Your periods as you get older
Our periods are affected by many factors, from age and body mass index to contraception, pregnancies, breastfeeding and menopause; they change over time. Below, Consultant Gynaecologist Narendra Pisal explains how these things can have an impact on hormone balance, and in turn cause period issues as we move through different stages of our lives.
The teenage years
The average woman starts her periods at around 11-14 years. It is normal to have irregular periods during the teenage years as the ovulation is still sporadic and unpredictable. It can take a few years (until the early 20s) for regular ovulation to establish and for periods to develop a particular pattern.
Twenties and thirties
This is a more stable period for the menstrual cycle and the periods are often regular and predictable.
If you’re on birth control, this can affect your periods. Read our blog for more information on periods and contraception here.
A missed period or late period can occur because of several reasons or sometimes for no reason at all. The common causes are:
- Pregnancy: If there is any chance of pregnancy at all, please do a pregnancy test. You should do this even if you are using contraception.
- Polycystic ovaries: Polycystic ovaries are common and occur in around 22% of women. Some women with polycystic ovaries can also have anovulation (lack of ovulation) and this can lead to a late or missed period. A scan and blood tests may be necessary to make this diagnosis.
- Hormonal imbalance: Thyroid hormone problems or pituitary (a gland in the brain) hormone issues can cause delayed or absent periods. Your doctor will be able to check for this.
- Eating disorder: Anorexia can cause reduced body fat and can affect ovarian function leading to late or even absent periods.
- Extreme exercise: The same can happen with a lot exercise. Many of the Olympic athletes often miss their periods due to reduced body fat.
- Perimenopause or menopause: Cycles can often be delayed around the time of menopause. This is because of unpredictable ovulation and ovarian function.
- No cause: Sometimes, periods can be late due to no obvious reason. Stress or long distance travel or some medications can affect the cycle too. If pregnancy is ruled out, it is OK to wait for a few more weeks before seeing a doctor. Keep a record of your period dates and any other symptoms you may have.
Thirties and forties
If you’ve had a baby, your periods will change afterwards.
- Breastfeeding stops the periods for up to twelve months. One can still get pregnant while breastfeeding, so it is best to use some form of contraception.
- Periods often improve after delivery. The cervix is more open and hence the periods are less painful.
- It is not uncommon for conditions such as fibroids or polyps to develop and cause period problems. So heavy, prolonged or irregular periods should always prompt a doctor’s visit.
As you approach peri-menopause in the mid-forties, periods can become heavier and more frequent (or sometimes even more spaced out). Whilst cycle length can vary, bleeding between periods and prolonged or heavy periods should act as red flag symptoms.
Fifties and beyond
Menopause is the period in a woman’s life when menstruation ceases. In normal circumstances this usually occurs after the age of 45.
During this time ovarian function declines and periods become irregular, unpredictable and eventually stop. This decline in ovarian function means the decreased release of hormones oestrogen and progesterone and this change in hormone level causes menopause symptoms such as hot flushes, night sweats, mood swings, lack of libido and vaginal dryness.
Menopause is a retrospective diagnosis and is made 12 months after the last period. The symptoms above can point towards onset of menopause and can sometimes affect your life in a major way. It’s best to see your doctor to see if hormone replacement therapy may be a solution for you.
If you are concerned about any changes in your period it is best to seek medical advice with either your GP or gynaecologist.