Heavy Bleeding During Menopause Is Not Normal Under Any Circumstances And Could Actually Mean Cancer Certain Cancers Can Cause Heavy Bleeding
Menopause means that you are no longer menstruating. So if youre bleedingone of two things is going on:
#1. Youre menstruating and are not going through menopause. Somehow, you mistakenly came to believe that you were undergoing the change. Menopause means no period. So if youre bleeding, youd better find out why.
Dr. Gino Tutera says that heavy bleeding during menopause is not normal, but adds that this would mean that a woman is entirely into menopause as evidenced by testing or having no menstruation for 12 months.
Dr. Gino Tutera is an OB/GYN and specialist in bioidentical hormone replacement therapy, and I interviewed him for this topic.
If you havent had lab testing, then its likely youve assumed that youre menopausal because youve missed several periods in a row.
But then some heavy bleeding occurs: menstruation. Or is it?
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The menopause brings an end to menstruation but in the lead-up, many women experience periods that can disrupt their lives and careers
If Emma Pickett needs to make a long journey, she checks her calendar very carefully. She will often take an emergency change of clothes when she goes out, and if giving a lecture for work, has to ensure it is no longer than half an hour. Yet she rarely hears anyone talk about the reason so many older women secretly go to all this trouble why theyve started to stick to black trousers, give up the sports they loved, or plan days out especially with children meticulously.
If you have a bunch of 12-year-olds in the car, you cant say: Sorry chaps, Im just bleeding heavily today, says Pickett, a 48-year-old breastfeeding counsellor and author of The Breast Book, who also happens to be among the one in five British women who suffer from heavy periods in the run-up to menopause . You can talk about hot flushes, make a joke about it. But because menstrual blood is gross in our society, theres no conversation about it. There must be women round the world just pretending they need to dash off for some other reason.
No one says erectile dysfunction is just part of mens lives. We say this is a typical thing and theres treatment
Ive come across women who are having extended sick leave because they didnt feel able to manage their bleeding
When Should I Contact My Doctor
Contact your healthcare provider if you experience vaginal bleeding:
- More than a year after your last menstrual period.
- More than a year after starting hormone replacement therapy .
A note from Cleveland Clinic
Its normal to have irregular vaginal bleeding in the years leading up to menopause. But if you have bleeding more than a year after your last menstrual period, its time to see your healthcare provider. It could be the result of a simple infection or benign growths. But in rare cases, bleeding could be a sign of uterine cancer.
Last reviewed by a Cleveland Clinic medical professional on 05/26/2021.
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Heavy Menstrual Bleeding And Vaginal Bleeding After Menopause
Reviewed on 8/5/2020
There are a few different medical conditions that are strongly associated with:
- Heavy Menstrual Bleeding
- Vaginal Bleeding After Menopause
While the symptoms above can be considered a guide to help associate symptoms common among the conditions below, this is not a substitute for a diagnosis from a health care provider. There are many other medical conditions that also can be associated with your symptoms. Below are the top condition matches for your symptom combination from MedicineNet:
What Is Postmenopausal Bleeding
Postmenopausal bleeding is bleeding that occurs after menopause. Menopause is a stage in a womans life when reproductive hormones drop and her monthly menstrual periods stop. Vaginal bleeding that occurs more than a year after a womans last period isnt normal. The bleeding can be light or heavy.
Postmenopausal bleeding is usually due to benign gynecological conditions such as endometrial polyps. But for about 10% of women, bleeding after menopause is a sign of uterine cancer . Uterine cancer is the most common type of reproductive cancer Talk to your healthcare provider if you experience any bleeding after menopause.
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What Symptoms Should I Watch For Between Pap Smears
Pre-cancerous conditions of the cervix seldom cause symptoms. For problems to be detected, a pelvic examination and a Pap smear are usually required.
When cancer is present in the cervix, the most common symptom is abnormal bleeding. Bleeding may start and stop between regular menstrual periods, or it may occur after sexual intercourse or douching . Abnormal vaginal discharge is another symptom. Pain is NOT an early warning sign of the disease. These symptoms can be caused by other conditions and are not sure signs of cancer but be sure to see your doctor if any of these symptoms occur.
Risk Factors For Bladder Prolapse
Risk factors for bladder prolapse include anything that puts pressure on the pelvic floor and affects its function, such as:
- pregnancy and childbirth
- regularly straining on the toilet to pass bowel motions or empty the bladder
- being overweight
- chronic cough secondary to smokers cough or chronic lung diseases
- repetitive lifting of children or heavy weights at work or in the gym, or any exercises where there is excessive downward pressure on the pelvic floor
- pelvic or gynaecological surgery
- strong family history
- connective tissue disease, in which the tissues in the body are not able to hold the weight of the organs
Postmenopausal women are more susceptible to bladder prolapse because they have reduced levels of oestrogen . Oestrogen helps to keep the vaginal tissues and muscles in good tone. When oestrogen levels drop after menopause, these tissues become thinner and less elastic, which may allow the bladder to bulge into the vagina.
