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Can You Still Have A Period During Menopause

What Else Should I Ask My Healthcare Provider

Can Periods Restart After Menopause?

You may also want to ask your healthcare provider:

  • How long should I expect perimenopause to last?
  • What can I do to decrease symptoms naturally?
  • Am I a candidate for hormone therapy?
  • What are the signs perimenopause is ending?
  • What do I need to do to take care of my health through this transition?
  • Am I up-to-date on all my health screening tests such as a pap smear and mammogram?

A note from Cleveland Clinic

Perimenopause is the transition to menopause. During perimenopause, you may start having menopause-like symptoms, such as hot flashes, mood swings or vaginal dryness. Most perimenopause symptoms are manageable. But if you need help managing symptoms, medications and other treatments are available. For some people, estrogen therapy may be an option. Perimenopause can last from a few months to several years. Perimenopause ends when youve had no period for a full year. At that point, you enter menopause.

Last reviewed by a Cleveland Clinic medical professional on 06/25/2021.

References

Symptoms Of The Menopause

Most women will experience menopausal symptoms. Some of these can be quite severe and have a significant impact on your everyday activities.

Common symptoms include:

Menopausal symptoms can begin months or even years before your periods stop and last around 4 years after your last period, although some women experience them for much longer.

What Is Hormone Therapy

During menopause, your body goes through major hormonal changes, decreasing the amount of hormones it makes particularly estrogen and progesterone. Estrogen and progesterone are produced by the ovaries. When your ovaries no longer make enough estrogen and progesterone, hormone therapy can be used as a supplement. Hormone therapy boosts your hormone levels and can help relieve some symptoms of menopause. Its also used as a preventative measure for osteoporosis.

There are two main types of hormone therapy:

  • Estrogen therapy : In this treatment, estrogen is taken alone. Its typically prescribed in a low dose and can be taken as a pill or patch. ET can also be given to you as a cream, vaginal ring, gel or spray. This type of treatment is used after a hysterectomy. Estrogen alone cant be used if a woman still has a uterus.
  • Estrogen Progesterone/Progestin Hormone Therapy : This treatment is also called combination therapy because it uses doses of estrogen and progesterone. Progesterone is available in its natural form, or also as a progestin . This type of hormone therapy is used if you still have your uterus.

Hormone therapy can relieve many of the symptoms of menopause, including:

  • Hot flashes and night sweats.
  • Vaginal dryness.

Also Check: Is Shortness Of Breath A Symptom Of Menopause

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.
  • Sweating.
  • 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 I Know If I Am Starting The Transition To Menopause

Hormone Replacement Therapy

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.

Recommended Reading: What Does Going Through Menopause Feel Like

Are There Any Other Emotional Changes That Can Happen During Menopause

Menopause can cause a variety of emotional changes, including:

  • A loss of energy and insomnia.
  • A lack of motivation and difficulty concentrating.
  • Anxiety, depression, mood changes and tension.
  • Headaches.
  • Aggressiveness and irritability.

All of these emotional changes can happen outside of menopause. You have probably experienced some of them throughout your life. Managing emotional changes during menopause can be difficult, but it is possible. Your healthcare provider may be able to prescribe a medication to help you . It may also help to just know that there is a name to the feeling you are experiencing. Support groups and counseling are useful tools when dealing with these emotional changes during 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” Hormones

“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.

Also Check: Why Do Your Breasts Get Bigger During Menopause

Will I Start Menopause If I Have A Hysterectomy

During a hysterectomy, your uterus is removed. You wont have a period after this procedure. However, if you kept your ovaries removal of your ovaries is called an oophorectomy you may not have symptoms of menopause right away. If your ovaries are also removed, you will have symptoms of menopause immediately.

How Can I Reduce My Risk Of Perimenopause Complications

Periods During Perimenopause | What’s Happening to Me?

Irregular periods are the most common symptom of perimenopause. But its important to know when to talk to your healthcare provider about your periods. Sometimes, irregular bleeding can point to an underlying problem.

