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Can You Have Spotting During Menopause

What Could Cause Spotting During Perimenopause

What to Expect During Perimenopause

Other than the hormonal ups and downs that occur during perimenopause, what else could cause spotting during perimenopause?

  • The early stages of pregnancy for one Yup, its still possible during perimenopause!
  • The insertion or removal of an intrauterine device
  • Being on the Pill or forgetting to take it
  • A uterine fibroma
  • A vaginal or cervical polyp or injury
  • An infection and/or sexually transmitted infection
  • Diseases such as endometriosis or cancer

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 Birth Control Masks Menopause Symptoms

Birth control pills are a form of hormonal contraception. Combination pills contain synthetic forms of estrogen and progesterone, two naturally occurring hormones. Minipills contain only progestin, which is the synthetic version of progesterone.

In addition to preventing pregnancy, birth control pills help regulate your bodys hormone levels. As you approach menopause, your bodys natural estrogen levels will start to decrease but the pills synthetic hormones prevent your body from recognizing this decline.

Youll also continue to experience a monthly bleed, though this will depend on the type of pill youre taking. For example, women who take combination birth control pills will continue to have a week of period-type bleeding each month. Women who take the minipill may experience more irregular bleeding.

Birth control pills also have side effects that are similar to menopause symptoms. These include:

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Spotting During Menopause: Is It Normal

    Menopause and perimenopause are a time in a womans life marked by endings and beginnings.

    While menopause technically starts 12 months after a womans last menstrual cycle, there are other factors to consider. As San Diego-based OB-GYN Dr. Diana Hoppe explains, menopause is when a woman goes from a reproductive stage to a non-reproductive one, with the average age around 51.

    Perimenopause, Dr. Hoppe notes, is the 2-8 years before menopause when a woman is still experiencing a menstrual cycle. During this time cycles can become more irregular, i.e. they can happen twice a month or they can skip altogether.

    She says both perimenopausal and menopausal women can experience shared symptoms including hot flashes, night sweats, mood swings, insomnia, and . So, how exactly does spotting factor in when it comes to menopause, and when should there be cause for concern?

    Mirena And Other Forms Of Contraception Dont Affect The Onset Of Menopause

    14 Signs of Menopause and Perimenopause

    Mirena partially suppresses ovulation the release of an egg from its follicle to stop you from getting pregnant. Stands to reason that releasing fewer eggs will make the ones you have last longer and make you go into menopause later, right? Wrong.

    Even if you dont ovulate, you steadily lose follicles as you get older. Mirena or any other type of contraceptive doesnt seem to affect the time it takes to get to menopause.

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    What Is Considered Abnormal Perimenopause Bleeding

    Typical irregularities aside, certain cases of perimenopausal bleeding could require closer medical attention. The following are considered abnormal perimenopausal bleeding patterns:

    • Very heavy menstrual bleeding, particularly with clotting
    • Bleeding after sexual intercourse

    Approximately 25 percent of women experience heavy perimenopausal bleeding, also referred to as menorrhagia, flooding, or hypermenorrhea. Potential reasons for increased menstrual flow include:

    • An imbalance of estrogen and progesterone hormones
    • Fibroids: benign tumors, which may grow larger and cause heavy perimenopausal bleeding
    • Endometrial hyperplasia: a thickening of the uterine lining that leads to irregular bleeding
    • Endometrial polyps: small, noncancerous tissue growths in the uterine lining enlarged by the onset of perimenopause
    • Thyroid problems: heavy perimenopausal bleeding is sometimes brought on by an underactive thyroid, or hypothyroidism
    • Polycystic ovarian syndrome: an endocrine disorder that produces irregular periods along with abnormal bleeding in the uterus

    How Does The Perimenopause Impact Your Periods

    In your peak reproductive years, levels of your reproductive hormones oestrogen and progesterone rise and fall somewhat consistently throughout your menstrual cycle. When you enter the perimenopause, however, your ovaries stop ovulating regularly.Since ovulation is more infrequent than before, circulating levels of oestrogen and progesterone become unpredictable and erratic, which can result in unusual bleeding patterns.

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    Mayo Clinic Q And A: Spotting Perimenopause And Menopause

    DEAR MAYO CLINIC: I am 52 and recently had gone 10 months without a period, so I had assumed I was in menopause. But, over the past three months, I’ve noticed some light spotting. Does this mean I’m not in menopause? How do I know when I’m in menopause, and do I need to see a gynecologist or health care provider about this issue?

    ANSWER: It’s possible that you haven’t reached menopause yet. Clinically, menopause is defined as going without a period for one year. At 10 months, you don’t quite meet that threshold, but it is possible that you are just beginning menopause. However, depending upon when you last saw your health care provider and had a pelvic exam, it might be worthwhile to make an appointment, as there are a number of conditions where breakthrough bleeding is the first indication of an issue.