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Treatment For Heavy Bleeding In Perimenopause
How heavy bleeding is treated will be determined by the diagnosis. If there is no pathologic cause for the bleeding , continued observation and re-evaluation may be the best plan, explains Dr. Bolton.
For growths such as fibroid tumors or endometrial polyps, minimally invasive gynecologic surgery such as hysteroscopic myomectomy, hysteroscopic polyp removal or endometrial ablation may be recommended. The ablation is a heat technique that removes the endometrial lining causing bleeding to slow down or in some cases, stop completely.
For persistent abnormal bleeding, hormone therapy may be an option. Hormone therapy can often help the bleeding problem while also alleviating the associated symptoms of perimenopause, such as hot flashes and night sweats. Oral contraceptives can be offered as treatment in the appropriate patient. Oral progestins can be given cyclically or only when the flow is heavy.
Some women respond well to a progesterone-containing IUD. This provides the endometrial lining with a boost in progesterone while not requiring a dose of hormones to the whole body. Placement of this type of IUD is done in a doctors office with no need for anesthetics. One newer option is a medication called tranexamic acid, a nonsteroidal medication in the same family as ibuprofen. It only needs to be taken at the beginning of the menses for three to five days, when there is a heavy flow.
Could I Have A Polyp
Polyps are soft outgrowths which can arise from the uterus and can cause heavy periods. They are usually benign with prevalence between 6% and 32%.3 Different research shows different prevalences and as polyps dont cause any symptoms apart from bleeding they are often under-diagnosed.
The prevalence usually increases with age which is why complaints of heavy periods/irregular bleeding may occur during menopause.4 It is still not known why polyps cause menorrhagia. A different blood supply to the polyp and impeded blood drainage may contribute to heavy bleeding.5
Polyps can be detected on ultrasound and removed using hysteroscopy . Very rarely can a polyp be cancerous .6 This risk increases with age, with post-menopausal people being most at risk, but there is no way of checking if polyps are cancerous until they are removed and sent to the lab.
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How Your Period Might Change
Perimenopause can make your once-regular periods suddenly irregular.
Before perimenopause, your estrogen and progesterone levels rise and fall in a consistent pattern during your menstrual cycle. When youre in perimenopause, hormone changes become more erratic. This can lead to unpredictable bleeding patterns.
During perimenopause, your periods may be:
- Irregular. Rather than having a period once every 28 days, you might get them less or more often.
- Closer together or further apart. The length of time between periods can vary from month to month. Some months you might get periods back to back. In other months, you might go more than four weeks without getting a period.
- Absent. Some months you might not get a period at all. You might think youre in menopause, but its not official until youve been period-free for 12 months.
- Heavy. You may bleed a lot, soaking through your pads.
- Light. Your bleeding might be so light that you barely need to use a panty liner. Sometimes the spotting is so faint that it doesnt even look like a period.
- Short or long. The duration of your periods can change, too. You might bleed for just a day or two or for more than a week at a time.
Is Heavy Bleeding After 50 Normal
Heavy bleeding is common among women transitioning into menopause, the point when your bodys reproductive system stops releasing eggs. One study found that among women ages 42 to 52, more than 90% experienced periods that lasted 10 days or more with 78% reporting their blood flow as heavy.
This is because when women approach menopause, there are fewer eggs to mature in the ovaries. The body releases higher levels of follicle-stimulating hormone in an attempt to maintain normal ovulation, which produces more estrogen.
These greater levels of estrogen thicken the lining of the uterus, often resulting in heavier, longer periods. The time it takes for a womans body to complete this cycle can extend as well, leading to longer gaps between periods and more blood flow.
This change in reproductive hormone levels called perimenopause generally begins about four years before a woman has her last period. But the transition can start as early as 10 years before menopause.
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When To See A Doctor
Speak with your healthcare provider if youre experiencing any of these:
- Abnormal length of period
- Bleeding with intercourse
While these are common during perimenopause and usually not a cause for concern, its best to keep your doctor in the loop and notify them of any changes. Anytime youre unsure or concerned about perimenopause symptoms, speak with your doctor.
Why Does Menopause Cause Heavy Periods
Your natural menstrual cycle is driven by your hormones. The menopause is the time that your hormone levels fall so that you no longer experience menstrual periods. In the lead up to this cessation, your hormone levels may fluctuate erratically, causing changes to your menstrual cycle, including heavy periods.
