Dear Doctor,

What is the right time for a woman to stop getting a period? I’m 40 but I haven’t seen a period for a while and I’m not on any family planning methods. Is this normal or there is something to worry about? Melissa

Dear Melissa,

Menstrual cycles start and occur due to certain equilibrium of hormones estrogen and progesterone in the body of a woman. Menopause is the time of cessation of these cycles (not having menses for 12 months), which again occurs due to change in balance of these hormones. There is no fixed precise time for menopause in a woman. Mostly, it occurs at the age of 50 or more but can occur early as well. Hitting menopause before 40 is considered to be premature. Hereditary factors are important here. If a blood relative like the mother or an aunt had early menopause, one can also have her menses stop early.

Premature menopause can occur due to ovarian failure. This can occur because of surgery, radiation or chemotherapy involving the ovaries. Hormonal disorders as those due to diseases of thyroid, pituitary or hypothalamus can cause premature menopause. It can be due to chromosomal disorders. Alcohol use can disrupt normal hormonal balance resulting in menstrual disorders or early menopause.

There is nothing to worry about if your menses have just stopped and you have no symptoms or signs of any underlying disorder. In case of any doubt, these can be excluded by suitable investigations. Most of these disorders are treatable.

In spite of menopause occurring at a younger age, you are vulnerable to have the features of menopausal syndrome, like hot flashes, early fatigue, depression, and etcetera. Due to reduced levels of estrogen, you are now susceptible to conditions like hypertension, cardiac problems, and osteoporosis. Menses once detained at this age cannot resume again. However, with a suitable diet and healthy lifestyle choice, one can overcome the sometimes difficult menopausal syndrome and prevent other medical disorders arising after menopause.