I’m Entering Menopause – Do I Still Need Birth Control?
One of the most common mistakes women make when entering menopause is believing they can no longer get pregnant.
By Dr. Sanjay Gupta
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Sanjay Gupta, MD, Everyday Health:Is menopause a discreet event?
Penny Castellano, MD, Chief Medical Officer, The Emory Clinic:It’s really not. It is a transition, so let’s talk a little bit about what happens with the ovaries that result in menopause. When you look at a normal menstrual cycle, there is a wonderful interplay of the brain, specifically the pituitary, sending signals to the ovaries. Interestingly, during most reproductive life in most women this cycle happens like clockwork. Eventually, the body will be sending that signal, and the ovaries will have nothing left of a response. That usually coincides with what we describe as the last period. And a year later, we will officially diagnose that woman as being post-menopausal. That time from when the ovaries began to falter in their response to the last period varies greatly. Some women will make that transition in a year, others will have five or six years.
Dr. Gupta:What are some of the biggest myths you think women have about menopause?
Dr. Castellano:One of the scariest myths is that once you begin the menopause transition that you are thereafter infertile. I always like to remind patients that until we have that one-year hallmark after the last period, consider yourself fertile. When you look at the age groups with the highest rates of unplanned pregnancies, teenagers are first and peri-menopausal women are second.
Dr. Gupta:What is the youngest, oldest, and normal age you’ve see for menopause?
Dr. Castellano:Let’s talk about the average age of menopause which is about 51 and a half in the U.S. Interestingly the age of first menses, first period, has been going down for decades. It used to be about 13 to 15, now it’s pretty close to 11. Average age of menopause hasn’t changed. It’s still about 51 and a half.
Now that’s the average. There’s a fairly big spread around that average. We normally think about anywhere from the early 40s to the really late 50s as being the span of normal. Now if we see a patient really early 40s or certainly earlier than 40, we will look for other things that may be at play; but once you hit mid-40s, we see pretty commonly that women can go through menopause very normally. A lot of them will ask, well is there a predicator? How do I know whether I am a 46-year-old menopause patient or a 56-year-old menopause patient. We tell women to ask their female relatives, there does seem to be a little bit of a genetic tendency.
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