Understanding The Menopausal Transition
Menopause is a point in time 12 months after a womanâs last period. The years leading up to that point, when women may have changes in their monthly cycles, hot flashes, or other symptoms, are called the menopausal transition, or perimenopause.
The menopausal transition most often begins between ages 45 and 55. It usually lasts about 7 years but can last as long as 14 years. During the menopausal transition, the bodyâs production of estrogen and progesterone, two hormones made by the ovaries, varies greatly. Bones become less dense, making women more vulnerable to fractures. During this period, too, the body begins to use energy differently, fat cells change, and women may gain weight more easily.
Menopause may be triggered by a hysterectomy or surgical removal of the ovaries, which produce hormones. If you have surgery to remove your ovaries or uterus and are not taking hormones, you will experience the symptoms of menopause immediately.
This time in a womanâs life is often full of other transitionsnot just physical ones. Women may be caring for aging parents or relatives, supporting their children as they move into adulthood, or taking on new responsibilities at work.
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What Are The Causes Of Spotting After Menopause
Women can experience itching, burning, and off-coloured discharge more regularly than what they did before entered menopause. Brown spotting after menopause is specifically a sign of blood mixing into the discharge. While fresh blood is red, it turns brown or black as it gets oxidized and leaves the vagina. The colour can be lighter or mixed with other colours if the woman is suffering from an infection, like yeast infection. Some of the common potential causes of brown spotting after menopause are:
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
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Make Your Health A Priority
Women are known to focus on their families first and put their own health second. But you cant care for loved ones if youre not healthy yourself. Listen to your body. Alert your doctor to any changes or abnormal issues such as postmenopausal bleeding as soon as possible.Dont stop seeing your general gynecologist for an annual exam when you hit menopause. Just because your reproductive years have ended doesnt mean those body parts go away! Your cancer risk increases as you age, and your gynecologist can screen for the disease and help you manage any conditions caused by hormone changes.If youre experiencing postmenopausal bleeding or have any concerns about your gynecologic health, request an appointment online or by calling .
When Should You Be Concerned About Spotting After Menopause
While causes for spotting after menopause may vary in severity, its not a good idea to wait for additional bleeding or symptoms to seek medical attention. After experiencing spotting, periods, or bleeding most of your life, you may not think twice about it now. But in the case of post-menopause spotting, you should take this symptom as a sign to see a medical provider promptly. While some causes of spotting after menopause may be less concerning, you will want to rule out right away whether the cause of yours is something more severe, such as cancer. In a nutshell? The wait and see approach is not advised for this scenario. Give yourself peace of mind and seek a medical professionals opinion as soon as possible.;
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Mayo Clinic Q And A: Spotting After Menopause
DEAR MAYO CLINIC: I am 52 and had recently gone 10 months without a period, so I had assumed I was postmenopausal. But, over the past few months, Ive had light spotting. Does this mean Im not past menopause? Do I need to see my health care provider about this?
ANSWER: Its possible that you havent reached menopause yet. Clinically, menopause is defined as going without a period for one year. At 10 months, you dont quite meet that threshold. But its also possible that you are postmenopausal, and the bleeding is a result of something else. It would be a good idea to make an appointment to see your health care provider and check your condition.
Menopause is the natural process that marks the end of a womans 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.
Bleeding after menopause is not normal, and it must be evaluated by a health care provider. Postmenopausal bleeding can have various causes.
Q: How Are Ovarian Cysts Diagnosed And Treated
A: Sometimes, cysts can be detected during a routine pelvic exam or when youre being examined for symptoms. Your doctor may order a pelvic ultrasound to confirm the diagnosis. And one or more blood tests may be done to pinpoint the cause of a cyst.
Ovarian cysts dont always require treatment. For premenopausal women, cysts usually go away on their own within a month or two. Thats typically not true in postmenopausal women; ovarian cysts tend to hang around longer in this group.
If a cyst is painful, large, or suspicious for cancer, treatment usually means removal.
Ovarian cysts cant be biopsied like you can biopsy skin or the cervix, Chu explained. You have to surgically remove them either by cystectomy or oophorectomy .