    Menopause is the natural process that marks the end of a woman’s reproductive years when menstrual cycles stop. It typically happens during the 40s or 50s, with the average age of menopause in the U.S. at 51.

    Skipping periods as you approach menopause a stage sometimes called perimenopause is common and expected. During that time, menstrual periods often will skip a month and return, or skip several months and then start monthly cycles again for a few months. Periods also tend to happen on shorter cycles during perimenopause, so they may be closer together than is typical for you.


    What To Expect During Diagnosis

    How to spot the signs of menopause

    After discussing your symptoms, your provider will perform a pelvic exam.

    During the exam, theyll check your vulva for unusual redness, swelling, or other symptoms. Theyll insert a speculum into your vagina so they can inspect inside the vagina and cervix.

    Your provider may take a small sample of discharge to send to a lab for testing. The lab technician will likely check the pH level. A high pH level means your discharge is more basic. Its easier for bacteria to grow in a more basic environment. This is a pH level above 4.5.

    They may also view the sample under a microscope to look for yeast, bacteria, and other infectious substances. An infection can change the texture, amount, or smell of your discharge.

    The results of these tests will help your healthcare provider determine whether treatment is necessary, and if so, which treatment is best.

    Fluctuations usually result from changing estrogen levels and dont require treatment.

    If your doctor diagnoses DIV, they may recommend topical clindamycin or hydrocortisone to help relieve symptoms.

    If your symptoms are the result of a fungal or bacterial infection, your doctor will recommend an over-the-counter or prescription topical to soothe irritation and clear the infection.

    Treatment options are also available for symptoms that result from a sexually transmitted infection or other cause unrelated to perimenopause.

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    Is It Possible To Stop Spotting After Menopause

    The spotting stopped on its own, and I have had no further issues. It is now over fifteen years after I had the spotting. What is missing from this article, in my opinion, is the increased chance of endometrial cancer and uterine cancer after being on tamoxifen for breast cancer treatment.

    Is it normal to have breakthrough bleeding after menopause? Bleeding after menopause is not normal, so take it seriously. Go directly to your ob-gyn. Polyps also can cause vaginal bleeding. If your ob-gyn discovers these benign growths in your uterus or on your cervix, you might need surgery to remove them. What medications can

    How Is It Diagnosed

    To find the cause of your bleeding, the doctor will do a physical exam and review your medical history. You may need one or more of the following tests:

    Transvaginal ultrasound: This image helps your doctor check for growths and look at the thickness of your endometrium. Theyâll place a small probe into your vagina. It sends off sound waves to create a picture of the inside of your body.

    Endometrial biopsy: The doctor uses a thin tube to take a small sample of the tissue that lines your uterus. Theyâll send it to a lab where scientists will look for anything unusual, like an infection or cancerous cells.

    Sonohysterography: Your doctor may use this test to measure the size of a polyp. Theyâll put a saltwater solution inside your uterus to create a clearer ultrasound image.

    Hysteroscopy: When the doctor needs to look inside your uterus, theyâll use a hysteroscope. This thin, lighted tube has a camera on one end.

    D& C : During this procedure, the doctor opens your cervix. They use a thin tool to scrape or suck a sample of the uterus lining. They send this to a lab that will check for polyps, cancer, or a thickening of the uterine lining .

    Ultrasound and biopsy are usually done in your doctorâs office. Hysteroscopy and D& C require anesthesia on one part of or your whole body. Youâll either go to a hospital or an outpatient surgical center.

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    How To Manage Bleeding During Perimenopause

    Again, if youre bleeding during menopause, youll want to see your doctor, but for women who experience bleeding or spotting during menopause, there are ways to manage.

    Pads and/or tampons may still be needed, especially for an unusually heavy menstrual cycle, Dr. Hoppe says.

    There is also a procedure called endometrial ablation, which can help with heavy bleeding in perimenopausal women, she adds.

    For some postmenopausal women on hormone therapy, sometimes a progestin-IUD can be used to help bleeding, Dr. Hoppe says, but only after a complete workup has been done to rule out any abnormalities.

    What Treatments Are Available

    10 reasons why you might be bleeding after sex

    If you havent completely gone through menopause and your cramps indicate that your periods are tapering off, you can treat them as you would period cramps. Your doctor might recommend an over-the-counter pain reliever such as ibuprofen or acetaminophen .

    Warmth can also help soothe your discomfort. Try putting a heating pad or hot water bottle on your abdomen. You can also try exercise if you are not in too much pain. Walking and other physical activities help relieve discomfort as well as ease stress, which tends to make cramps worse.

    When your cramps are caused by endometriosis or uterine fibroids, your doctor might recommend a medicine to relieve symptoms. Surgery can also be an option to remove the fibroid or endometrial tissue thats causing you pain.

