In your 40s, your oestrogen levels often go on a rollercoaster, leading to symptoms of perimenopause including irregular periods, heavy bleeding and an emotional rollercoaster to match the oestrogen one. Oestrogen levels can also decline in your 40s, leading up to menopause which usually happens in your late 40s or early 50s.
Do periods get worse in your 40s?
Periods can get heavier and more painful for some women after the age of 40. I often think of perimenopause as puberty in reverse. So, if you think of the hormonal rollercoaster we experience in our teens, that can give you an idea of what is happening in perimenopause, only backwards!
We often think of oestrogen declining in the years leading up to menopause, when our periods finally cease, and in an ideal world our levels would decline so gradually that we don't notice any symptoms at all. And for some women that is the case!
However, for many women oestrogen goes on a rollercoaster in perimenopause, which is the lead-up to menopause, and can last 10-12 years. This means in your forties your oestrogen levels may be higher than ever at times, which can lead to heavier periods, or flooding, more frequent periods, more painful periods, and all the symptoms associated with PMS: mood changes, anger and irritability, breast tenderness. This is a great time to try the herb Agnus castus.
On top of the oestrogen rollercoaster, your progesterone levels also decline gradually in your 40s. And progesterone helps to counteract those excess oestrogen symptoms, so with your body struggling to make progesterone, the symptoms of higher oestrogen can be even worse!
And then it can swing roundabout, and oestrogen can take a big dive causing the typical menopause symptoms of lower oestrogen, like hot flushes and night sweats.
So, it can be a very confusing time. And taking synthetic oestrogen, in the form of HRT, on top of this rollercoaster can really add fuel to the fire.
Why is my period so painful in my 40s?
The oestrogen rollercoaster of perimenopause can also be to blame for more painful periods in your 40s. Period pain seems to be associated with substances called prostaglandins, which cause the muscles of the uterus to contract. If these muscles become too tight, the blood flow can be reduced to this area, causing pain. (1)
Additionally, when we have higher levels of oestrogen, the uterine wall gets thicker and more prostaglandins are produced in the shedding process, making the pain worse.
Often the bleed can last longer as well, and bleeding can be heavier. This is often referred to as flooding. It is important to see your doctor if you are bleeding excessively. Excessive blood loss is never ok! It can lead to anaemia and is definitely worth getting checked out. If we were bleeding that much from any other part of the body, it would be a cause for concern.
Some good questions to ask yourself if you're bleeding heavily and you're not sure if it's normal are as follows:
- Do you have to wear tampons and towels together?
- Do you have to change your period product more than once every 2 hours?
- Does blood ever soak through your clothes?
- Do you have to stay off work or cancel social engagements?
If so, it's best to seek medical advice!
But not everyone experiences this oestrogen rollercoaster in perimenopause; for others it is a gentler decline of oestrogen, and while other symptoms of menopause may show up in your 40s, as oestrogen levels decline your period will get lighter and less painful before eventually stopping altogether. (2)
Can your period stop in your 40s?
Your period can stop in your 40s. The late 40s to mid-50s is the average age for menopause, which actually refers to your last period, rather than the years leading up to it, which is called perimenopause. Your periods will continue until you reach menopause and may start to become less frequent over a few months or years before stopping altogether. For many women, this does happen in their late 40s.
Some women may experience early menopause, which is usually defined as periods stopping before age 45. This can happen naturally for some women, or it can be a side effect of medication or surgery or a disease. If your periods have stopped before age 45 and you're not sure why, it is worth seeking some medical advice and perhaps having tests just to rule some things out.
The average age of menopause (your final period) in the UK is 51 years old, so most women do continue to have periods throughout their 40s; but it is common enough for periods to stop altogether in your late 40s.
Which supplements can help in perimenopause?
For symptoms associated with high oestrogen, like heavy bleeding, periods coming closer together than usual with a cycle of fewer than 28 days, more painful periods and exacerbated symptoms of PMS, I recommend Agnus castus herbal tincture. It is a great remedy to help balance these symptoms of excessive oestrogen in the perimenopause phase.
For later on in perimenopause, when you are more likely to be dealing with low levels of oestrogen, you could try a supplement like A.Vogel's Menopause Support, which contains non-GMO fermented soy isoflavones. This is a great option for when your periods are becoming lighter and further apart.
It is always worth mentioning Sage as well, my favourite herb for treating hot flushes. Sage is not hormonal in its action so it can be used alongside the above remedies, or alongside HRT if need be. It's suitable irrespective of oestrogen levels, so if you are still getting heavy periods or if you haven't had a period in months, but you are getting hot flushes, then try the herb Sage!
Magnesium is a really important supplement too. I recommend up to 500mg of magnesium in the form of magnesium citrate, especially if your bowels are sluggish at all, or magnesium bisglycinate which is really easily absorbed.
Lastly, if you are dealing with heavy bleeding or flooding, I recommend a natural iron supplement like Floradix.
