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Should I be worried about late-onset menopause?

At what age do you expect menopause to occur?  How does it affect your health and cancer risk?

Menopause occurs when a woman’s ovaries stop releasing hormones. Naturally,  a woman’s production of estrogen and progesterone hormones decrease in her late forties, which may cause menstrual periods eventually stopping. The age where most women become menopausal is between 50 and 54 years. In this context menopause is defined as not having a menstrual cycle for 12 consecutive months. As the hormone levels decrease, this may come with symptoms such as hot flushes, headaches, insomnia, mood swings and depression. Some women don’t have symptoms at all. Others may have symptoms at varying severity for 5 to 10 years.

Age and menopause

There is no set age when menopause should start, but according to the Australasian Menopause Society the average age is 51. If a woman is 55 or older and still hasn’t begun menopause, it is considered late-onset menopause. Menopause that occurs before age 40 is called premature.  Up to 8% of women may have early menopause. Removal of both ovaries (bilateral oophorectomy) before the normal menopause is called “surgical menopause”. Menopause can also be induced by chemotherapy or radiotherapy to a woman’s pelvis.

meopause

Cancer risk and age at menopause

According to the American Society of Clinical Oncology, women who experience late-onset menopause have an increased risk of uterine and breast cancer. This is due to having an increased exposure to hormones such as estrogen. As women menstruate longer, they have more ovulations which also increases the risk of ovarian cancer. Women with a long reproductive life, menarche (onset of periods) before the age of 12 years and menopause after age 55 years have an increased risk of these hormone-dependent cancers. A pooled analysis of data from more than 400,000 women found for every year older a woman was at menopause, breast cancer risk increased by approximately 3%.

Benefits of late-onset menopause

It’s not all bad news, research findings suggest that later age at menopause and longer reproductive lifespan may result in longer life expectancy. Even though women who reach menopause later are at a higher risk for breast, uterine and ovarian cancers, women who go through menopause late are at a lower risk for heart disease and stroke.

A study of 12,123 postmenopausal women followed for 17 years found that age-adjusted mortality was reduced 2% with each increasing year of age at menopause. Though the risk of dying from uterine or ovarian cancer was 5% higher, ischemic heart disease was 2% lower for those with later menopause, and the overall effect was an increased lifespan. Life expectancy in women with menopause after age 55 years was 2 years longer than those with menopause before the age of 40 years.

Another study indicated women with longer reproductive years are more likely to live to 90 years of age. The study collected data from 16,251 participants, starting between 1993 and 1998 and followed for 21 years. Women who menstruated for more than 40 years were 13% more likely to reach age 90 years than those who had less than 33 reproductive years. Women who were at least 50 years of age when their menstrual cycles stopped were about 20% more likely to reach age 90 years than women who entered menopause before the age of 40 years.

Women who experience late-onset menopause also suffer less from osteoporosis, have stronger bones, and develop fewer bone fractures.

How do I decrease my cancer risk after menopause?

Late-onset menopause usually occurs because of a genetic predisposition. If your mother went through menopause late, chances are you may also. A study found that late menopause is not uncommon among obese women because fat tissue produces estrogen. If you are worried about your age and menopause exercise, eat a healthy diet, don’t smoke, and maintain a healthy body weight which can have a plethora of health benefits. Regular mammograms and Pap smears are also important for women experiencing late-onset menopause. Remember, pap smears have changed to the HPV test in December 2017.

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