No period and peri symptoms have disappeared

[OakBush]

I'm 41 and for the last year or so have been getting symptoms which I believed were due to peri (emotional, hot flashes, nausea, insomnia, dryness). My periods were relatively regular up until end of 2025, but so far this year I've only had one in January and one in March - so nothing for 3 months now. (I'm absolutely 100% not pregnant!)

I've assumed this is another peri symptom, but weirdly since my period has disappeared, so have all the other symptoms, or they've greatly reduced at least. I'm assuming that my estrogen levels are very low so I'm wondering what's going on?

I'm particularly interested to know as I have been advised to have a risk reducing hysterectomy (genetic risk of endometrial/ovarian cancers) and one thing which really scares me is surgical menopause, but if I already have low estrogen and feel ok, maybe it wouldn't be so bad!

Any ideas?

I think fluctuating estrogen can cause a lot of symptoms, as can sudden changes up or down - these are pretty characteristic of perimenopause.

Perhaps you have moved to a later stage ?

Have you spoken to a doctor? If you have an increased risk of endometrial/ ovarian cancers and had a change in your periods that would definitely be the best thing to do.

They can check if your hormones are at post-menopausal levels.

If you're going through menopause at 41 then that's early enough I'd have thought some medical advice would be needed just for that alone.

PS - meant to say, my symptoms do also vanish when my period is very delayed. I'm on HRT and don't have low estrogen, it's just that they're not rapidly fluctuating anymore.

Symptoms (eg migraine) always return with my period.

Thank you for replying - I had a transvaginal scan and ultrasound recently and that was all fine, but yes probably a good idea to get hormone levels checked - I'm very conscious of how important estrogen is for bones/heart etc.

I guess for you it would be very useful to know if you have had your last period.

No idea when hormone levels drop after menopause though, so I'm not sure if they'd be able to tell you.

At the very least it sounds like you're late perimenopause stage

I'd not jump to conclusions. Missing a period for 3 months and not having symptoms doesn't mean you're menopausal. You'd be classed as having an early menopause if you were, at 41.

Lower estrogen (if that is what you have when missing a period) is nothing like loss of ovaries. The ovaries continue to secrete very small amounts of estrogen and testosterone even after menopause. The biggest loss in estrogen is in the first 5 years after a final period.

What genetic link do you have for endometrial and ovarian cancer?
Are you carrying a gene or is it more that close family have had these diseases?

I'm not aware of a gene for endo cancer, only ovarian which is linked to the BRACa gene.

If you had a total hysterectomy, would you use estrogen only HRT?
There would be no womb or ovaries to be stimulated by it.

I have Lynch syndrome, so a high risk of certain cancers including endometrial, and slightly increased risk of ovarian cancer.

And yes, I believe if I had a total hysterectomy the advice would be estrogen only HRT.

With your diagnosis you need to get checked.

You need to be referred to a specialist if you're not already seeing one.
I don't know anything about your condition other than a quick read just now.
The main risk appears to be bowel cancer. There is some evidence that HRT reduces the risk of bowel cancer, but in the context of your risk you need advice from a very good menopause consultant and a specialist in Lynch syndrome.
All I would stress is that a couple of missed periods is not a guide to how you'd feel post menopause (or with no ovaries.)

Yes I'm already seeing a consultant and also having regular colonoscopys for bowel cancer. Endometrial cancer risk is actually higher (up to 50% lifetime risk for tge variant I have) which is why total hysterectomy is recommended.

I will also get my estrogen levels checked though to try and find out what is happening with my period.

That's good.

Be aware that blood tests for estrogen are rarely accurate. They need to be done over 2 months, on days 2- 5 of your cycle.

What I read online about Lynch syndrome was that the risk of bowel cancer over a lifetime is 80% higher which put it at the top risk.

Endometrial cancer is highly treatable with early detection so whatever you decide, if you don't have surgery, an annual scan would be good and you would probably be given the Mirena coil to protect against endo cancer, if you use HRT.