You can lower your risk of complications by seeking treatment when necessary. Talk to your healthcare provider if you:

  • Bleed for more than seven days in a row.
  • Bleed between periods.
  • Change pads or tampons every one to two hours.
  • Have periods more frequently than every 21 days.

Read Also: Do You Feel Sick During Menopause

Hot Flashes During Perimenopause

Most women don’t expect to have hot flashes until , so it can be a big surprise when they show up earlier, during perimenopause. Hot flashes sometimes called hot flushes and given the scientific name of vasomotor symptoms are the most commonly reported symptom of perimenopause. They’re also a regular feature of sudden menopause due to surgery or treatment with certain medications, such as chemotherapy drugs.

Hot flashes tend to come on rapidly and can last from one to five minutes. They range in severity from a fleeting sense of warmth to a feeling of being consumed by fire “from the inside out.” A major hot flash can induce facial and upper-body flushing, sweating, chills, and sometimes confusion. Having one of these at an inconvenient time can be quite disconcerting. Hot flash frequency varies widely. Some women have a few over the course of a week others may experience 10 or more in the daytime, plus some at night.

Most American women have hot flashes around the time of menopause, but studies of other cultures suggest this experience is not universal. Far fewer Japanese, Korean, and Southeast Asian women report having hot flashes. In Mexico’s Yucatan peninsula, women appear not to have any at all. These differences may reflect cultural variations in perceptions, semantics, and lifestyle factors, such as diet.

What Causes Period Symptoms Without A Period During Menopause

So, why does this happen? It’s nearly always due to low oestrogen. All that’s happening here is that your oestrogen is starting to fall, but it still has a cycle every month, so it still goes up in the middle of the month and down towards the end of the month. It’s still high enough to trigger those PMS symptoms but it’s not high enough to trigger a period.

Recommended Reading: How To Combat Menopause Weight Gain

How Is Menopause Diagnosed

There are several ways your healthcare provider can diagnose menopause. The first is discussing your menstrual cycle over the last year. If you have gone a full year without a period, you may be postmenopausal. Another way your provider can check if you are going through menopause is a blood test that checks your follicle stimulating hormone level. FSH is a hormone produced by the pituitary gland this gland is located at the base of your brain. However, this test can be misleading during the beginning of menopause when your body is transitioning and your hormone levels are fluctuating up and down. Hormone testing always need to be interpreted in the context of what is happening with the menstrual period.

For many women, a blood test is not necessary. If you are having the symptoms of menopause and your periods have been irregular, talk to your healthcare provider. Your provider may be able to diagnose menopause after your conversation.

What Can Cause Bleeding After Menopause

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There can be several causes for vaginal bleeding after menopause, including:

  • inflammation and thinning of the lining of the vagina
  • thinning of the lining of the uterus
  • thickening of the lining of the uterus, often caused by hormone replacement therapy
  • polyps or other abnormalities in the cervix or uterus

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With All That Said You Can Still Have A Great Sex Life In Menopause

Pizarro and Brown-James both agree on this point. In fact, Dr. Pizarro says meno post-menopausal people have very active sex lives even without taking estrogen. Whats more, sexual satisfaction might increase once someones been through menopause.

There are a few reasons that might happen. The worry of being pregnant is no longer there, says Brown-James. Also, some people experience an increase in their sexual awareness of their bodies. Many women have not been taught to explore their bodies and have internalized ideas that the vulva or vagina are dirty or for someone elses pleasure, not theirs, she explains. A lot of times, if the knowledge that none of that is true hasnt taken root before, it gets dispelled at this point, and women realize their bodies are really for themselves. Bonus: That may also lead to more intense orgasms, says Brown-James.

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.

Also Check: Does Being On Birth Control Delay Menopause

Q When Should I Call A Doctor About My Perimenopausal Symptoms

  • If you are experiencing hot flashes and night sweats under the age of 45, contact your OBGYN to see what else might be causing them. When you have abnormal uterine bleeding, it is important to alert us regardless of age as we may recommend an ultrasound or endometrial biopsy to rule out abnormal changes in the uterus.
  • If you have not had a period for 12 months and then experience vaginal bleeding, contact your doctor. It is not normal for bleeding to recur after this period of time. Read our article about when you should see your OBGYN.

