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.


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.

If you wish to receive regular information, tips, resources, reassurance and inspiration for up-to-date care, that is safe and sound and in line with latest research please subscribe here to receive my blog, or like Dr Andreas Obermair on Facebook. Should you find this article interesting, please feel free to share it. 

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  • Di 18/10/2023 9:16pm (4 months ago)

    I'm glad I came across this article and was able to read the comments because I'm so worried. 55 years old, and my period started after not having any since age 54. I did see it after my 54th bday but its been months so I'm shocked and disappointed to see that it came back. All kind of scenarios playing in my mind, will schedule an appointment with my gyno as soon as it stops. Normally for the first 3 days its a regular good flow, not heavy, then spots for the last 2 days so i'll see if anything changes. So far it's not heavy, color looks rich like before also, so i'll be checking to see how long it's going to last. Hoping for the best, cause i'm not sure if at 55 yrs old I should be having periods. Last pap smear was good. I do have fibroids though.

  • Tina 22/08/2023 3:30pm (6 months ago)

    I am 55 and 3 months old. I started my periods at age 14 I think. I remember it being later than most of my friends. I had Polycystic Ovary syndrome in my mid to late 20’s but did go on to have 4 wonderful children. With the expecting of missing a month here or there, still get a period every month. I had a uterine biopsy last year and the year before and am pleased to say that all was well with both of them. I intend to keep in contact with my OBGYN whilst going through this phase of my life. I have been offered a uterine oblasion Which I decided against as it did seem this time last year that my heavy periods were easing up. My mum, grandmother and sister all had hysterectomies in their late 40’s so I have no point of reference regarding whether this is the norm for my family. However, my Grandmother lived until she was 93 and my mum is now 83 and still going strong, so I hope that I am as lucky as them!

  • Lorraine 01/08/2023 12:57pm (7 months ago)

    I'm still on my menstration cycle at 50

  • Ttudi 23/07/2023 7:00pm (7 months ago)

    I am nearly 55 and started my periods age 9. I recently went for an internal ultra sound and was told my uterus is still very youthful. So no menopause anytime soon.
    I am under the family history clinic for breast cancer as there have been 4 primary breast cancers between my mother and sister.
    I am on the mini pill so don't actually have periods but have been told it can help with menopause symptoms if any come

  • Naomi 07/07/2023 11:05pm (8 months ago)

    It was so so helpful to read all the comments and knowing I’m not alone. I am 57 still getting my period. My last period is still on going since a month ago , not stopping yet. Under the care of a GYO. though. Hang in their ladies ,it is just of question of when will it ever end!

  • Pat 23/04/2023 10:35pm (10 months ago)

    I’m 54 in 3 months I have never missed a period started at 14 I have had 3 children and all. my life up to this day my periods are very regular/ consistent to the month the day have no menopause symptoms at all this article I think I will show my GYN at next visit

  • MaryAnn 23/04/2023 8:43am (10 months ago)

    I am 62 years and still not in menopause. I started menses at age 11, almost age 12I have had endometriosis since my teens and infertility but did have one child. I took fertility drugs for 7 years. I have had a biopsy and multiple hormone level checks with normal results. I am also obese but trying to lose weight. Thank you for addressing late onset menopause!! Most sources say age 57 is the oldest. Both my mother and grandmother had hysterectomies before age 50 so no idea regarding family history.

  • TYLEAH DUNN JOSEPH 29/03/2023 6:28pm (11 months ago)

    Loved the article.

  • Lee 26/03/2023 5:27pm (11 months ago)

    I’ve had Monthly periods through age 54, (except during 3 pregnancies) After 5 months w/out a period, I thought it was the beginning of the end, but just started a period! With this reset, I’m looking at being a minimum of 56 before I enter menopause.

  • Angie 22/01/2023 6:39am (13 months ago)

    This article was very helpful, and reassuring. I’ll be 54 in 2 months. Never missed a period except for the pregnancies of two children. I’ve been having my period since I turned 11, so like many other commentators here am very tired of it. Reading the cancer risks are a little concerning. I haven’t been on the pill since age 25, so hopefully that makes a difference. You’d think through evolution and biology my body would learn that I don’t want to get pregnant at this age lol. Go away period! Hugs to you all!

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