If a cyst isnt causing problems, monitoring any symptoms and repeating ultrasounds is a common approach.
The most important take-away message about ovarian cysts is to not panic, Chu said. Management of cysts really depends on a persons age and how a cyst looks. A lot of cysts can be followed with scans to make sure they are going away or not growing.
If you are concerned after receiving a diagnosis of an ovarian cyst or are having unusual symptoms that are worrisome, it is a good idea to see a specialist.;
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Thinning Or Thickening Of Tissues
Another common reason for spotting is related to the thickness of the vaginal tissues. In this case, it may be either thinning or thickening of the tissues that are also called endometrial atrophy and endometrial hyperplasia respectively. The thinning develops because the body lacks estrogen. The thickening develops because of too high levels of estrogen and too low levels of progesterone.
Things To Know About Postmenopausal Bleeding
Spotting or light bleeding after menopause might not seem like a serious problem, but you should never ignore it or wait to bring it up with your doctor. After a womans periods have stopped, vaginal bleeding could be a sign of a health issueincluding endometrial cancer. Heres what every postmenopausal woman should know.
Tips For Womens Reproductive & Sexual Health
1. Have Annual Pelvic Examinations
A womans first pelvic examination should occur prior to turning 21 or when she becomes sexually active. A gynecological examination is quick, painless and only takes a few moments. For many women, it can be stress-inducing and embarrassing, but your health care provider should be gentle and reassuring.
In addition to annual pelvic exams, you should make an appointment with your gynecologist if you experience any of the following:
- Menstrual periods have not started by the age of 15
- Menstrual periods have not started within three years of breast development
- Brown discharge that burns, smells bad and causes itching
- If your sexual partner has an STD
- Vaginal bleeding lasts more than 10 days
- Unexplained lower belly pain
- Debilitating menstrual cramps
2. Practice Safe Sex
STDs like chlamydia and gonorrhea are major risk factors for abnormal vaginal bleeding. Using condoms properly can help protect you from sexually transmitted infections, but keep in mind that condoms do have an 18 to 21 percent failure rate according to the Centers for Disease Control and Prevention.
Being in a committed and monogamous relationship where both partners have been tested and treated for any STDs is the safest way to prevent STD exposure.
3. Use Contraception
If you are not trying to get pregnant, talk to your doctor about your options for contraception and family planning. Today, there are many choices including:
- Fertility awareness based method
How Do You Know The Cause Of Postmenopausal Bleeding
- Identifying the cause of the bleeding can include the following:
- Exam by your provider of the vagina and cervix.
- Pap smear to check the cervical cells.
- Ultrasound, usually using a vaginal approach, which may include the use of saline to make it easier to see any uterine polyps.
- Biopsy of the endometrium or uterus. In this procedure, your healthcare provider gently slides a small, straw-like tube into the uterus to collect cells to see if they are abnormal. This is done in the office and can cause come cramping.
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Bleeding After Menopause: Its Not Normal
Too often I see women with advanced endometrial cancer who tell me they experienced postmenopausal bleeding for years but didnt think anything of it. This shows we need to do a better job educating our patients about what to expect after menopause.
Women need to know postmenopausal bleeding is never normal, and it may be an early symptom of endometrial cancer. Any bleeding, even spotting, should trigger a visit to your doctor as soon as possible. Dont wait to make an appointment until after the holidays or even next week. Do it today.
Perimenopause: Rocky Road To Menopause
What are the signs of perimenopause? Youre in your 40s, you wake up in a sweat at night, and your periods are erratic and often accompanied by heavy bleeding: Chances are, youre going through perimenopause. Many women experience an array of symptoms as their hormones shift during the months or years leading up to menopause that is, the natural end of menstruation. Menopause is a point in time, but perimenopause is an extended transitional state. Its also sometimes referred to as the menopausal transition, although technically, the transition ends 12 months earlier than perimenopause .
