The Significance Of Bleeding After Menopause
Bleeding after menopause or “postmenopausal bleeding” can be defined as the resumption of vaginal bleeding at least 6 months after a woman experiences her last menstrual period. This assumes of course that she is indeed menopausal ie. in her late 40’s, perhaps having hot flashes and night sweats, mood swings, insomnia, perhaps experiencing some vaginal dryness.
Bleeding after menopause or “postmenopausal bleeding” can be defined as the resumption of vaginal bleeding at least 6 months after a woman experiences her last menstrual period. This assumes of course that she is indeed menopausal ie. in her late 40’s, perhaps having hot flashes and night sweats, mood swings, insomnia, perhaps experiencing some vaginal dryness. The bleeding pattern most women experience as they approach menopause is one where the periods become lighter, shorter in duration, and the interval between periods changes so that the periods are either somewhat closer together or intervals greater than her customary 28 days. Cycles may be missed entirely for a couple of months.
Polyps and fibroids are common benign growths that develop in the uterine cavity. The former is most often associated with irregular light spotting, staining or actual light bleeding. The latter may also present this way, but in fact may be associated with much heavier bleeding.
Cancer obviously requires a much more aggressive surgery, namely hysterectomy.
Why Am I Bleeding Two Years After My Last Period
It all started when I had this awesome idea to change my HRT delivery method. I decided to have the Mirena fitted to deliver my Hormone Replacement Therapy directly where its needed. Oh how I wish Id left my body alone
After a torturous Peri-menopause& experimenting with various types of treatmentI settled on Evorel patches& Utrogestan pills. This combination was a complete success & I was living my best life. Sleeping well, no menopause symptoms at all & absolutely no bleeding what so ever.
Then I read that the safest delivery for HRT is the Mirena. I could stop using patches & would no longer take a pill every night, thus protecting my kidneys. All I had to do was have the tiny device fitted & Id be good for seven years AWESOME! It sounded so simple.
Well, it wasnt. From day one of having the Mirena I bled. Some days it was lighter than others but it was every single day. I knew beforehand this was a possible side effect of healing from the Mirena settling in. However, by the fourth month, Id had enough. Me and Mirena are clearly not getting along.
Out it came.
Period Back After More Than Two Years
Now, if you have been more than two years without a period and you get one, or several come back, this is when you go to the doctor. It’s unlikely, although not impossible, to be a hormonal shift going on again, but in this case, we say, “Please don’t worry, but go and see your doctor as soon as you can.”
So I hope this has given you a little bit more of an insight into all the wonderful different ways that our periods can change when we start our approach to the menopause.
If any of you have had any other issues with this and you’d like to share with us, I would love to hear about it. And until then I’ll see you next week on another A.Vogel Talks Menopause.
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What Causes Bleeding After Menopause
Bleeding after menopause is rarely cause for concern. It does need to be investigated, however, because in very few cases it will be an indicator of something more serious.
In about 90 per cent of cases, a particular cause for bleeding after menopause will not be found. This is not a cause for alarm, if there is a serious problem it will be identified through investigations. Most of the time, postmenopausal bleeding is caused by:
- inflammation and thinning of the lining of your vagina
- thinning of the lining of your uterus
- growths in the cervix or uterus which are usually not cancerous
- thickened endometrium often because of hormone replacement therapy
- abnormalities in the cervix or uterus.
These are generally not serious problems and can be cured relatively easily.
However, about 10 per cent of the time, post-menopausal bleeding is linked to cancer of the cervix or uterus and so it is very important to have it investigated.
Stress Increases During Menopause: 6 Ways To Stay Calm Through It All
An estimated 1.5 million people enter the menopause transition each year, yet it’s a time of life that isn’t talked about nearly enough.
After two decades of helping women around the world through this transition, clinician-informed researcher Lisa J. Taylor-Swanson, Ph.D., MAcOM, LAc, has found that there’s a huge lack of education about what to expect during this life stageone that’s totally natural, and that every person with a uterus will go through eventually.
This can cause isolation and uncertainty, which, on top of other common menopausal biological phenomena like hot flashes, night sweats, vaginal dryness, difficulty sleeping, and metabolism changes, can seriously increase feelings of stress and anxiousness. There’s also research demonstrating that the hormonal variation during menopause can signal cortisol secretion, further increasing stress pathways in the body. “And socially, it’s such a massive pressure cooker for a lot of women,” Taylor-Swanson says on a call to mbg.
All of this to say, menopause and the period leading up to it, perimenopause, can be incredibly stressful. “Happily,” Taylor-Swanson adds, “there’s a bunch of really good research showing at least moderate help from yoga, acupuncture, herbal medicine, mindfulness-based stress reduction, and cognitive behavioral therapy. Those interventions have all been tested, and certainly, none of them show any kind of harm.”
Treating Post Menopause Bleeding
If you have postmenopausal bleeding it is important to have it investigated.
