How Does Menopause Affect Iron Levels In My Blood
If you are still having periods as you go through menopause, you may continue to be at risk of a low iron level. This is especially true if your bleeding is heavy or you spot between periods. This can lead to anemia. Talk with your doctor about the amount of iron thats right for you. Good sources of iron include spinach, beans, and meat. Your doctor may also suggest that you take an iron supplement.
What Medications Are Used To Treat Postmenopausal Symptoms
Hormone therapy could be an option, although healthcare providers often recommend using it for a short amount of time and in people under the age of 60. There are health risks associated with hormone therapy like blood clots and stroke. Some healthcare providers do not recommend using hormone therapy after menopause has ended or if you have certain medical conditions.
Some medications your healthcare provider may consider helping with postmenopausal symptoms are:
- Antidepressants for mood swings or depression.
- Vaginal creams for pain related to sexual intercourse and vaginal dryness.
- Gabapentin to relieve hot flashes.
Oftentimes your provider will recommend lifestyle changes to help manage your symptoms.
Not Sure What To Do Next
If you are still concerned about bleeding after menopause, use healthdirects online Symptom Checker to get advice on when to seek medical attention.
The Symptom Checker guides you to the next appropriate healthcare steps, whether its self care, talking to a health professional, going to a hospital or calling triple zero .
Irregular Periods In Your 40s Is It Perimenopause Or Something Else
If youre in your mid- to late 40s and your periods are becoming irregular, you may be in the menopausal transition, or perimenopause. This is the natural stage your body goes through as you approach menopause.
This stage lasts about four years on average, although some women may experience only a few months or many more years of symptoms. It is characterized by fluctuations in hormones as your ovaries are nearly out of eggs. Your estrogen levels drop and you may have markedly irregular menstrual cycles. On top of irregular periods, hormonal changes can lead to weight gain, hot flashes, trouble sleeping, vaginal dryness, mood changes, and depression.
Perimenopause ends with menopause, at which point you have not had a period for 12 months.
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:
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How Do You Know You’re In Postmenopause
Your healthcare provider will be able to tell you if you’re in postmenopause based on your symptoms and how long it’s been since your last menstrual period. In some cases, your healthcare provider will take a blood sample and check your hormone levels to confirm you’ve gone through menopause. Remember, you’re not considered to be through menopause until it’s been over one year since youve had a period.
What’s The First Sign Of Perimenopause
The first perimenopause sign is typically a disruption of your menstrual cycle. For many women, your period starts earlier or later than normal. For example, if your menstrual cycle has always been 28 days, during perimenopause, your period could come as early as 21 or as late as 35 days. Some women start skipping months entirely and then experience heavier-than-normal periods when they do have them.
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Status Of Hormone Replacement Therapy
Assessment of the risks versus the benefits of HRT has become a challenging task for the physicians. Controversial issues have surrounded the status of HRT for postmenopausal women lately. Several randomized controlled trials present contradicting evidence and have raised questions about the short-term risks of long-term benefits of HRT. Evidence from clinical trials like the WHI and The Heart and Estrogen/Progestin Replacement Study trial does not support HRT use for prevention of cardiovascular disease. The association of HRT with cancer, stroke, cognition, cardiovascular disease, venous thromboembolism, osteoporosis, gallbladder disease is under scrutiny. The latest controversial results of randomized controlled trials in recent years have posed newer challenges for the physicians in prescribing HRT for postmenopausal women.
How Do I Manage Bleeding After Menopause
Your doctor will want to do some investigations to find the cause of your bleeding. Let them know if you have noticed any changes going to the toilet, whether you have pain, have lost weight or whether you are on HRT. You may also want to check whether you need a cervical screening test.
Some women may need to have an ultrasound, blood test or may be referred to a gynaecologist for further tests.
Treatment will depend on what is causing the bleeding. It may involve medicines to control problems with the lining of the uterus, or surgery to remove polyps.
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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.
How Is It Treated
That depends on whatâs causing the bleeding.
Estrogen therapy: This hormone is used to treat vaginal and endometrial atrophy. Your doctor may prescribe it in one of the following forms:
- Pills: Youâll take them by mouth.
- Vaginal cream: Youâll use an applicator to get it inside your body.
