Your period through the decades: What's normal?
It's common for your menstrual periods to change throughout your reproductive years. Here's how to tell whether those changes are normal or not
By Marcia Kaye
Your period in your 40s
What’s typical: Longer, shorter, heavier, lighter—change is the name of the game now as you head into perimenopause, the six to 10 hormonally haywire years that precede the end of menstruation. You may find that your periods are coming every three weeks or, conversely, arriving further apart. Then, bingo, you’re suddenly back on schedule for a few cycles—until you go off-track again. Your PMS symptoms could intensify, with some cycles worse than others. Same with cramps; you may now experience pain that radiates into your back and down your thighs, likely due to estrogen levels spiking and plummeting while ovulation becomes intermittent.
As you get older, you’re more likely to develop one of the annoying but generally benign conditions that subside after menopause. Adenomyosis occurs when the uterine lining grows into the uterus’s muscular wall; while it’s harmless, it may cause very painful, prolonged, heavy periods. It’s different from endometriosis but the two may co-exist, and both improve after menopause when the condition may stop progressing, eliminating symptoms. Adenomyosis is especially common among women who have had C-sections. If over-the-counter pain relievers and heating pads don’t help, seek medical advice, says Tomiuk.
One in four perimenopausal women has flooding—a heavy, gushing flow that is sometimes accompanied by clots. It’s a medical problem only if you’re soaking more than one pad or tampon every hour for several hours and if clots are larger than a loonie.
While about half of all women under age 50 have fibroids—benign growths in the uterus that are most common in your 40s— “fibroids rarely cause heavy flow,” says Prior. She adds that in a study of 91 women who had had hysterectomies because of heavy bleeding, only six showed any evidence that fibroids may have been a contributor.
Causes for concern: By age 43, Pat Chiappetta found that her periods were lasting only a day or two and were pain-free but involved heavy bleeding that even extra-absorbent pads couldn’t contain. “Once when we had company over, I stood up and I had soaked the chair,” recalls the public health nurse from Aurora, Ont. “It was most embarrassing.” Over the next several months she became increasingly exhausted, despite taking iron supplements for anemia. On three occasions she passed out and was taken to three different hospitals. Each time, doctors ruled out heart problems and sent her home.
Finally she received a referral to a gynecologist, who diagnosed her with hyperplasia (an unusually thickened uterine lining) and performed an in-office uterine ablation, scraping away the lining. “Almost overnight, I went from tripled-up maxi-pads to panty liners.” Chiappetta, now 53, adds, “I’m a nurse and I should have known better, but no doctor ever asked me to describe my periods and I think that’s an important question physicians should ask.”
Prior and Tomiuk agree: If your bleeding persists in being unusually heavy, if you have any new or increased pain, or if your PMS overwhelms you, get medical advice.
As you get older, you’re more likely to develop one of the annoying but generally benign conditions that subside after menopause. Adenomyosis occurs when the uterine lining grows into the uterus’s muscular wall; while it’s harmless, it may cause very painful, prolonged, heavy periods. It’s different from endometriosis but the two may co-exist, and both improve after menopause when the condition may stop progressing, eliminating symptoms. Adenomyosis is especially common among women who have had C-sections. If over-the-counter pain relievers and heating pads don’t help, seek medical advice, says Tomiuk.
One in four perimenopausal women has flooding—a heavy, gushing flow that is sometimes accompanied by clots. It’s a medical problem only if you’re soaking more than one pad or tampon every hour for several hours and if clots are larger than a loonie.
While about half of all women under age 50 have fibroids—benign growths in the uterus that are most common in your 40s— “fibroids rarely cause heavy flow,” says Prior. She adds that in a study of 91 women who had had hysterectomies because of heavy bleeding, only six showed any evidence that fibroids may have been a contributor.
Causes for concern: By age 43, Pat Chiappetta found that her periods were lasting only a day or two and were pain-free but involved heavy bleeding that even extra-absorbent pads couldn’t contain. “Once when we had company over, I stood up and I had soaked the chair,” recalls the public health nurse from Aurora, Ont. “It was most embarrassing.” Over the next several months she became increasingly exhausted, despite taking iron supplements for anemia. On three occasions she passed out and was taken to three different hospitals. Each time, doctors ruled out heart problems and sent her home.
Finally she received a referral to a gynecologist, who diagnosed her with hyperplasia (an unusually thickened uterine lining) and performed an in-office uterine ablation, scraping away the lining. “Almost overnight, I went from tripled-up maxi-pads to panty liners.” Chiappetta, now 53, adds, “I’m a nurse and I should have known better, but no doctor ever asked me to describe my periods and I think that’s an important question physicians should ask.”
Prior and Tomiuk agree: If your bleeding persists in being unusually heavy, if you have any new or increased pain, or if your PMS overwhelms you, get medical advice.
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