As menopause approaches, many women begin to notice changes in their menstrual cycles, which can be different from their usual cycles. Previously regular cycles may become shorter, longer, or even missed altogether. This is a natural part of the aging process, but it often raises questions and concerns, especially if accompanied by other symptoms such as mood swings, sleep disturbances, or hot flashes .
Understanding the changes in the menstrual cycle leading up to menopause is important so that women can be better prepared physically and emotionally to face this phase.
When Does the Menstrual Cycle Leading to Menopause Occur?
Menstrual changes that begin to occur before menopause usually occur during a phase called perimenopause, the transitional period before a woman completely stops menstruating. Perimenopause typically begins in her 40s, although it can occur as early as her late 30s in some women.
During this phase, estrogen and progesterone levels begin to decline and become unstable, affecting the menstrual cycle. As a result, periods can become more frequent or less frequent, heavier or lighter than usual. This perimenopausal period can last 4–10 years before finally entering menopause, when menstruation stops completely for 12 consecutive months.
5 Signs of Menopause That You Need to Pay Attention to
As menopause approaches, a woman's body undergoes many changes closely related to hormonal fluctuations. One of the most obvious signs is a menstrual cycle that begins to change from normal. These changes can often be confusing because the symptoms vary from person to person.
To be more alert, here are the characteristics of menstruation approaching menopause that you need to pay attention to:
- Irregular Menstrual Cycle
If your menstrual cycle was previously regular, approaching menopause, it often begins to become irregular. Periods can come earlier, for example, every 20 days, or even later, up to more than 40 days. This instability is caused by changes in estrogen and progesterone levels, which affect the ovulation process. - Menstrual periods can last longer or shorter.
In addition to changes in the schedule, the length of your period can also vary from usual. Some women experience periods lasting only 2–3 days, while others experience them lasting more than a week. This is normal during perimenopause, but if the bleeding persists, it's best to consult a doctor immediately. - Changes in Menstrual Blood Color
As menopause approaches, menstrual blood may become darker or lighter in color than usual. This occurs because the thickening and shedding of the uterine lining is unstable. Color changes are generally normal, but if they are accompanied by an unpleasant odor or large clots, medical attention is necessary. - Amount of Menstrual Blood Released
Some women experience heavier bleeding, requiring frequent pad changes, while others experience very little. This difference in bleeding is influenced by hormonal fluctuations and declining ovulation quality. - Spotting Outside the Menstrual Cycle
In addition to changes in the schedule and amount, spotting or spotting often occurs outside of the menstrual cycle. This spotting usually occurs due to the thinning of the uterine lining and hormonal imbalance. While often dismissed as trivial, if spotting occurs consistently, it's a good idea to get checked.
Changes in the menstrual cycle leading up to menopause are a natural process that every woman experiences, although symptoms vary. Recognizing the signs early will help us be better prepared, both physically and mentally, for this transition. If the changes are excessive or disruptive to daily activities, don't hesitate to consult a medical professional for appropriate treatment.
How Long Do Menstrual Disorders Last Before Menopause?
Menstrual irregularities before menopause usually appear during perimenopause, the transitional period before menstruation completely stops. Perimenopause can last around 4–8 years, although some women experience it for only 2–3 years or even more than 10 years.
During this period, hormonal changes cause the menstrual cycle to become irregular: it can be longer or shorter, the amount of blood loss varies, and sometimes menstruation stops for several months and then returns. This disruption ends when a woman is declared menopause, which is when she has not had a period for 12 consecutive months.
Other Symptoms of Menopause Beyond Menstrual Disorders
In addition to changes in the menstrual cycle, the body also exhibits various other signs as menopause approaches, influenced by hormonal fluctuations. Some of these can significantly disrupt daily activities, making it important to recognize them early.
- Hot Flashes and Night Sweats
A sudden feeling of heat accompanied by excessive sweating often appears at night and disrupts sleep. - Sleep Disorders
Difficulty sleeping or frequent waking at night due to hormonal changes or hot flashes. - Mood Swings
Mood swings, anxiety, or quick anger are more often felt due to hormonal fluctuations. - Vaginal Dryness
Decreased estrogen makes the vaginal area dry and causes discomfort. - Decreased Energy and Concentration
The body tires more easily and has difficulty focusing, often influenced by decreased sleep quality.
When to Call a Doctor?
Menstrual symptoms leading up to menopause are generally a normal part of the aging process. However, it's still important to contact a doctor if you experience any symptoms that feel excessive or unusual, such as heavy bleeding, irregular menstrual cycles, persistent spotting between periods, or severe pain that interferes with your daily activities.
Additionally, a medical consultation is also necessary if you need further information about body changes, treatment options to relieve symptoms, or advice on maintaining reproductive health during the transition to menopause. This will help you feel more at ease and receive treatment tailored to your specific condition.
This article was written by Dr. Ervina Ningsih, Sp.OG (Obstetrics and Gynecology Specialist at EMC Pulomas Hospital).