DEAR DR. ROACH: At what age does menopause occur? I’m 54, and my periods are still the same. I had a blood test and was told I’m not even close to menopause. I read in an old medical book that it occurs between 45 and 55. Is this still correct? My friend said she knows of someone 68 years old who is still menstruating. I am terrified that I will have to suffer this horrible curse until I die. Please don’t advise me to get a hysterectomy, because at this point in my life I am no longer having surgeries. I am in good health and take no medicines. Is there any way to tell the exact age that I’ll be when I’m done with it? — C.G.

ANSWER: The medical book you had may be old, but human physiology usually doesn’t change very quickly. Indeed, the majority of women will go through menopause between the ages of 47 and 53. However, human physiology is highly variable. Women can be menopausal in their 30s or in their late 60s, so I am afraid it is possible that yours could last a lot longer. There does seem to be some familial component, so if your mother had a late menopause, you are more likely to as well. Otherwise, I don’t know any way to predict time of menopause.

I am concerned to hear you call your periods a horrible curse. I know you take no medicines, but there are many treatments — prescription and over-the-counter, traditional and complementary — that may be able to help you.

DEAR DR. ROACH: I read your column about deep vein thrombosis. A few years ago, when she was in her 50s, my sister developed a deep vein thrombosis. DNA testing found that she had a genetic mutation Factor V Leiden R506Q, and she was advised that she must take warfarin for the rest of her life. The genetic mutation may have been inherited from my father’s side of the family, as he had a stroke in his 60s and his brother had a DVT in his leg in his 50s and had part of his leg amputated as a result. His brother’s son died as a result of a stroke at about the age of 60. I discussed this with my family physician years ago, but apparently at that time DNA testing was expensive, and it was not thought to be of benefit to me, as it could not be prevented. What is the current view on DNA testing for genetic mutations that cause DVT? — B.D.

ANSWER: Factor V Leiden mutation is a change in the gene for blood-clotting factor V, and having this mutation increases the risk for abnormal clotting of the blood, such as a deep vein thrombosis or pulmonary embolus. Testing family members of those with genetic predisposition for blood-clotting abnormalities makes sense only if it changes what you would do about it.

Having the mutation increases the risk of developing a DVT or PE by about 0.5 percent per year. The risk of preventive treatment, such as warfarin, is higher than that, and I don’t recommend treatment with warfarin for someone with the mutation. Consequently, doing the testing may not be advisable. However, there are some times when it may be useful to know if there is increased risk for blood clotting, such as if a woman were considering taking birth-control pills.

There are things everyone can do to help prevent blood clots: Maintain a normal weight and get regular exercise. Don’t smoke. On a long plane trip or car ride, periodically get up and walk around.

READERS: The booklet on peripheral vascular (arterial) disease explains it in greater detail. Readers can obtain a copy by writing: Dr. Roach — No. 109, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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