Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Perimenopause & Menopause

The transition from regular menstrual cycling to menopause is called peri-menopause. It is usually characterized by hormonal fluctuations for about two years before and after the last natural period.

Also known as the change of life or the climacteric, menopause is the point in a woman’s life cycle where menstruation ceases completely, normally around the age of 50. For a number of years prior to this time, the menstrual cycle is likely to be irregular and there is a significant chance of mid-cycle staining. This tends to increase the number of times a woman has questions as to her niddah status.

The Menopause Process

During the course of a woman’s lifetime, the number of ova (eggs) in her ovaries decreases, from over six million four months before she is born, to about 400,000 at puberty, to approximately 20,000 in her late thirties.

Due to this winding-down process, many women start to notice changes in their cycles as they reach their late 30’s or early 40’s. Often, the intervals between periods become shorter, so that women are niddah more often. There may be more episodes of mid-cycle staining, and many women start to experience a brown discharge several days before their menses actually begin. While these changes are biologically normal, they can be halachically quite frustrating. However, with advance knowledge and some practical suggestions on how to minimize time in the niddah status, this phase of the life cycle can pass with relative calm.

Towards the late 40’s and early 50’s, intervals between periods get longer and are often irregular, a further sign of approaching menopause. The transition from regular menstrual cycling to menopause is called peri-menopause. It is usually characterized by hormonal fluctuations for about two years before and after the last natural period.

Menopause is the permanent cessation of menstruation due to loss of ovarian activity and the depletion of follicles (the egg-forming portions of the ovary). The median age of menopause is 51.5 years, with a general range of 48-55 years. Surgical removal of the ovaries will induce menopause at any age. If bleeding resumes at this time of life after one year without a period, a woman should be examined by a physician to rule out cancer.

Menopause in Halacha

Halachically, a woman who resumes menses after menopause does not observe onot perishah if she meets two conditions: she has gone at least ninety days without menstruating, and she is a zekeinah. A zekeinah (literally, old woman) is halachically defined as a woman who wouldn’t mind being referred to as elderly or a grandmother. Halachic authorities differ as to the exact age at which a woman attains this status, ranging from 53 to the mid-sixties.

A zekeinah who has not menstruated for ninety days is considered mesuleket damim, not expected to menstruate. However, the halachot are somewhat different than those for a pregnant or nursing woman:

  • If a woman menstruates once or twice, she does not observe any onot perishah the following month.
  • If she menstruates three times in a row at intervals of less than 90 days, she is no longer considered mesuleket damim and observes onot perishah as before.
  • If she menstruates at least three times at intervals of more than 90 days, she should ask a specific halachic question about whether and how to keep onot perishah.
  • If she previously had a veset kavua, and menstruated on the day of her veset kavua, the veset kavua is reestablished.

These halachot apply only if to a woman who has reached the age of a zekeinah (53 according to lenient opinions). If a woman resumes menses after menopause, but before she is halachically a zekeinah, she observes the regular onot perishah.

Mikveh after Menopause

Menopause generally marks the end of regular mikveh immersion. The laws of taharat hamishpacha, which were an integral part of a marriage for years or decades, will no longer determine the rhythm of the couple’s relationship.

For some couples, especially those for whom hilchot niddah or the perimenopause years were emotionally challenging, this can be a pleasant development. However, the transition to life after mikveh can also create new stresses or conflicts. Every marriage is unique, and there are a wide variety of normal responses to this stage of life. As always, sensitivity and open communication can be very helpful in resolving any tension that develops.

Halachically Mandated Immersion

Even after menopause, there are some situations in which a woman is halachically required to perform a hefsek taharah, count shivah neki’im, prepare as usual for mikveh, and immerse with a bracha:

  • If she has spotting or bleeding that makes her niddah. (For medical reasons, a woman should notify her health care provider if bleeding resumes after a year’s hiatus following menopause.)
  • If she undergoes a gynecological procedure that makes her niddah (e.g., through cervical dilation)
  • If she is getting married after menopause – even if she was previously married and hasn’t become niddah since her last immersion.

In addition, a married woman who was unaware of the laws of taharat hamishpacha, or did not observe them, is halachically considered niddah even if she has not menstruated for years. She still can – and still should – fulfill the halachic requirement of mikveh immersion at any age. Ideally, she should speak with a kallah teacher, mikveh lady, yoetzet halacha, or female mentor who can guide her through the process. If she is no longer menstruating, she will probably need to use the mikveh only once.

Voluntary Immersion

Some women specifically miss the experience of immersing in the mikveh. It is permissible for a married woman to use the mikveh even if she is not halachically obligated to do so. Thus, she may visit the mikveh voluntarily. If a woman was not niddah and is immersing voluntarily, she does not need to perform all of the preparations. She does not recite a bracha upon immersion, but may recite other prayers.

An especially appropriate time to visit the mikveh may be on erev Yom Kippur. In many communities, the custom to immerse on that day includes both single and married women, as well as men (one should check ahead of time about hours and arrangements). This immersion is for spiritual purification and is not halachically required. Therefore, one does not need to prepare and does not recite a bracha.

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All health and health-related information contained within Nishmat's Women's Health & Halacha Web site is intended to be general in nature and should not be used as a substitute for consulting with your health care professional. The advice is intended to offer a basis for individuals to discuss their medical condition with their health care provider but not individual advice. Although every effort is made to ensure that the material within Nishmat's Women's Health & Halacha Web site is accurate and timely, it is provided for the convenience of the Web site user but should not be considered official. Advice for actual medical practice should be obtained from a licensed health care professional.

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