- Vaginal ring: You or your doctor can put it in place. It releases a steady dose of estrogen for about 3 months.
- Vaginal tablet: Youâll insert it using an applicator. You may need to do it daily, or a few times a week.
Progestin therapy: This lab-made version of progesterone is used to treat endometrial hyperplasia. Your doctor may prescribe it in a pill or shot, a vaginal cream, or intrauterine device.
Hysteroscopy: This procedure can remove polyps. Doctors also use it to remove thickened parts of the uterine lining caused by endometrial hyperplasia. Theyâll insert a hysteroscope into your vagina and pass tiny surgical tools through the tube.
D& C : In this surgery, the doctor opens your cervix. . They use a thin tool to remove polyps or thickened areas of the uterine lining caused by endometrial hyperplasia.
Hysterectomy: This surgery removes part or all of your uterus. Itâs a treatment for endometrial or cervical cancer. Some people with a precancerous form of endometrial hyperplasia may also need it. In some cases, the doctor may also take out your ovaries, fallopian tubes, or nearby lymph nodes.
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How Are Cramps After Menopause Diagnosed
If you have cramps after menopause, make an appointment with your primary care doctor or OB-GYN so you can find out whats causing them. Your doctor may do a pelvic exam to look at your uterus to see if there are any physical problems.
You might also need imaging tests to look inside your body at your uterus or ovaries. These tests can include:
- a CT scan
- an MRI scan
- a hysterosonography and hysteroscopy, which involve placing a salt and water solution, or saline, into your uterus so the doctor can examine it more easily
- an ultrasound, which uses sound waves to create pictures of the inside of your body
If your doctor suspects you have cancer, you may need to have a procedure to remove a piece of tissue from your uterus or ovaries. This is called a biopsy. A specialist called a pathologist will look at the tissue under a microscope to determine if its cancerous.
How Long Does The Transition To Menopause Last
Perimenopause, the transition to menopause, can last between two and eight years before your periods stop permanently. For most women, this transition to menopause lasts about four years. You will know you have reached menopause only after it has been a full year since your last period. This means you have not had any bleeding, including spotting, for 12 months in a row.
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Postmenstrual Bleeding Treatment Options
Treatment options for postmenopausal bleeding will largely depend on whats causing your symptoms. Estrogen therapy can be used to treat conditions such as vaginal and endometrial atrophy. Progestin therapy, on the other hand, is used to treat endometrial hyperplasia.
Polyps can be removed during a hysteroscopy, or they might require surgery. Cancer and severe cases of endometrial hyperplasia can require a hysterectomy. If youre diagnosed with cancer, your doctor will discuss several options with you, including chemotherapy, radiotherapy, and hormonal treatments.
As with most other conditions, the most important step when it comes to postmenopausal bleeding is to get an early diagnosis. Once you know whats causing your symptoms, you and your doctor will be able to discuss treatment options and decide on the best course of action for your individual case.
Discovering that youre bleeding after menopause can be scary, but in most cases, the underlying condition can be treated with simple therapeutic options. Ensuring your wellbeing and overall health should always be your main concern.
When Does Menopause Occur
Most women reach menopause between 45-55 years of age, and the average age for women in Australia to reach menopause is 51-52 years. Some women will have a later menopause, at up to 60 years of age, especially if there is a family history of late menopause.
Menopause sometimes occurs earlier than expected as a result of cancer treatment, surgery or unknown causes. This is discussed further in ‘Causes of menopause’.
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Gaps In Knowledge And Future Directions
It has been difficult to distinguish between symptoms that result from loss of ovarian function and those from the aging process or from the socio-environmental stresses of midlife years. Symptoms which result from loss of ovarian function should resolve by hormone replacement, but it has not been found so. Further research is required in this direction.
Symptoms have variable onset in relation to menopause. Some women experience symptoms earlier during perimenopause while some experience them at a later time. When should treatment start is also an issue for debate.
As recent data from the WHI establish the risks of long-term HRT use, concern about using HRT, even as a short-term intervention, has increased substantially. Although HRT remains the first-line treatment for hot flushes, the WHI findings have drawn attention to nonhormonal treatments of hot flushes and other menopausal symptoms. Growing evidence to support the efficacy of serotonergic antidepressants and other psychoactive medications in the treatment for hot flushes suggests that nonhormonal interventions will prove important alternatives to HRT. As further evidence of the benefits of psychoactive medications for menopausal symptoms is established, the choice between using hormonal and nonhormonal therapies for the management of menopausal symptoms will continue to evolve.
