Introduction
Menopause is a natural biological process that marks the end
of a woman's reproductive years. While the average age of menopause in the
United States is 51, some women experience menopause much later in life. In
fact, it is not uncommon for women to go through menopause after the age of 60.
This phenomenon, known as late menopause, can sometimes cause confusion and
anxiety for women who are unsure if their symptoms are normal or indicative of
an underlying health issue.
Causes of Late Menopause
There are several factors that can contribute to a woman
experiencing menopause after the age of 60:
- Genetics:
Late menopause often runs in families. If your mother or grandmother went
through menopause later in life, you may also experience late menopause.
- Hormonal
Factors: Women with higher levels of estrogen may experience menopause
later in life. Additionally, some medications and hormonal therapies can
delay the onset of menopause.
- Lifestyle:
Factors such as diet, exercise, and smoking can all impact the timing of
menopause. Women who maintain a healthy lifestyle may experience menopause
later in life.
- Medical
Conditions: Certain medical conditions, such as polycystic ovary syndrome
(PCOS) and hypothyroidism, can cause a delay in menopause.
Case Report: Menstruation at Age 65
A peer-reviewed case report describes a 65-year-old
woman presenting with vaginal bleeding, initially presumed to be
post-menopausal. However, further hormonal testing revealed low LH
and FSH levels—in the premenopausal range—indicating she was still
menstruating naturally at age 65
- The
patient maintained regular 28-day cycles, with bleeding lasting
about 5 days.
- Family
history revealed late menstruation and pregnancies in close
relatives, suggesting a possible genetic predisposition
In medical literature, this is cited as the latest known
case of natural menstruation continuing into the geriatric years.
A 65-year-old G2P2 Caucasian
woman was admitted to the emergency department (ER) with a possible
cerebrovascular accident. During admission, it was noted that the patient had
vaginal bleeding. CT scan revealed a large fibroid, and ultrasound revealed an
extremely thin endometrium, excluding endometrial pathology. Gynecology was
consulted for post-menopausal bleeding, but in interviewing the patient, she
was not surprised at her bleeding. Her LH and FSH levels were low, in the
premenopausal range.
What This Means
- Average
age of menopause in the U.S. is around 51, with “late” defined
as after age 55
- About 5–10%
of women experience it.
- This
case of menstruation at 65 with normal hormone levels is
extraordinarily rare and appears unique in the literature.
Health Implications of Late Menopause
Research shows that women who reach menopause later
may enjoy certain health benefits:
- Improved
vascular function, healthier lipid profiles, and less oxidative
stress—suggested to be related to longer estrogen exposure.
- Better
long-term physical functioning, such as faster walking speed and
lower odds of functional limitation, compared to those experiencing
earlier menopause.
Possible risks accompanying prolonged estrogen
exposure (as seen in late menopause) include an increased risk of breast or
endometrial cancers, and potential elevated risk of thrombosis