    Remember, perimenopause and menopause are natural and normal transitions, but they can be stressful. Many symptoms can be managed which can help you regain a sense of control, well-being, and confidence to thrive in your next stage of life.

    We want you to feel supported, heard, and cared for as you go through this change.

    Sometimes, the biggest help is simply confirmation that what youre experiencing is normal!

    Dr. Ashley Durward has been providing healthcare to women in Madison since 2015 and joined Madison Womens Health in 2019, specializing in high and low risk obstetrics, contraception and preconception counseling, management of abnormal uterine bleeding, pelvic floor disorders, and minimally invasive gynecologic surgery.

    How Long Will Menopausal Transition Symptoms Last

    How to Deal with a Heavy Period during Perimenopause

    Menopause is technically one full year without bleeding, and perimenopause is the stage before the final menstrual period, also known as the menopausal transition. Puberty and perimenopause are similar in that they both involve hormonal changes, and the transitions can take place over several years. Some medical organizations, such as the American Osteopathic Association, refer to perimenopause as reverse puberty in women.

    According to NAMS, this phase can last four to eight years, and it comes with symptoms caused by hormone fluctuations, such as mood swings, poor sleep, and hot flashes.

    RELATED: Coping With Hot Flashes and Other Menopausal Symptoms: What 10 Celebrities Said

    The age at which a woman begins perimenopause can help predict how long the transition to menopause will last, according to research published in the journal Menopause in February 2017. The authors found that perimenopause lasted longer in women who started the transition at a younger age, and the women had more symptoms, such as hot flashes.

    Also Check: What To Do About Hair Loss In Menopause

    The Most Important Part Of Post

    Along with the physical changes that occur after menopause, women may need to improve their health care routines.

    Postmenopausal women are at greater risk for heart disease, so redirect your diet toward low-fat foods and lower your salt intake this reduces the risk of heart attack and atherosclerosis, a condition in which plaque builds up on the insides of the arteries.

    As part of your routine check-ups, you should have a blood test at a minimum of every five years until age 50, and then at regular intervals. Your doctor will recommend what that interval should be based on how high your cholesterol is, if you are on cholesterol treatment, and on other cardiovascular risk factors that you may have, such as hypertension or obesity.

    Women also should have their bone density checked once every two years to spot early signs of osteoporosis, a weakening of the bones. Postmenopausal women are particularly at risk for this condition: Research shows that up to 20 percent of bone loss can occur in the first five years of menopause.

    Estrogen is one of the best stimulators of bone growth, Audlin says. The risk of osteoporosis is very low before menopause, but post-menopausally, fractured hips and problems related to bone density are very likely.

    Women ages 50 and up should consume at least 1,200 milligrams of calcium every day to maintain bone health. This can be accomplished with supplements, by consuming calcium-rich foods like milk, or a combination of the two.

    Do All Menopausal Women Experience A Decrease In Sexual Desire

    Not all women experience a decreased sexual desire. In some cases, its just the opposite. This could be because theres no longer any fear of getting pregnant. For many women, this allows them to enjoy sex without worrying about family planning.

    However, it is still important to use protection during sex if not in a monogamous relationship. Once your doctor makes the diagnosis of menopause, you can no longer become pregnant. However, when you are in the menopause transition , you can still become pregnant. You also need to protect yourself from sexually transmitted infections . You can get an STI at any time in your life.

    Read Also: How Long Between Periods During Menopause

    I Got My First Period Early Does That Mean Ill Go Through Menopause Early

    I have many patients tell me, I know Im going to go through menopause earlier because I started my period really early, says Streicher. The reason women think that is because they think menopause occurs when you run out of eggs. This isnt going to happen were born with millions of eggs and many of those are never used. When you go through menopause is really about the aging of eggs and what causes them to age more quickly, she says.

    The average age of menarche in the United States has gotten younger for a variety of reasons, but that hasnt made women go through menopause earlier, she points out.

    Irregular Periods In Your 40s Is It Perimenopause Or Something Else

    13 reasons why you have not period but have cramps

    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.

    Recommended Reading: Do Periods Get Closer Together During Menopause

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