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Is Heavy Bleeding Normal In Menopause

How Your Period Might Change

Heavy bleeding during perimenopause / menopause

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.

Can Vaginal Atrophy Be Prevented

A womans body naturally secretes less estrogen with age. This cannot be prevented. Without intervention, its unlikely that the ovaries will make more of the hormone.

However, there are ways to keep vaginal atrophy from getting worse. Avoid tight-fitting clothing, panty liners, perineal pads and any of the following that you may find irritating to your vagina:

  • Perfumes.

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Natural Solutions For Heavy Menstrual Bleeding

Have you ever felt like youve had to hide from the world when you get your period? Or that your heavy bleeding is going to seep through your pants while youre at work or out for dinner?

Although I havent personally experienced heavy bleeding, also known as Menorrhagia yes, thats the fancy term for heavy bleeding, I work with many women in my practice who experience and dread their monthly period for this very reason.

In fact, aside from your typical pms symptoms such as bloating, cramping, fatigue and moodiness, heavy bleeding is by far one of the top concerns my clients are suffering with.

And suffering it is! From literally having to wear a super tampon, and a super pad, plus 2 pairs of undies, its embarrassing, frustrating and down right uncomfortable.

So whats a woman supposed to do? How exactly can you fix your heavy bleeding?

First off, its important to note that an average blood loss ranges from 10-80 milliliters. Each soaked regular pad or tampon holds roughly 5ml of blood, so its normal to soak 2-7 pads/tampons during each period. A super tampon holds 10 mL. So, 80 mL equates to 16 fully soaked regular tampons, or 8 fully soaked super-tampons over all the days of the period.

Very heavy bleeding is much more than 80 mL. Some women report that they lose up to 500 mL, or 2 cups of blood. That is A LOT! This can literally mean blood-soaked clothing or sheets.

So how much are you actually bleeding?

So why heavy periods? Whats the actual cause?

  • Polyps
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    How Your Doctor Will Investigate Postmenopausal Bleeding

    If you do experience unusual or postmenopausal bleeding, make an appointment with your doctor to have the problem investigated, says Dr. Berkowitz. Your doctor will likely recommend an ultrasound, a biopsy, or both. Ultrasound can measure the thickness of the lining inside the uterus. In some women with endometrial cancer, this lining becomes thicker than usual, which alerts doctors to the possibility that it is cancerous. Not all thickened linings mean cancer, though. The ultrasound should be followed by a biopsy, even if the ultrasound doesnt show any thickening of the uterine lining, says Dr. Berkowitz. A biopsy can often be done as an in-office procedure, in which the doctor uses a thin tube with a collection device on the end to gather some uterine cells. The sample is then examined under a microscope to check for cancer or precancerous changes.

    When To See Your Doctor

    Pin on Postmenopause: Symptoms, Causes and Treatments

    Heavy bleeding and unusual period cycles are common in women over 50. But if your symptoms interfere with your life and well-being, you should contact your doctor. You may be a good candidate for hormone therapy that helps balance your estrogen and progesterone levels, easing heavy bleeding and other perimenopausal symptoms.


    Bleeding can occur in women over 50 after they experience menopause as well. Studies show that this postmenopausal bleeding is usually caused by conditions like uterine fibroids or polyps. It can also be a sign of endometrial cancer, which affects 2 to 3% of women and is most common among postmenopausal women.

    Heavy bleeding could also be a symptom of another underlying health condition. Make sure to monitor your flow and see your doctor if you experience:

    • Extremely heavy bleeding like soaking through a sanitary product hourly
    • Consistent spotting between cycles
    • Several cycles in a row that are shorter than 21 days or several days longer than usual
    • More than three months between periods

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    Do You Need Tests To Diagnose Menopause

    You don’t need to be tested to see if you have started perimenopause or reached menopause. You and your doctor will most likely be able to tell based on irregular periods and other symptoms.

    If you have heavy, irregular periods, your doctor may want to do tests to rule out a serious cause of the bleeding. Heavy bleeding may be a normal sign of perimenopause. But it can also be caused by infection, disease, or a pregnancy problem.

    You may not need to see your doctor about menopause symptoms. But it is important to keep up your annual physical exams. Your risks for heart disease, cancer, and bone thinning increase after menopause. At your yearly visits, your doctor can check your overall health and recommend testing as needed.

    Is Spotting Between Periods Normal

    Is spotting normal during perimenopause? If you observe small amounts of blood on your underwear between cycles , its considered spotting.

    Aside from hormonal changes, perimenopause spotting is also the direct result of endometrial buildup. It happens either before your period starts or near the end of it. If youre spotting between periods, however, it might be an indication of hormonal imbalance and should be discussed with your doctor.

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    Postmenopausal Bleeding Is Never Normal

    Whether its light spotting or a heavier flow, vaginal bleeding after menopause can signal potential health problems.

    It should always be brought up with your provider, said Gina M. Mantia-Smaldone, MD, a gynecologic oncologist at Fox Chase Cancer Center. And the sooner, the better. Rather than waiting for your next planned checkup, give your gynecologist a call quickly to schedule an evaluation.

    What Is Premature Menopause

    Menopause and You: Abnormal Bleeding

    If a woman has menopause before her 40s, it is called premature menopause. It can happen naturally, or it might be induced artificially.

    Premature menopause happens when the ovaries in a womans body get damaged from chemotherapy or are removed through a surgery called hysterectomy.

