What Are Hot Flashes And How Long Will I Have Them
Hot flashes are one of the most frequent symptoms of menopause. It is a brief sensation of heat. Hot flashes arent the same for everyone and theres no definitive reason that they happen. Aside from the heat, hot flashes can also come with:
- A red, flushed face.
- A chilled feeling after the heat.
Hot flashes not only feel different for each person they also can last for various amounts of time. Some women only have hot flashes for a short period of time during menopause. Others can have some kind of hot flash for the rest of their life. Typically, hot flashes are less severe as time goes on.
How Will Menopause Affect Me
Symptoms of menopause may begin suddenly and be very noticeable, or they may be very mild at first. Symptoms may happen most of the time once they begin, or they may happen only once in a while. Some women notice changes in many areas. Some menopausal symptoms, such as moodiness, are similar to symptoms of premenstrual syndrome . Others may be new to you. For example:
- Your menstrual periods may not come as regularly as before. They also might last longer or be shorter. You might skip some months. Periods might stop for a few months and then start up again.
- Your periods might be heavier or lighter than before.
- You might have hot flashes and problems sleeping.
- You might experience mood swings or be irritable.
- You might experience vaginal dryness. Sex may be uncomfortable or painful.
- You may have less interest in sex. It may take longer for you to get aroused.
Other possible changes are not as noticeable. For example, you might begin to lose bone density because you have less estrogen. This can lead to osteoporosis, a condition that causes bones to become weak and break easily. Changing estrogen levels can also raise cholesterol levels and increase your risk for heart disease and stroke.
Talk to your doctor about possible for your menopause symptoms if they bother you.
Prolonged And Heavy Bleeding During Menopause Is Common
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ANN ARBORWomen going through menopause most likely think of it as the time for an end to predictable monthly periods. Researchers at the University of Michigan say its normal, however, for the majority of them to experience an increase in the amount and duration of bleeding episodes, which may occur at various times throughout the menopausal transition.
The researchers from the U-M School of Public Health and U-M Health System offer the first long-term study of bleeding patterns in women of multiple race/ethnicities who were going through menopause. They say the results could impact patient care and alleviate undue concern about what to expect during this life stage that can last anywhere from 2-to-10 years.
For most women in their 30s, menstrual periods are highly predictable. With the onset of the menopausal transition in their 40s, womens menstrual periods can change dramatically. These dramatic changes can be disconcerting and often provoke questions about whether something is wrong, said Sioban Harlow, U-M professor of epidemiology.
Women need more descriptive information about the bleeding changes they can expect. We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention.
The study, Menstruation and the Menopausal Transition, is reported in the current issue of BJOG: An International Journal of Obstetrics and Gynaecology.
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What You Can Do
Consider keeping a journal to track your periods. Include information such as:
- when they start
- whether you have any in-between spotting
You can also log this information in an app, like Eve.
Worried about leaks and stains? Consider wearing panty liners. Disposable panty liners are available at most drugstores. They come in a variety of lengths and materials.
You can even buy reusable liners that are made of fabric and can be washed over and over again.
A skipped period can also cause the lining to build up, leading to heavy bleeding.
Bleeding is considered heavy if it:
- soaks through one tampon or pad an hour for several hours
- requires double protection such as a tampon and pad to control menstrual flow
- causes you to interrupt your sleep to change your pad or tampon
- lasts longer than 7 days
When bleeding is heavy, it may last longer, disrupting your everyday life. You may find it uncomfortable to exercise or carry on with your normal tasks.
Heavy bleeding can also cause fatigue and increase your risk for other health concerns, such as anemia.
Why Your Periods Might Suddenly Come Back
Many women going through the menopause find that they can go months or even years without a period, only to wake up one day and discover that theyve returned! Today Im exploring why hormones and even diet can cause your periods to return, and when you should go and see your doctor.
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It Might Be Worth Seeing A Specialist
Your gynecologist should be able to perform your initial evaluation. But, if he or she suspects that your bleeding might be related to cancer, its important to see a gynecologic oncologist, Mantia-Smaldone said.
