Bleeding during menopause, also known as perimenopausal bleeding, can vary for each woman. As the body transitions into menopause, fluctuating hormone levels can cause unpredictable and often heavy bleeding. It's important to understand what's normal and when to seek medical advice.
What is Perimenopausal Bleeding
- Perimenopausal bleeding refers to irregular vaginal bleeding during the years leading up to menopause. It occurs due to hormone shifts as the ovaries prepare to stop releasing eggs.
- Estrogen and progesterone levels rise and fall unevenly, signaling the ovaries to release eggs less often. As a result, menstrual cycles become less frequent and bleeding patterns change.
- Many women first notice perimenopausal symptoms in their 40s. However, it can start earlier for some.
Common Patterns of Perimenopausal Bleeding
There are a few common bleeding patterns:
- Irregular cycles - Periods come closer together or further apart. Cycles longer than 38 days or shorter than 24 days are considered abnormal.
- Heavy/prolonged bleeding - Periods with flooding or clots larger than a quarter. Bleeding over 8 days is prolonged.
- Unpredictable episodes - Unexpected bleeding between periods or spotting.
- Period stopping and starting - Menstruation starts again after no period for several months, often heavier than normal.
What's Considered Normal?
- There is a wide range of normal when it comes to perimenopausal bleeding. Heavy, irregular periods don't necessarily indicate a problem.
- That said, paying attention to what's normal for you can help determine when to get checked out. Tracking your cycles and symptoms enables you to spot changes.
- Seeing your doctor once a year can reassure you that things are progressing normally towards menopause. Certain screening tests may be recommended too.
Abnormal Bleeding to Watch out For
See your doctor if you have:
- Bleeding longer than 12 days
- Flooding through a pad/tampon every 1-2 hours
- Passing blood clots larger than a golf ball
- Bleeding between periods after 12 months without one
These can indicate hormonal issues, uterine problems, or other conditions requiring evaluation. Getting checked when in doubt can detect issues early.
Managing Perimenopausal Bleeding
Here are some tips to alleviate symptoms:
- Track periods and symptoms to anticipate heavy flows. Changing pads/tampons more often can help.
- NSAIDs like ibuprofen help minimize flow during your period.
- Get sufficient iron levels through diet changes and supplements if bleeding heavily.
- Try hormonal IUDs or birth control pills to regulate cycles.
- Discuss other hormonal therapies if periods remain very heavy or prolonged.
The Takeaway
Navigating changing cycles and unexpected bleeding can be challenging.
While frustration is normal, remember that perimenopausal bleeding tends to resolve within a few years. Staying on top of your cycles enables you to determine when something may be wrong. Don't hesitate to discuss ongoing struggles with your doctor.
