What many women start to experience in their 40s is a change in the flow, duration, and length of their cycles. Some may be bloodbath heavy, and others very light; some last longer and others not as long; some have a negligible pain factor, while others feel debilitating. That there will be a change of some sort is inevitable, says Dr. Javaid, though some changes should not be shrugged off as typical.
“If cycles all of a sudden become very painful, last longer than 7 days, become heavy, or occur less than every 21 days, you should see a health care provider for an exam and possibly lab testing and a pelvic sonogram,” she adds. Heavy bleeding can also be an indicator of something more insidious like fibroids, polyps, cysts, adenomyosis, thyroid issues, bleeding disorders, or certain cancers, which is why many health care practitioners advise women to use an app (Clue is a great one) to track their periods and keep a log of their symptoms.
Pregnancy, which an increasing number of women are waiting until their 40s to embark on, can also alter your menstrual cycle because it essentially resets the endocrine (hormone) and immune system, says New York–based holistic ob-gyn Eden Fromberg, M.D. “Post-pregnancy disruption of circadian rhythms influences melatonin secretion, which is related to menstrual-cycle pacemaker control,” Dr. Fromberg explains, adding that oxytocin and stress hormones also feel the impact of pregnancy and breastfeeding, which can affect your cycle.
Recently, some people have reported experiencing menstrual changes after receiving the COVID vaccine or contracting COVID itself. Dr. Amersi points out that these hormonal changes typically last four to six weeks and will not affect fertility or one’s ability to get pregnant, though more research is needed into the impact of the vaccine on the female body.
Does Hormonal Birth Control Help or Hurt?
Women in their 40s who complain of heavy bleeding may find themselves being prescribed birth control, something Dr. Amersi likens to putting a Band-Aid over your symptoms rather than addressing the root cause of an imbalance. “I always caution patients against birth control pills or synthetic hormones for a long period of time because of the risk factors for stroke, blood clots, and mood changes that accompany it,” she adds. Dr. Fromberg agrees: “When used for an extended period of time, the pill may impact menstrual periods via the recalibration of hormonal receptors and hormone production in endometrium, ovary, pituitary, hypothalamus, and other tissues.”
What Does This Mean for My Skin?
With or without birth control, our skin can be a mirror for our 40-something hormonal upheaval. “The underlying hormonal changes that impact your flow can also impact your skin,” says Dr. Javaid. Estrogen pulls water with it, she explains, so when those levels drop, skin becomes drier. Collagen production also dips when estrogen does, and acne is a common occurrence with hormonal cascades. When acupuncturist Sandra Chiu sees a new patient for any skin disorder, she always asks about and evaluates their menstrual cycle. “It gives us clues about what might be off internally that could affect healthy skin function,” she says, adding that rosacea and melasma are issues she often sees among women in their 40s with menstrual irregularities.
Is There Any Way to Create a Smoother Shift?
There are ways to ease the hormonal transition of your 40s. And if you can start that easing early, even better. “Developing healthy lifestyle habits in your 30s is important because every decade is preparing you for the next one,” says Dr. Amersi.
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Perimenopause Periods: How to Manage the Shift in Your Menstrual Cycle - Vogue
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