Endometrial cancer is usually treated with surgery that includes a hysterectomy, which may be followed by radiation and/or chemotherapy. Because gynecologic oncologists deal with female reproductive cancers every day, they have more experience operating on cancers, staging them correctly, and determining the best course of therapy. And that can add up to a more successful treatment outcome.
When To See The Doctor For Bleeding Between Periods
Never hesitate to make an appointment with your doctor if youre worried about bleeding between periods. Dr. McDonald and Dr. Wilson provide comprehensive exams to diagnose potential causes of spotting, so we can recommend an appropriate treatment plan.
Light bleeding between periods typically isnt an indication of something more serious, but its important to recognize signs that something isnt right. Make an appointment with your gynecologist if you have spotting along with lower abdominal pain, pelvic pain, or fever.
If bleeding between periods gets worse or starts happening more often, it could indicate an underlying health condition. If you experience bleeding between periods that isnt light or doesnt stop within a few days, make an appointment with your doctor.
After youve entered menopause, see the doctor if you experience vaginal bleeding at any point. Even if its light bleeding, bleeding after menopause could be a sign of cancer or other serious health condition.
Listening to your body is important. If youre concerned about spotting or bleeding between periods, schedule a check-up at OB/GYN Specialists. Call our team at 940-202-0566 or send us a message online.
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How Long Are Normal Perimenopause Periods
Ordinarily, your menstrual cycle occurs every 21 to 35 days and lasts from 2 to 7 days. However, perimenopause periods can last much longer. Some months, the ovaries might not produce sufficient levels of estrogen and progesterone, preventing menstruation altogether. Other months, the imbalance might cause the uterine lining to become overly thick, which means it will take longer to be shed by your body to shed.
Excessive bleeding and long periods are fairly common during perimenopause. Many women experience an increased flow and extended perimenopause periods before entering menopause.
If youve had periods that are several days longer or more frequent or heavier than usual, its a good idea to see your doctor.
What Other Changes Should You Expect
Your period evolves in a number of ways once youve entered perimenopause. While some women have perimenopausal periods closer together, others might notice them occurring further apart. Further changes in your menstrual cycle after 40 often include:
- Heavier periods: Your flow may become more intense over time. If bleeding is unusually heavy, however, be sure to consult your doctor.
- Lighter periods: Inversely, a lot of women experience decreased flow for up to a year before their periods stop completely.
- Skipped periods: Anovulatory cycles are another possibility during perimenopause. Keep in mind, though, that youre still fertile at this stage. So if youve recently had sex and missed your period, consider taking a pregnancy test.
- Longer or shorter periods: Perhaps your period has always lasted for 4 days, but now its 2 or 6 days. You might even experience a random combination of both shorter and longer cycles while in perimenopause. This, too, is a fairly common occurrence.
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Should You Get Tested For Perimenopause
The short answer: No.
The blood tests that measure your ovarian reserve are rarely accurate during perimenopause. FSH and estrogen change by the day and throughout the day so they are generally not helpful.
We do consider testing these hormones if you experience perimenopausal symptoms under the age of 45. We generally will also check other pituitary hormones, like TSH and prolactin, if you are experiencing these symptoms prematurely.
Keeping a menstrual diary is generally the best test you can do. This will give you and your OBGYN insight into what your body is doing and for how long.
Any time you experience abnormal uterine bleeding , checking in with your doctor is a good idea to make sure it is normal and that no other work-up is needed.
How Will I Know If I Am Starting The Transition To Menopause
Sometimes it can be hard for you and your doctor to tell whether you are in perimenopause, the transition to menopause:
- Symptoms: Tell your doctor or nurse about any menopause symptoms, such as hot flashes or trouble sleeping.
- Irregular periods: Track your periods. Irregular periods may be your first sign of menopause.
