeping troubles. Some changes might even be a sign of a serious condition that does not involve menopause.
In order to understand the changes in periods which occur after 40, it is important to learn about menopause and its various stages. The first stage of menopause is perimenopause.
About Perimenopause Symptoms
Perimenopause has an average length of about 4 years. However, some women might not experience this stage of menopause for more than a few months, while for others it might last for up to 10 years. If a woman goes without having a period for over a year, then it is a sign of the conclusion of the perimenopause stage.
The following are some of the symptoms that are experienced by women in perimenopause:
Tenderness in the breasts
Severe premenstrual syndrome
Diminished sex drive
Periods that occur irregularly
Dryness in the vagina that causes discomfort when having sex
Leakage of urine when sneezing and coughing
Increased need to urinate quickly (Urinary urgency)
Period Changes After 40
Cramps During the Menstrual Cycle
Dysmenorrhea or menstrual cramps are common period changes after 40 experienced by women during their monthly periods. They are usually accompanied with lower abdominal pain. Endometriosis is supposed to be the cause of dysmenorrhea which is a benign condition resulting in the scarring of the pelvic organs and the development of chocolate-colored cysts in the ovaries. Oral contraceptive pills and analgesics are common forms of treatment while keyhole surgery is an option that is used in case of big cysts.
Heavy blood flow during the menses is known as heavy periods or Menorrhagia. It involves passing of blood clots during the initial days of the period. Heavy periods before menopause can result in fibroids which could then lead to anemia and cause symptoms like fatigue and lethargy. The severity of the symptoms and number and size of fibroids decide the treatment option to be used. Treatment options include NSAIDs, contraceptive pill and tranexamic acid. Surgery to remove the fibroids or the womb is also an option and so is the use of levonorgestrel-releasing intrauterine contraceptive device.
Periods Occurring In an Irregular Fashion
28 days is the usual time gap between two periods. Last periods before menopause can become irregular and start occurring earlier like every fortnight or infrequent like not occurring for over 3 months. Menopause or dysfunctional uterine bleeding can be the reason of irregular periods. Menopause is characterized by insomnia, hot flashes and mood swings and is reached by most women in their 50s. These symptoms are pure physiological and start around two years before menopause. Osteoporosis is caused by long-term menopause which is why calcium supplements and exercise is recommended for women over 50.
Bleeding During the Menstrual Cycle
Irregular bleeding which occurs before or after the period is called intermenstrual bleeding and it is among the period changes after 40. This is not like irregular menstruation. Women suffering from intermenstrual bleeding must get a pap smear to rule out cervical cancer. Moreover, ultrasound scan of the pelvis must be done to check the womb and hysteroscopy dilation must be performed to check for uterine cancer. Treatment for cervical or uterine cancer depends on how far the cancer has metastasized and generally involves chemotherapy and radiation surgery.
When to See a Doctor for the Changes
It is perfectly normal during perimenopause to have irregular periods. However, there are other conditions that might change the course of the menstrual bleeding. See your doctor immediately if you notice any of the following situations:
The periods either have blood clots or they are very heavy.
The periods stretch longer than normal.
Spotting occurs between periods.
Spotting occurs after sex.
There is no sizeable gap between periods.
Blood clotting issues, hormone problems, fibroids, birth control pills, pregnancy and occasionally cancer are some of the reasons that might cause abnormal bleeding.
What Body Changes Will You Have After 40?
Increment in Weight and Lowering of Muscle Mass
It is common for both men and women to start losing muscle mass as they age. Women over 40 tend to lose half pounds of muscle per year. Because of the loss of muscle, the resting metabolism declines resulting in less burning of calories and weight gain.
Loss of Bone
Bone density remains more or less the same until women reach the age of 35 years. However, after crossing this age, women lose 1 percent of bone each year. This loss of bone can be stopped by weight bearing exercises and strength training. It can even help in making bones denser and stronger.
Cancer in Breasts
National Cancer Institute notes that women in their 30s have a 1 in 233 chance of developing breast cancer but during the years from 40 to 49, it increases to 1 in 69. Although the US Preventive Services Task Force recommends that women have regular mammograms after the age of 50, Mayo Clinic researchers are adamant that women start having them when they turn 40.
Other Issues Concerning Hormones
With age, the thyroid gland becomes less effective and starts producing too much or too low amount of thyroid hormones resulting in symptoms like fatigue, weight loss, temperature intolerance, diarrhea and constipation. The processing of insulin by pancreas is also affected by aging which might lead to diabetes.