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When Spotting Happens During Menopause
If bleeding or spotting occurs at any point during menopause, a woman needs to be seen by her doctor. During your visit, there will likely be a pelvic ultrasound and a possible biopsy of the uterine lining . Dr. Hoppe explains that this is to rule out any precancerous conditions.;
If a woman is menopausal, she should not have spontaneous bleeding, Dr. Hoppe says, adding, Sometimes might be due to a thyroid abnormality. Signs of anemia and fatigue, along with spotting or bleeding, is also cause for concern and lab tests should be performed.;
Treating Post Menopause Bleeding
If you have postmenopausal bleeding it is important to have it investigated.
You will most likely be referred to a gynaecologist who may:
- ask you questions about the history of your health
- examine you
- do a blood test
- look at the inside of your vagina and cervix using special tongs . At the same time, they may take a tiny sample of your cervix for testing .
The kind of treatment you have will depend on what is causing the bleeding.
- Atrophic vaginitis;and;thinning of the endometrium;are usually treated with drugs that work like the hormone oestrogen. These can come as a tablet, vaginal gel or creams, skin patches, or a soft;flexible ring which is put inside your vagina and slowly releases the medication.
- Polyps;are usually removed with surgery. Depending on their size and location, they may be removed in a day clinic using a local anaesthetic or you may need to go to hospital to have a general anaesthetic.
- Thickening of the endometrium;is usually treated with medications that work like the hormone progesterone and/or surgery to remove the thickening.
Before treatment there are a number of tests and investigations your gynaecologist may recommend.
All treatments should be discussed with you so that you know why a particular treatment or test is being done over another.
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Q: What Causes Ovarian Cysts
A: The most common causes include:
- Hormones. Drugs that help with ovulation can cause cysts. Hormonal problems can trigger them too. Most hormone-related cysts go away on their own.
- Pregnancy. A cyst usually develops early in pregnancy. Its there to help support the pregnancy before the placenta forms.
- Endometriosis. Women with this condition can develop cysts called endometriomas. This type of cyst can cause pain during menstruation and sex.
- Severe pelvic infection. Cysts can form when infections spread to the ovaries and fallopian tubes.
Q&a About Ovarian Cysts
If youre a woman with ovaries, chances are youve had an ovarian cyst at some point in your lifetheyre very common. Its possible that you never even knew it. Most of the time theyre harmless, dont cause symptoms, and go away on their own. While most ovarian cysts will never develop into cancer, it still pays to know the answers to some frequently asked questions about ovarian cysts.
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Perimenopause Bleeding: Symptoms And Treatment
Menopause occurs once youve not had a period for at least one full year. The stage prior to menopause is called perimenopause, a term meaning around menopause. So what is it that triggers perimenopausal bleeding?;Major hormonal changes are largely to blame for symptoms, such as night sweats, hot flashes, sleep disturbances, and perimenopausal bleeding. This particular phase could last anywhere from a few months to 10 years.;
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.
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Can You Spot After Menopause
Yes. As weve outlined above, there are various reasons for spotting after menopause. Most will require an examination or procedure to diagnose. Your doctor may refer to postmenopausal bleeding ICD 10, which is the International Classification of Diseases, regarding further testing or investigations they recommend.
Perimenopause Spotting Before And After Periods
Hi, I posted this under general health earlier:Im 43 and have had heavy periods causing anaemia for the past few years. My mother starting having heavy periods in her early 40s and went through the menopause at around 46/48, so I assume I will follow a similar pattern. Ive been to the Doctors about the heavy periods and she thinks its my age. I had a smear a year ago, all fine, and an abdominal ultrasound and transvaginal ultrasound 6 months ago, both fine. My GP also had a look at my cervix and said it looked fine.My periods have always been very regular and normal, although has become shorter in the past few years, since Ive had children, every 23/24 days instead of every 28.6 months ago I had 4 days of spotting before a period and 4 days of spotting after it finished. So from start to finish was 2 weeks. I checked with my GP and she said it was fluctuating hormones and not to worry about it. She said that spotting for a few days before or after a period is quite normal . Since then Ive had a couple of normal periods with just a few days of spotting before. However this month I had an afternoon of spotting mid-cycle and then with my last period had 4 days of spotting before and after, so 2 weeks altogether.Sorry this is long!!! Do you think these symptoms could be the perimenopause? Thanks.
Thanks again purplepeony, its very reassuring. I dont feel so worried now but will keep an eye on it.
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