During a normal menstrual cycle, the hormone oestrogen is produced to stimulate the thickening of the lining of the womb. When the egg is released from the ovaries, they produce the hormone progesterone.
The interplay of these two hormones means that your periods are regular and not too heavy or light. However, as you approach the menopause, sometimes an egg is not released from the ovaries, although oestrogen is still produced. This means that there is not enough progesterone to balance the effect of oestrogen, leading to heavy periods.
During the menopause, you may encounter other factors which could result in heavy periods, ranging from stress to the side effects of medication. If you suspect that there is an underlying cause to your heavy periods, then it is important to consult a doctor to tackle this.
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Iud : : Abnormal Heavy Bleeding And Blood Clots
In January I had polyps removed and an IUD put in. There haven’t been any issues until now. Tuesday evening/early Weds morning I noticed some breakthrough bleeding. My period had just ended on the 6th. It continued on and I started to have some slight cramping so I called my doctor and got an appointment. He took a look and said my IUD seemed a little lower than usual . I made an appointment for an ultrasound and thought everything was ok. My bleeding was getting heavier and heavier, but a regular tampon managed it. In the afternoon I was out and I stood up and apparently I had bled through my tampon and underwear and it was coming down my leg. I called my doctor and they said keep and eye on it and if it continued to be like that or if it was a pad an hour go to the hospital. But it seemed to slow down. Today, however, it seems I have been clotting even more. And I just felt what I thought was a really large gush of blood, I went to the restroom and it was a huge blood clot. About an inch or so long and it wasn’t flat nor did it just fall apart when I grabbed it with a tissue. What should I do? Has anyone experienced something similar?
When To Seek Medical Help
You should consult your doctor any time you have abnormal vaginal bleeding. The cause of the bleeding could be serious and should be determined. See your doctor right away if youre pregnant and have vaginal bleeding.
If you have other serious symptoms in addition to bleeding, you may need emergency medical attention. These include:
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What Can I Expect If Ive Been Diagnosed With Vaginal Atrophy
You dont have to just live with vaginal atrophy. Even if youre in menopause or postmenopausal, that doesnt mean you should have to deal with UTIs, endure itching or burning, or painful sex. Treatment not only helps with symptoms, but it helps restore a healthy pH and bacterial balance back to your vagina.
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But Here Is Why You Really Need To See Your Doctor
Endometrial cancer, which affects 2% to 3% of American women, is the most common type of gynecological cancer. According to the American Cancer Society, it most often affects postmenopausal women 60 is the average age at diagnosis. There is currently no way to screen for endometrial cancer. Identifying it early has become a pressing issue, because the incidence of this cancer has risen gradually but steadily over the past 10 years, according to the National Cancer Institute.
Endometrial cancer is a fairly common disease, and its unfortunately becoming more common due to the growing rates of obesity, says Dr. Berkowitz. A womans risk of endometrial cancer can increase substantially if she is obese. Generally, risk rises among women who are 50 pounds or more above their ideal body weight, he says.
This is because of the role estrogen plays in endometrial cancer. The most common type of endometrial cancer, known as type 1 cancer, is fueled by estrogen. Estrogen is produced by body fat, so women with a larger amount of fatty tissue generally have higher levels of estrogen. They also typically have more free estrogen, an active form that produces stronger effects. This may lead to cancerous changes in the uterine lining.
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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.
Is It Normal To Have Longer And Heavier Periods During Perimenopause
Excessive bleeding and long periods are fairly common during perimenopause. Many women experience an increased flow and extended perimenopause periods before entering menopause.
In fact, one in four women say that their periods are heavy enough to interfere with day-to-day activities, such as going to work or attending social events. According to University of Michigan researchers, 91 percent of women aged 4252 surveyed reported heavy menstruation for 10 or more days during their transition to menopause. This phenomenon occurred one to three times within a three-year period.
There are various other health factors which come into play, including body mass index , use of hormones, and the presence of uterine fibroids.
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The Common Signs And Symptoms Of Perimenopause Include:
- Hot flashes
Women often describe it as suddenly feeling very warm and feverish. This happens because of the unstable estrogen levels in the body.
- Sleep Problems
This is usually caused by the discomfort of going through perimenopause.
- Leaking during coughing or sneezing
This is caused by the weakening pelvic muscles brought about my menopause. You can stop it from getting worse by doing kegel exercise and using kegel weights. You can get one from Vkegel.com.
- Vaginal Dryness
Estrogen is the one maintaining the lubrication in the vagina, so without it, there will also be vaginal dryness, itching and in most cases, pain during sex.
- Heavy Bleeding During Menstruation
The hormonal imbalances a woman undergoing perimenopause experiences includes heavy bleeding during menstruation.