Menstrual cycle changes to expect as you age

Women expect that as the decades go by, changes will occur.  Hair turns gray, wrinkles appear, metabolism slows down, and periods also can evolve too.  What a woman experienced as a pubescent girl when her first menstrual cycle arrived, will begin the process of years of numerous transformations over time.

Menstruation and hormones

 Thanks to the “female” hormones a woman’s body produces, menstrual cycles are dictated by these chemicals which can change during phases of a woman’s life. 

Starting with follicle-stimulating hormone, this begins the process of getting an egg from the ovary ready to be released. Luteinizing hormone is what makes the egg be released from the ovary.  The hormone progesterone is released by the ruptured follicle (which has released an egg) which closes and become a corpus luteum that secretes increasing amounts of progesterone. While all of this is occurring, the hormone estrogen is responsible for the buildup of the uterine lining or endometrium getting the uterus ready to accept a fertilized egg. When a released egg is not fertilized, the levels of estrogen decrease which loosens the support for the built up lining which then separates from the uterine lining resulting in menstruation.

Due to all the various hormonal release going on each month, every woman has her own unique menstrual cycle that can and often will fluctuate over her lifetime.  However, here are some generally accepted characteristics of a normal or healthy period:

·      Typical menstrual cycle between periods is 24 to 35 days in length

·      Monthly bleeding during a period usually lasts between four to eight days

·      No more than 80 milliliters (about 2.7 ounces) of blood is lost during one period.  Any woman who experiences soaking through a pad an hour for more than two hours in a row, needs to discuss this with her gynecologist.

Changes to expect over the decades

·      Teenage years 

Menstrual cycles during the teen years can be erratic.  Fewer than 10% of U.S. girls start to menstruate before 11 years of age, and 90% of all U.S. girls are menstruating by 13.75 years of age, with a median age of 12.43 years.  

It is normal in the beginning for a young woman’s periods to be irregular but after about 2-3 years, her periods should be coming around once every 4-5 weeks.  Periods will vary between teens but usually they last about 5 days in length with some girls getting their period a little less or more often. 

Many teen girls experience menstrual cramps also known as dysmenorrhea.  Dysmenorrhea means “difficult or painful periods” caused by uterine contractions.  Not all teen girls will have menstrual cramps but for some, their monthly period can be accompanied by cramps, painful enough to be absent from school or to miss sporting or social events.

·      In the 20s

Usually by the time a woman arrives into her 20s, her periods have become more normalized and it is not unusual for any painful cramps during her teen years to often go away after a she has a baby.  This can be caused by a number of things but since the cervical opening becomes a little wider after giving birth, the menstrual flow comes out without requiring as strong of uterine contractions. However, most women are using some form of birth control during this phase of their life and going on or off birth control can cause changes in the flow or length of her cycle. 

Even though a woman’s cycle may become more regular during her 20s, she may begin experiencing premenstrual syndrome (PMS), more mild cramps if any, and breast tenderness.

·      In the 30s

The decade of the 30s should bring more predictability and consistency of the menstrual cycle. But, after having had a baby or several, some women’s periods might be different – heavier, longer or sometimes more painful while other women may see their periods improve. Women, who suddenly are noticing a heavier flow or more intense pain than usual cramping, may be a sign of a bigger issue. Benign growths called uterine fibroids might be the cause leading to heavier bleeding.  Another possible menstrual cycle change affecting between 3% and 10% of women of reproductive age is endometriosis.  Endometriosis is a disorder in which tissue that normally lines the uterus grows outside the uterus causing pain with periods along with lower abdominal pain or pain with sexual intercourse.

·      In the 40s and beyond

As a woman enters into the decade of her 40s, this marks the beginning of perimenopausal hormonal fluctuations, which are precursors to menopause. The ovaries slow down production of estrogen leading to shorter and lighter periods, or that come less frequently. However, estrogen level fluctuation can also lead to a woman experiencing missed periods, a heavier flow, and spotting between periods.  Keep in mind, every woman is different – what may happen to one woman will be completely opposite of another.  All women during this phase or erratic menstrual cycles should remember they can still get pregnant.  If they wish to avoid this scenario, they will need to still be practicing some form of birth control.

Menopause occurs when a woman’s period stops completely for 12 consecutive months.  For most women this happen in their late 40s or early 50s, with the average age being 51. 

No matter what a woman’s age, if she experiences any unusual symptoms associated with her menstrual cycle, it’s advisable to see their doctor. Irregular periods or drastic changes to their flow could be a sign of thyroid issues, polycystic ovarian syndrome, or a number of other (treatable) health concerns.