What Changes in Your 40s?

In your 40s, your menstrual cycle may undergo significant changes as you approach perimenopause, the transitional period leading up to menopause.

Perimenopause typically lasts about 4-8 years and ends when a woman has not had a menstrual period for 12 consecutive months, marking the onset of menopause.

The Early Stage of Perimenopause

During the early stage of perimenopause, the ovaries gradually produce less estrogen. You may notice the following symptoms:

• Irregular periods: One of the first signs of early perimenopause is a change in menstrual cycle regularity. Periods may become shorter, longer, or the interval between periods may change.
• Mood changes: Hormonal fluctuations can cause mood swings, irritability, and increased emotional sensitivity.
• Hot flashes: Some women begin to experience hot flashes, though they may be mild and infrequent at this stage.

The Late Stage of Perimenopause

As perimenopause progresses into menopause, you may experience more significant hormonal changes and more pronounced symptoms:

• Missed cycles: Your cycles may become more erratic, with some cycles being skipped altogether and can be for months at a time.
• Abnormally heavy bleeding: A skipped period can also cause the uterus lining to build up, leading to abnormally heavy bleeding in the next cycle.
• Vaginal dryness: Decreased estrogen levels can also lead to vaginal dryness, causing discomfort during intercourse and increasing the risk of vaginal infections.

An increased flow and prolonged periods particularly in your 40s and 50s can also indicate underlying conditions such as fibroids. Fibroids are often coupled with other symptoms such as pelvic pain and a feeling of pressure or fullness in the lower abdomen. If you experience these symptoms, consult with your ob-gyn. 

How Do I Know if My Bleeding Is Normal?

While some irregularities are expected, you should still consult with your ob-gyn about your bleeding changes. Abnormal bleeding sometimes can be a sign of underlying conditions such as polyps, endometrial atrophy, or hyperplasia. The risk of ovarian and endometrial cancer also increases with age, particularly for women in their 40s.

Consult with your ob-gyn immediately if you notice bleeding after menopause.