Fertility during Pre-menopause
Menopause is the natural end to the reproductive phase of a woman's life. When a woman reaches the age of 45 to 58 years, the ovaries no longer respond to stimulation from the brain to produce ova (eggs), and menstruation stops completely.This is usually preceded by a period of irregular cycles called pre-menopause which may be brief or may extend for many years.
Three main changes indicate that a woman is in pre-menopause: fluctuations in cycle length, modification in the menstrual flow, and, possibly, anovulatory episodes.
Changes in Cycle Length Variations in cycle lengths results from ovulation occurring either earlier in the cycle than it previously occurred (creating shorter cycles), or later in the cycle (creating longer cycles).
We define two phases when we discuss cycle length in pre-menopause:
During the first phase of pre-menopause, menstrual cycles tend to shorten while they remain relatively regular. For example, a woman whose cycles used to vary from 28 to 30 days will vary from 25 to 28 in her late 30s or early 40s. This phase often passes unnoticed.
During the second phase of pre-menopause, menstrual cycles gradually become more and more irregular. At first there can be one isolated cycle that is one or two weeks longer than normal, followed by many cycles of the usual length. Later, longer cycles will be more and more frequent, but still interspersed with occasional short cycles. Closer to menopause, cycles may be up to several months long, however occasional short cycles can still occur.
Menstrual Flow Before pre-menopause, the menstrual flow is heaviest for a few days, and then tapers off gradually. When women reach ages 35 to 45, it often becomes irregular. The menstrual flow may last longer or shorter, and be more or less abundant than before. But more strikingly, flow may vary during the same menstrual period from spotting to very abundant, or it may contain blood clots (especially following long cycles).
Anovulatory Bleeding When an ovary fails to respond to hormonal signals, a follicle does not develop, and ovulation does not occur. During the second phase of pre-menopause, this is a common occurrence. A woman will then experience anovulatory bleeding, which is the shedding of the superficial layers of the lining of the uterus (this is not true menstruation). Blood flow can range from brief or spotty to excessively heavy or long lasting.
Will a natural method of family planning still be applicable and effective during pre-menopause? Yes, the Sympto-Thermal Method, as taught by Serena, is still applicable and effective during pre-menopause.
The STM teaches couples to recognize the approach of ovulation and the fertile time as well as to confirm when ovulation is passed and the late infertile phase is reached. Thus, irregularities in cycle length do not reduce effectiveness, unlike the Calendar Method (Rhythm), which would no longer be reliable, due to the possible irregular cycle length.
Couples can continue to effectively achieve their family planning goals by using the Sympto-Thermal Method throughout pre-menopause.