- Hormone levels: Your doctor may test the amount of hormones in your blood if your periods stopped at an early age . Doctors dont usually recommend this test unless there is a medical reason to do so. This is because, for most women, hormone levels go up and down in an unpredictable way during the transition to menopause. So it is difficult to tell for sure whether you have gone through menopause or are getting close to it based on this blood test.
How Can You Treat Symptoms Of Perimenopause
What can and should you do if you are experiencing these symptoms? The first is lifestyle changes. Now is the time to focus on a healthy diet and exercise. Alcohol especially is known to increase physical symptoms like hot flushes and may contribute to insomnia. Other self-help measures such as yoga, meditation and mindfulness may help.
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One of the main treatments for these psychological symptoms has been anti-depressants. GPs have offered these to women often as Dr Currie explains: ‘Because they thought the woman was too young for peri-menopause.’ Now we know that these symptoms can begin in the early forties, it’s time for a re-think on treatment.
The recent NICE report on menopause advises women: ‘It has not been shown that antidepressant drugs called SSRIs and SNRIs can help with low mood during menopause if you haven’t been diagnosed with depression.’
For many women the best treatment is HRT. There is no reason why women can’t use HRT if they are still having periods.
Dr Currie says: ‘Some women say, “I don’t want to give in by using HRT”. But these psychological symptoms do respond to oestrogen. In a woman’s forties, we simply top-up low levels and start with a low dose.
‘In women who are post menopause a higher dose of HRT may be required.’
In addition, some women are concerned that starting HRT early could mean they reach the ‘time limit’ for use before they are post menopause.
What Are The Symptoms Of Perimenopause
During perimenopause, you can experience a variety of symptoms. The reason: Your ovaries have been making estrogen since your first period. During perimenopause, the estrogen production decreases substantially. Your body has to adjust to functioning with less of the hormone, putting you into estrogen withdrawals. The type and intensity of symptoms vary greatly among women some just feel a little off or don’t notice anything at all.
Others can experience perimenopausal symptoms including:
- Trouble sleeping
- Feeling irritable, anxious or depressed
- Night sweats
- Hot flashes
About 80 percent of women will experience some form of a hot flash during perimenopause or menopause. Hot flashes happen when your brain has trouble regulating your internal temperature, which is a common response to having less estrogen. The shift in temperature may not be noticeable. Or, it may feel like someone cranked up the thermostat on your core body temperature. You suddenly feel uncomfortably hot and sweaty, or you may wake up drenched in sweat .
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What Happens After Menopause
After menopause you will no longer be able to get pregnant and you will no longer get a period. If you have any type of vaginal bleeding after menopause, you should see a doctor as soon as possible. Vaginal bleeding after menopause is not normal and can mean that you have a serious health problem.
You may experience any of the following after menopause:
- Low hormone levels. With menopause, your ovaries make very little of the hormones estrogen and progesterone. Because of changing hormone levels, you may develop , including osteoporosis, .
- Menopause symptoms instead of period problems. After menopause, most women get relief from or menopause . However, you may still experience symptoms such as hot flashes because of changing estrogen levels. One recent study found that hot flashes can continue for up to 14 years after menopause.,
- Vaginal dryness. Vaginal dryness may be more common post-menopause. Learn more about for vaginal dryness.
How Long Is Too Long For A Period During Perimenopause
The road to menopause comes with many changes. Night sweats, hormonal imbalances, and vaginal dryness are a few of the well-known symptoms of perimenopause. Heavy, painful periods are also a symptom thats quite common roughly 25 percent of women report experiencing them. Read on to learn the basics of perimenopause bleeding and how to manage extended perimenopause periods.
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Other Drugs Used For Menopausal Symptoms
Despite its risks, hormone therapy appears to be the most effective treatment for hot flashes. There are, however, nonhormonal treatments for hot flashes and other menopausal symptoms.
The antidepressants known as selective serotonin-reuptake inhibitors are sometimes used for managing mood changes and hot flashes. A low-dose formulation of paroxetine is approved to treat moderate-to-severe hot flashes associated with menopause. Other SSRIs and similar antidepressant medicines are used “off-label” and may have some benefit too. They include fluoxetine , sertraline , venlafaxine , desvenlafaxine , paroxetine , and escitalopram .
