When it counts as menopause
According to the World Health Organization, natural menopause has occurred after twelve consecutive months without a period, with no other cause. This usually happens between 45 and 55. The years before, when the cycle changes, are called perimenopause; they end one year after the last period.
Women can also be without periods after a hysterectomy, with some contraceptive methods or after cancer treatment. Then the timing often can't be read from bleeding, although the hormonal change can still take place.
What changes afterwards
For many women, hot flushes and sleep problems ease over the years. Other changes stay or only appear later:
- Bones: according to the WHO, the loss of bone density around menopause is a major reason why osteoporosis and fractures become more common in women.
- Heart and blood vessels: the advantage women have over men in cardiovascular risk gradually disappears as oestrogen falls, the WHO says.
- Vagina and urinary tract: unlike hot flushes, dryness, burning and more frequent urinary tract infections usually don't go away on their own (Mili 2021).
More on this in the articles bones and strength training and vaginal dryness.
Bleeding after menopause: always get it checked
Usually the cause is harmless, such as a thinner lining or a benign polyp. In a 2018 meta-analysis of around 34,000 women with postmenopausal bleeding, about 9 percent had womb (endometrial) cancer. Conversely, 91 percent of women with this cancer had had such bleeding beforehand. That's why it is such an important warning sign.
What Rhythmus does during this time
If you tell the app you don't have periods (any more), it no longer shows cycle phases, ovulation or period predictions. You can keep logging energy, symptoms, training and food. If bleeding does occur, you can record it in the calendar, and the cycle report lists it as a reason to see a doctor.
How the last period comes about is described in the article on perimenopause.