    How cancer is treated depends on its location and stage. Doctors often use surgery to remove the tumor and chemotherapy or radiation to kill cancer cells. Sometimes, doctors also use hormone medicines to slow the growth of cancer cells.

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    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 Happens At Menopause

    Women are born with about a million eggs in each ovary. By puberty about 300,000 eggs remain, and by menopause there are no active eggs left.

    On average, a woman in Australia will have 400-500 periods in her lifetime. From about 35-40 years of age, the number of eggs left in your ovaries decreases more quickly and you ovulate less regularly until your periods stop. Menopause means the end of ovulation.

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    When Spotting Happens During Perimenopause

    Irregular bleeding and spotting are very common when it comes to perimenopause. This is because there are usually 1-3 years of irregular periods during this time, which can include spotting, explains Houston-based OB-GYN Dr. Susan Hardwick-Smith.

    During perimenopause, many women experience changes in their bleeding patterns, which can include spotting around ovulation, says Dr. Yael Swica, a womens health doctor from New York City. This spotting can occur leading up to their periods, or afterward.

    Dr. Swica says women can also experience heavier periods or changes in cycle length during this time as well.

    This is not normal, however, during menopause. When it comes to menopause, Dr. Hoppe puts it simply: a woman should not have any bleeding or spotting.

    Stop Suffering And Get Help For Abnormal Perimenopausal Bleeding

    Menopause Symptoms: Bleeding

    Over your reproductive years, youve come to expect a certain degree of predictability with regard to your menstrual cycle. Whether its timing, length or amount of flow, there is generally not much variation from month to month. But as you enter perimenopausethe three to five years leading up to menopauseall of this changes. And while some of these changes are manageable, some are not.

    Just as every womans menstrual cycle is different, so is her experience of perimenopause, says Beverly M. Vaughn, MD, a gynecologist at Lankenau Medical Center, part of Main Line Health. Many women are caught off guard by the many changes that occur during these premenopausal years and I see a lot of women suffer through heavy bleeding even though there are very effective and minimally invasive treatments for it.

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    What Causes Perimenopause Spotting

    Spotting refers to any light bleeding outside your usual menstrual window. As the name suggests, you may find small spots of red or pink blood in your underwear or when you go to the loo. Spotting doesnt usually require sanitary protection.Generally speaking, spotting is the result of your bodys changeable hormones and endometrium build-up. Many perimenopausal women spot just before their period starts or as it ends. On occasion, you may also spot in the middle of your cycle when you ovulate.Although some spotting is normal, if youre regularly spotting every fortnight or, in some cases, every day of the month you may want to speak to your GP.

    How Much Bleeding Is Normal After Menopause

    You may think you have reached menopause if you have not had a period for a few months. However, it is still possible to have a period up to a year after your last one. After 12 months without a period, any bleeding at all is not normal.

    Up to 1 in 10 women experience bleeding or spotting after their menopause. In most cases the bleeding is not serious and a cause may not be found. However, it needs to be checked because sometimes it can be a sign of cervical or uterine cancer, so it is always important to see a doctor if you notice any vaginal bleeding after menopause.

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    Ovarian And Uterine Cancers

    Cancer of the ovary or uterus can cause abdominal cramps. Your risk for these cancers increases in your 50s and beyond. Cramps alone arent reason to assume you have cancer. Women who have cancer usually have other symptoms along with cramps, such as:

    • vaginal bleeding
    • fatigue
    • unexplained weight loss

    Any worrisome symptoms warrant a visit to your doctor just to make sure theyre not due to something serious.

    You may be more likely to get one of the conditions that causes cramps after menopause if you:

    • took estrogen for menopause symptoms
    • have a family history of ovarian or uterine cancer
    • got your first period before age 12
    • started menopause after age 52
    • used an IUD to prevent pregnancy

    Think about whether you have any of these risk factors. Then, discuss them with your doctor.

    Heavy Periods And Flooding During Perimenopause

    What are the 34 Symptoms of Menopause?

    Alongside changes in regularity, you may notice your period is heavier than usual. Before the perimenopause, your ovaries secreted oestrogen to thicken the lining of the womb. Once the ovaries released the egg, they produced progesterone.The synergetic relationship between oestrogen and progesterone ensured your periods werent too heavy or light. However, as you enter the menopause, ovulation becomes more sporadic, even though your ovaries continue to secrete oestrogen. Since there isnt enough progesterone to stabilise the effects of oestrogen, you may experience heavier periods.Some perimenopausal women can experience extremely heavy periods with flooding, medically known as Perimenopausal Dysfunction Bleeding . In this, bleeding can be so heavy that sheets or seating become soaked with blood when lying or sitting down.1 Naturally, this can interfere with your everyday life.Though heavy bleeding is common during the menopause, you shouldnt ignore it. We recommend discussing this with your GP.

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