Psychological Or Social Conditions
Numerous psychological and social theories have been proffered to explain why women may become depressed during perimenopause. Some of these are related to the following factors:
Change in the childbearing role
Loss of fertility, which may be associated with a loss of an essential meaning of life
Empty nest syndrome
The societal value of youth .
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Period Again After None For 2 Years
I am 50 years old. I have not had a period for two years, but today I started. Is this normal?
26 likes, 1070 replies
Edited 4 months ago
I did have this happen to me also – postmenopausal bleeding – only a bit earlier . I could not attribute it to any particular changes and was frightened. Saw my family doc asap. He ordered a transvaginal ultrasound and I think I also had a smear. All was normal. You certainly should report this to your doctor, though – standard orders for any such bleeding. Call today.
Edited 4 months ago
I am so glad to have found this forum. Suddenly had a period after a 13 month period. I was not surprised to see it as two weeks prior had some signs that I was ovulating. But on being advised by a friend to see a doctor I googled post menopausal bleeding and was scared to death with what I read about it possibly being signs of cancer. I didn’t sleep last night as a result and will certainly get it checked out by the Doctor but I feel loads better to read that it seems to happen to quite a lot of women. Fingers crossed that everything is normal. But thanks everyone for sharing.
Edited 4 months ago
Sorry – should clarify: it is important to report vaginal bleeding that occurs AFTER 12 months have passed without a period. You clearly fall within that guideline.
Edited 4 months ago
i had a clear smear test this year but after 2 years of nothing, am having a heavy period. do i need to see doc still? i cant bare the thought of being poked about again.
Memory And Concentration Problems
During perimenopause, women often complain of short-term memory problems and difficulty with concentration. Study results looking at the relationship between falling hormone levels and cognitive function have been inconsistent. Some women do believe that low dose estrogen after menopause helps them think. But the research has not supported this. Stress likely plays a more important role in memory and thinking compared to hormonal fluctuations.
Treating memory and concentration problems. Just as it isn’t clear what causes memory and concentration problems, there is no obvious remedy. Staying physically active and scheduling at least 150 minutes per week of dedicated exercise may be the best way to maintain brain health. Brain and memory experts also recommend that people work to keep their brain functioning at its peak by taking on new and interesting challenges. Use your mind in many different ways. Do crossword puzzles. Learn a new musical instrument or sport. Play chess. Read more books. Learn a new language or how to use the computer. The idea is to challenge your brain in new ways.
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Menopause And Mental Health
Many women experience symptoms of anxiety, loss of confidence, brain fog and other symptoms relating to their mental health during menopause.
These psychological symptoms are a result of the changes happening to your body and can have a big impact on your life.
Sometimes these symptoms are not recognised as menopause symptoms, but if you know what to expect, it can help you decide on what to do to manage the symptoms and feelings you are experiencing.
Uterine Bleeding: What’s Normal What’s Not
One concern for perimenopausal and postmenopausal women is knowing whether irregular uterine bleeding is normal. Most women notice normal changes in their cycle as they approach menopause. Periods are often heavy or more frequent, and they may stop and start. But abnormal uterine bleeding may be a sign of benign gynecologic problems or even uterine cancer. Consult your physician if any of the following situations occur:
- You have a few periods that last three days longer than usual.
- You have a few menstrual cycles that are shorter than 21 days.
- You bleed after intercourse.
- You have heavy monthly bleeding .
- You have spotting .
- You have bleeding that occurs outside the normal pattern associated with hormone use.
When you report abnormal vaginal bleeding, your clinician will try to determine whether the cause is an anatomic problem or a hormonal issue. He or she also will investigate other possible causes. In addition to identifying the cause, he or she will help you manage any excess bleeding, which sometimes leads to anemia.
On rare occasions, postmenopausal women experience uterine bleeding from a “rogue ovulation,” which is vaginal bleeding after a hiatus that may be preceded by premenstrual symptoms such as breast tenderness. Presumably, the ovaries are producing some hormones and maybe a final egg.
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