Menopause is a universal occurrence in a woman's life where menstruation ceases, with an average age of 51.4 years in the United States. Late-onset menopause is defined as menopause after age 55. A thorough PubMed search revealed that there are currently no records of extended cycles through the entirety of a woman's geriatric years. A 65-year-old G2P2 Caucasian woman was admitted to the emergency department (ER) with a possible cerebrovascular accident. During admission, it was noted that the patient had vaginal bleeding. CT scan revealed a large fibroid, and ultrasound revealed an extremely thin endometrium, excluding endometrial pathology. Gynecology was consulted for post-menopausal bleeding, but in interviewing the patient, she was not surprised at her bleeding. Her LH and FSH levels were low, in the premenopausal range. This is a cautionary tale of an appropriate workup, and the importance of taking a gynecologic history, in the geriatric population.
Keywords: geriatric gynecology; geriatric menopause; irregular menstruation; late-onset menopause; menopause transition.
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