    Whether a woman undergoes premature Menopause or natural Menopause, they will have similar symptoms such as hot flashes, missed periods, and sleeplessness. Doctors run physical exams and test the blood to diagnose premature menopause.

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    The Reassuring News On Postmenopausal Bleeding

    The analysis found that most post-menopausal bleeding is caused by a noncancerous condition, such as vaginal atrophy, uterine fibroids, or polyps. That information doesnt really differ from what doctors have historically thought about the incidence of endometrial cancer and bleeding, says Dr. Berkowitz. But it does finally put solid data behind those figures, which was missing in the past, he says. The researchers who conducted this study were looking for clues about postmenopausal bleeding and how it relates to endometrial cancer.

    Cystic Fibrosis : : Bleeding Began Again After Shots For Cyst/bleeding/clots

    I was told I had cyst in my ovaries before, but I received a shot that made the bleeding and blood clots stop and I was getting regular periods. Now I haven’t gotten a period for almost 2 months now and I’m starting to bleed again like before. Should I be worried that the cysts may have came back? What is my best option?

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    What Changes In Menstruation Can You Expect

    During perimenopause, your body undergoes a shift in progesterone and estrogen levels. Estrogen, specifically, rises and falls in an arbitrary manner, which in turn affects ovulation and menstrual cycles. Expect to see irregular periods, spotting, missed periods, and certain perimenopausal bleeding patterns.

    Major hormonal changes are largely to blame for symptoms, such as night sweats, hot flashes, sleep disturbances, and perimenopausal bleeding.

    Occasionally, youll notice heavier and longer periods , while at other times, youll notice lighter and shorter periods . Early perimenopause tends to produce shortened menstrual cycles as well as periods lasting 2 to 3 days less. In contrast, late perimenopause creates longer cycles , often associated with anovulatory menstruation .

    Furthermore, missed periods might sometimes be followed by normal periods as perimenopausal bleeding patterns and cycles are highly irregular. In this phase, menstrual blood ranges in color from dark brown to bright red. You might notice brown discharge or perimenopause brown spotting throughout the month. The texture of your discharge will also vary from thin and watery to thick and clumpy.

    How Long Are Normal Perimenopause Periods

    What Causes Heavy Bleeding After Menopause

    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.

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    What To Expect During Diagnosis

    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.

    How Do You Know If Your Bleeding Is Too Heavy

    It is very difficult to determine whether your bleeding is too heavy. The best guide is to decide whether your period is having an impact on your quality of life if it is causing you to be housebound, interrupting your daily activities, or causing you stress and anxiety. The following signs might indicate you are experiencing heavy bleeding:

    • bleeding or flooding not contained within a pad/tampon
    • changing a pad/tampon every hour or less
    • changing a pad overnight
    • clots greater than a 50-cent piece in size
    • bleeding for more than seven to eight days.

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    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.

    What Is A Normal Period

    Bleeding Irregularities Common in Menopause

    There is a range of normal bleeding some women have short, light periods and others have longer, heavy periods.

    Normal menstrual bleeding has the following features:

    • Your period lasts for 3-8 days
    • Your period comes every 21-35 days
    • The total blood loss over the course of the period is around 2-3 tablespoons

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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.

    There Are Several Potential Causes But Some Are More Serious Than Others

    In most cases, postmenopausal bleeding is caused by issues such as endometrial atrophy , vaginal atrophy, fibroids, or endometrial polyps. The bleeding could also be a sign of endometrial cancera malignancy of the uterine lining, but only in a small number of cases. A 2018 study by the National Cancer Institute found that only about 9 percent of postmenopausal women who saw a doctor for bleeding later received a diagnosis of endometrial cancer.

    Still, we want the option to intervene early if it is cancer, since treating it sooner leads to better outcomes, Mantia-Smaldone said.

    If endometrial cancer is found early, a woman has a 95 percent chance of surviving the cancer for at least 5 years.

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    Lorna Could Set The Clock By Her Periods When Her Periods Became Irregular She Knew The

    Menopause. I think the first time I was aware was about when I was about 51, 52. 51 probably. When my periods started to not be as regular as they were. Now you could set a clock by my periods. Okay. Twenty eight days more or less to the hour, almost to the minute I mean it was amazing, and just as regular as clockwork. And they started to not be the regular twenty eight. And there were delays, the period extended. So I knew that this was the start of the menopause because Id been so incredibly regular for so many years.

    How Is It Treated

    Migraine In Menopause Can Bleeding ? Cause Between Uterine ...

    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 Exercise Affects The Uterus

    Then she switches gears a bit, and explains further. Your uterus is a muscle. It can sense dehydration. It can cramp like other muscles. When you do strenuous exercise, you can cause your uterus to cramp, and this causes the spotting. Wow. Im embarrassed that I hadnt known that the uterus was a muscle. Then again, I never had a health or science class cover this material which would have been great to know, as a woman. But, I know this now, and am grateful.

    Then Dr. Wright addresses the CrossFit. Take something like CrossFit. CrossFit is lots of motion, so even in that friction that motion can result in some spotting. This makes sense. She continues, Other patients have cramping after exercise. That can just be a normal uterine muscle response.

    The connection that I had noticed years ago is completely accurate, but not for the reasons I understood. Wright is able to help me see that strenuous exercise isnt making my endometriosis worse exercise is not causing the endometriosis to grow faster or in greater amounts.

    Rather, the exercise was simply putting a strain on the muscles of the uterus, which form a lining of blood and mucosal tissue every month. Agitation of those muscles disrupts that natural process.


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