You will most likely be referred to a gynaecologist who may:
- ask you questions about the history of your health
- examine you
- do a blood test
- look at the inside of your vagina and cervix using special tongs . At the same time, they may take a tiny sample of your cervix for testing .
The kind of treatment you have will depend on what is causing the bleeding.
- Atrophic vaginitis and thinning of the endometrium are usually treated with drugs that work like the hormone oestrogen. These can come as a tablet, vaginal gel or creams, skin patches, or a soft flexible ring which is put inside your vagina and slowly releases the medication.
- Polyps are usually removed with surgery. Depending on their size and location, they may be removed in a day clinic using a local anaesthetic or you may need to go to hospital to have a general anaesthetic.
- Thickening of the endometrium is usually treated with medications that work like the hormone progesterone and/or surgery to remove the thickening.
Before treatment there are a number of tests and investigations your gynaecologist may recommend.
All treatments should be discussed with you so that you know why a particular treatment or test is being done over another.
How To Track Your Period
Tracking your period is a good idea even when your period is regular. You can track your period on a calendar or in a notebook, or use one of the many period tracking apps available.
Begin tracking your period by marking the first day of your period on a calendar. Within a few months youll begin to see if your periods are regular or different each month.
Keep track of the following:
- PMS symptoms, such as headaches, cramps, bloating, breast tenderness, and moods
- when your bleeding begins and whether or not it was earlier or later than expected
- how heavy your bleeding was, including how many pads or tampons you used
- symptoms during your period, such as cramping, back pain, and other symptoms and how bad they were
- how long your period lasted and whether or not it was longer or shorter than your last period
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What Happens At Your Gp Appointment
The GP should refer you to hospital or a special postmenopausal bleeding clinic. You should not have to wait more than 2 weeks to see a specialist.
What happens at your hospital or clinic appointment
A specialist, who may be a nurse, will offer you tests to help find out what’s causing the bleeding and plan any necessary treatment.
The tests may include:
- a small device being placed in your vagina to scan for any problems
- an examination of your pelvis and vagina a speculum may be inserted into your vagina to hold it open, so the inside of the vagina and the cervix can be seen
- a thin, telescope-like camera being passed up your vagina, through the cervix and into your womb to look for any problems and to take a tissue sample for testing under local or general anaesthetic
- the specialist may press on your tummy and inside your vagina to check for lumps, tenderness or other abnormalities
Biological Relationship Between Stress And The Reproductive System
Stress activates a hormonal pathway in the body called the hypothalamic-pituitary-adrenal axis . Activation of the HPA axis is associated with increased levels of cortisol and corticotropin–releasing hormone . The HPA axis, cortisol, and CRH help control stress response in the body . CRH and cortisol release can suppress normal levels of reproductive hormones, potentially leading to abnormal ovulation, anovulation , or amenorrhea . Furthermore, abnormal levels of CRH in reproductive tissue have been associated with negative pregnancy outcomes, such as preterm birth .
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Mental Health Depression And Menopause
Menopause Can Affect Your Mental Health
Approaching middle age often brings increased stress, anxiety, and fear. This can partially be attributed to physical changes, such as decreasing levels of estrogen and progesterone. Hot flashes, sweating, and other symptoms of menopause may cause disruptions.
There may also be emotional changes, such as worries about getting older, losing family members, or children leaving home.
For some women, menopause may be a time of isolation or frustration. Family and friends may not always understand what youre going through, or give you the support you need. If youre having trouble coping, it is possible to develop anxiety or depression.
Everyone feels sad once in a while. However, if you regularly feel sad, tearful, hopeless, or empty, you may be experiencing depression. Other symptoms of depression include:
- irritability, frustration, or angry outbursts
- anxiety, restlessness, or agitation
- feelings of guilt or worthlessness
- loss of interest in activities you used to enjoy
- trouble concentrating or making decisions
- lapses in memory
- sleeping too little or too much
- changes in your appetite
The Emotional Impact Of Early Menopause
When menopause comes early, it can pack an emotional punch. How you react to early menopause may depend on your health, the amount of stress you are experiencing, and what kind of relationships and emotional support you have. For many women, early menopause can cause shock, sadness, fear, and anxiety. There may be a sense of loss and loss of control. Loss of fertility may change your self-image and affect your self-esteem. Early menopause can change the way you see yourself as a sexual partner.
If you have symptoms that could indicate early menopause, see your doctor. If you have been diagnosed with early menopause and you are feeling anxious or depressed, talk to someone. Many women with early menopause have found it useful to join a support group. Adapting to a new image of yourself is a challenge, but help is available. Seeking out education and support can help you cope with the emotional impact of early menopause.
Even if you arent having emotional issues, an irregular period is a good reason to see your doctor. Irregular menstrual cycles and symptoms of stress may be symptoms of a medical condition such as thyroid disease or diabetes. Your doctor may do a blood test to measure your hormone levels, which will tell how well your ovaries are functioning. When you take steps to help your body be its healthiest, your stress levels may smooth out as well.