Several small studies have suggested that gabapentin , a drug used for seizures and nerve pain, may relieve hot flashes. This drug is sometimes prescribed “off-label” for treating hot flash symptoms. However, in 2013 the FDA decided against approving gabapentin for this indication because the drug demonstrated only modest benefit. Gabapentin may cause:
Is Bleeding During Perimenopause Normal
The years before menopause are called perimenopause. During this time, your hormones shift. Your period may be heavier or lighter than usual. You may also have spotting. Thatâs normal. But if your bleeding is heavy or lasts longer than usual, talk to your doctor. You should also get checked out if you bleed after sex or more often than every 3 weeks.
Ming Tsai, MD, associate professor, obstetrics and gynecology, NYU School of Medicine chief of service, obstetrics and gynecology, NYU Lutheran, New York City.
American College of Obstetricians and Gynecologists: âEndometrial Biopsy,â âEndometrial Cancer,â âEndometrial Hyperplasia,â âHysterectomy,â âPerimenopausal Bleeding and Bleeding After Menopause,â âSonohysterography.â
Mayo Clinic: âBleeding After Menopause: Is It Normal?â âDilation and curettage ,â âDiseases and Conditions: Menopause,â âVaginal Atrophy.â
Journal of Midwifery and Womenâs Health: âAbnormal Uterine Bleeding.â
Cleveland Clinic: âWhat is Hysteroscopy?â
Obstetrics & Gynecology: âManagement of Endometrial Precancers.â
What Are The Stages Leading Up To Menopause
After puberty, there are three other phases of female fertility:
- Pre-menopause: Women have full ovarian function, regularly produce estrogen and ovulate.
- Perimenopause: The ovaries begin to fluctuate in their ovulation and production of estrogen, which can result in unpredictable menstrual cycles and symptoms.
- Menopause: When the ovaries have shut down. Someone would be in menopause after 12 months without menses.
Your Age Affects Your Risk
The longer youve been in menopause, the less likely you are to experience postmenopausal bleeding. Women are significantly more likely to have bleeding in the first year of menopause compared to later on, research shows.
But women whove been postmenopausal for a while still need to pay attention to any bleedingendometrial cancer most commonly affects women in their mid-60s.
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When Does Perimenopause Start
The average age of menopause is 51, and perimenopause symptoms typically begin about four years before your final period. Most women start to notice perimenopause symptoms in their 40s. But perimenopause can happen a little earlier or later, too. The best predictor of when your final period will be is the age at which your mother entered menopause .
Ht Forms And Regimens
HT comes in several forms:
- Oral tablets or pills
- Vaginal ring
- Topical gel or spray
HT pills and skin patches are considered “systemic” therapy because the medication delivered affects the entire body. The risk for blood clots, heart attacks, and certain types of cancers is higher with hormone pills than with skin patches or other transdermal forms.
Vaginal forms of HT are called “local” therapy. Doctors generally prescribe vaginal applications of low-dose estrogen therapy to specifically treat menopausal symptoms such as vaginal dryness and pain during sex. This type of ET is available in a cream, tablet, or ring that is inserted into the vagina.
“Bioidentical” hormone therapy is promoted as a supposedly more natural and safer alternative to commercial prescription hormones. Bioidentical hormones are typically compounded in a pharmacy. Some compounding pharmacies claim that they can customize these formulations based on saliva tests that show a woman’s individual hormone levels.
The FDA and many professional medical associations warn patients that “bioidentical” is a marketing term that has no scientific validity. Formulations sold in these pharmacies have not undergone FDA regulatory scrutiny. Some of these compounds contain estriol, a weak form of estrogen, which has not been approved by the FDA for use in any drug. In addition, saliva tests do not give accurate or realistic results, as a woman’s hormone levels fluctuate throughout the day.