Menopause — the end of a woman’s menstrual cycle — is a natural process which happens when the ovaries stop producing eggs and releasing hormones. While there’s no set age when menopause should start, a woman usually enters menopause between the mid-40s to mid-50s. If a woman, 55 or older, still hasn’t entered menopause, it is called ‘late-onset menopause’.
According to the Center for Menstrual Disorders and Reproductive Choice, the average age for menopause is 51. “The age at which women attain menopause is usually between 45 to 55 years. Various factors determine the onset of menopause which include race, ethnicity, education, nutrition, parity, active smoking, use of oral contraceptives, physical activity and body mass index,” Dr Savitha Shetty, Senior Consultant Obstetrician and Gynaecologist, Apollo Hospitals, Sheshadripuram, Bangalore, said.
A woman may experience late-onset menopause due to a range of factors. Dr Gunjan Gupta Govil, Founder and Chairman, Gunjan IVF World Group listed a few of them:
Genetics: Genetics determine the onset of menopause about half of the time, she explained. “If your mother entered menopause late then you may also have late-onset menopause.”
Obesity: According to Dr Govil, overweight and obese women have a 50 per cent higher risk of late menopause than other women. “Fat tissue produces and stores estrogen, which delays its depletion and leads to late-onset menopause,” she explained. According to a study published in the International Journal of Obesity and Related Metabolic Disorders, late menopause is common among obese women as fat can produce estrogen.
Thyroid problems: A dysfunctional thyroid gland or any other problems with this gland can lead to a range of hormonal disorders in women. These hormonal problems could be the reason for late menopause.
Menstrual cycle patterns: Women who started menstruating late, had lifelong irregularities, or have naturally high estrogen levels may experience later menopause.
Pregnancies: The timing and number of pregnancies you’ve had, too, may delay the onset of menopause in many women.Late-onset menopause is fairly common with around 5 to 10 per cent of women facing this condition, Dr Shetty highlighted. However, it’s still a cause of concern as “women who reach menopause later are at a higher risk for breast, uterine and ovarian cancers,” Dr Mannan Gupta, Managing Director and Infertility Specialist, Elantis Healthcare, New Delhi, said.
The American Society of Clinical Oncology, too, came to a similar conclusion as it stated that women who menstruate for many years have many ovulations and increased exposure to estrogen, increasing the risk of such cancers.
Dr Shetty added that such women are also at an increased risk of endometrial cancer, ovarian tumours and genital tract malignancy. “It is absolutely necessary to have yourself examined by a gynaecologist and get necessary screening tests to rule out the possibilities of these health risk occurrences,” she said.
While the risk for breast, uterine and ovarian cancers increase with late-onset menopause, women who go through menopause late are at a lower risk for heart disease and stroke, Dr Govil said. “Women who experience late-onset menopause also suffer less from osteoporosis, have stronger bones, and develop fewer bone fractures,” she added.