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Can Stress Cause Early Menopause
Many people ask whether stress can bring on an early menopause. Generally, it is thought that high levels of stress can cause women to experience symptoms similar to menopause due to increased cortisol levels, but that it doesn’t actually induce menopause. “Stress is a symptom of life, and often more so at this stage of life,” says Dr Heather Currie, chair elect of the British Menopause Society and founder of Menopause Matters. “The difference with stress around the menopause, when hormone levels are changing, is how we deal with the stress and that the changes and symptoms of hormonal changes can then lead to stress”.
Dr Currie advises women who are approaching menopause to learn as much as possible about the hormonal changes involved, as well as what impact they may have and what diet and lifestyle changes can help. “They should see it as a time to invest time in themselves and really look at exercise, relaxation or whatever they enjoy.”
Vivian Diller agrees: “Menopause, like menstruation, is a time of change. It isn’t easy to adjust to the changes but eventually our bodies and minds do. Hormones calm down and a new phase of life begins. Rather than see menopause as the beginning of the end, it’s best to view it as a transition to a new beginning.”
Nikki Withers is a freelance health and medical writer, personal trainer and fitness instructor and was previously editor of Drug Target Review and European Pharmaceutical Review.
Can Stress Cause Postmenopausal Bleeding
As we women age, our bodies go through some drastic and remarkable changes. After the childbearing years, the 40s and the 50s, the female body begins to change away from procreation as the production of reproductive hormones naturally begins to decline. This phase of a womans life is called menopause and is signaled by 12 continuous months since the last menstrual cycle.
The average age in the United States for women to start menopause is around 51 years of age. There are three phases of menopause that women typically go through and they are perimenopause , menopause, and then postmenopause .
Many questions surround this phase of female life, and for the purpose of this article, we are going to look at the postmenopause phase and a common question that arises often.
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A Change In Your Schedule
Changing schedules can throw off your body clock. If you frequently change work shifts from days to nights, or if your schedule is generally all over the place, your period can be fairly unpredictable.
A change in your schedule shouldn’t cause you to completely miss your period, but it can cause your period to start earlier or later than expected. Your cycle can also change by a few days if you experience jet lag.
Stress And Early Menopause Answered
For women between the ages of 40 and 45 early menopause can be a difficult situation to manage physically and emotionally. There are a number of things that can increase the liklihood of early menopause.
The best thing you can do to maintain sexual and reproductive wellness is to take care of your body and your emotional wellbeing. The truth is that engaging in negative health behaviors like smoking or excessive drinking can contribute to early menopause.
It is also important to take care of your mental and emotional health.
So, to answer the question directly, can stress bring on early menopause, the answer is yes. However, stress is usually one of several factors and does not act alone in causing early menopause.
If you want to read more about womens health and specifically hormone health, check out some of our other blogs.
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The Effect Of Hormones
The two key hormones involved in the menstrual cycle are oestrogen and progesterone. If levels of these hormones become imbalanced, it can result in irregular or unpredictable periods. Because oestrogen is responsible for regulating the thickening of the uterine lining, if levels become erratic the lining can shed sporadically and lead to heavy bleeding.
Similarly, fluctuations in the level of progesterone, the hormone which regulates when the uterine lining is shed and also controls the intensity and duration of bleeding, can lead to irregular periods and unpredictable bleeding.
What Are The Signs Of Early Menopause
Symptoms of early menopause are typically the same as for typical menopause but they happen at a younger age.
Early signs of menopause usually include irregular or missed periods, or heavier or lighter periods than is typical for you. Other symptoms of early menopause include hot flashes, difficulty sleeping, changes in mood, vaginal dryness, and lack of sex drive.
You may also want to consult a medical professional if you are aware of a family history of early menopause or you are struggling to get pregnant after the age of 40. These might be early warning signs of menopause.
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Other Common Causes Of Spotting
Stress is one possible cause of spotting, but its not the only one. Other common reasons you might notice spotting include:
- Hormonal birth control
- Early pregnancy
- Underlying conditions like uterine fibroids, polyps, or polycystic ovarian syndrome
Spotting that comes with early pregnancy is known as implantation bleeding. When you get pregnant, the fertilized egg implants in the uterus and may cause spotting. Its not uncommon to experience light bleeding during the first few weeks of pregnancy.
Another common cause of spotting is perimenopause. Perimenopause is the time before you enter menopause, and hormonal fluctuations that come with perimenopause and menopause can lead to spotting and irregular periods.
Most of the time, spotting isnt a sign that something is seriously wrong. But if spotting is accompanied by abdominal pain or fever, or if youre bleeding after menopause, make an appointment with your doctor.
If you have heavy or persistent bleeding, particularly if youre pregnant, seek prompt medical care. Irregular bleeding could be a sign of miscarriage or an ectopic pregnancy.
Your menstrual cycle relies on a delicate balance of hormones. When you experience stress, hormones can fluctuate and cause occasional spotting. To learn more about keeping your menstrual cycle regular, schedule your appointment at Advanced Womens Care today to get answers.