What is Menopause - Dr. Suzanne Welsch

So, menopause is really that time after which you don't have periods at all. So even somebody who is age 60 or age 70 and hasn't had a period in several decades, they are in menopause. So, average age of menopause here in the United States is 51. We consider premature menopause as occurring before age 40. So, some women who will come in without a period before the age of 40, that will actually tend to lead to a different workup and different questions to being asked than somebody who goes through menopause at the more average age of 51. I can say I've seen patients still at the age 56, 57 still having periods and they are not in menopause. So, there is definitely a bell-shaped curve. There are some on the very early side of menopause in their early 40s, and there are some on the very late side as well in their mid to late 50s.

For many women, menopause is also marked by higher risk of other medical conditions. So for example, we start to see and we start to screen for colon cancer after age 50 in the general population. Breast cancer is more common in post-menopausal than pre-menopausal women. Uterine cancer as well as cervical cancer tend to be post-menopausal type cancers. So, menopause in and of itself is defined by a loss or an absence of the menstrual period. However, what menopause means to us as physicians is it's a time where we really want to try to be preventive towards other health conditions that we know are closely linked with being in menopause as we age.

So, some of the things that we caution women about after their period has stopped is if they all of a sudden start to bleed again, it's not that their period has come back. They're actually having abnormal bleeding, post-menopausally. Now, the majority of this bleeding doesn't represent uterine cancer which we all fear, but the biggest symptom of uterine cancer is post-menopausal bleeding. So, that is something that we always caution women that if they are starting to bleed again, several years into their menopausal years, that they need to come back and see us for that. Any change I think that women experience outside of their normal state of health, I think women are very in tune to their bodies nowadays and probably are a better judge than we are with regard to that. So if they have a concern, I have a concern, and I invite them to come in and have it checked out.

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