Abnormal Bleeding After Menopause
In some cases, bleeding continues after menopause. It is easy to mistake this type of bleeding for symptoms of perimenopause, which may mislead someone to think they have not reached full-menopause when they actually have.
Any spotting or bleeding after menopause is abnormal and should be checked out by a healthcare provider . Spotting or bleeding after menopause can be caused by a medical condition, such as uterine polyps . Uterine polyps are growths on the inside lining of the uterus , and become more common with age .
In Jewish And Islamic Slaughter
Jewish kashrut and Islamic dhabihah dietary laws mandate that slaughter is performed with a cut that immediately severs the esophagus, trachea, and the large blood vessels in the neck, causing loss of consciousness and death by exsanguination. The double-edged pointed knife is prohibited. Instead, a long knife with a squared off end is used that in Jewish law must be at least twice the width of the animal’s neck. The operation of sticking or exsanguination is executed faster than when using the pointed knife, as four large blood vessels in the neck are severed simultaneously.
In Islamic and Jewish law, captive bolts and other methods of pre-slaughter paralysis are not permissible, as consumption of animals found dead are regarded as carrion and stunned animals that are later killed fall into this category. Various halal food authorities have more recently permitted the use of a recently developed fail-safe system of head-only stunning using a mushroom shaped hammer head that delivers a blow that is not fatal, proved by it being possible to reverse the procedure and revive the animal after the shock.
Such methods, particularly involving unstunned animals, have been criticized by veterinarians and animal welfare organizations, among others. Prohibitions against unstunned slaughter have been enacted in several countries. See Animal welfare controversies in shechita for further information.
When To Be Concerned
Most women know their bodies and can recognize when something changes. Seek medical care with any of the following:
- Unexplained vagina bleeding in post-menopausal women.
- Bleeding accompanied by fever, chills, nausea, and pain.
- An unpleasant odor from vaginal discharges.
- Bleeding in young girls prior to puberty.
Most sporadic spotting between periods is usually not cause for alarm, but it is always best to err on the side of caution. If you have any further questions, or would like to set an appointment with Pacific Gynecology Surgical Group today, call or request an appointment online today!
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Classic Menopause Signs And Symptoms
The most obvious signal indicating you’re officially in menopause is the absence of a period for 12 consecutive months.
Once your period has officially stopped, the estrogen levels in your body will gradually decline also, you will no longer produce another female hormone called progesterone. Such hormonal changes may intensify the hot flashes, mood swings, or other symptoms you may have been experiencing throughout perimenopause, or they may trigger symptoms you have yet to experience.
In addition to no longer having a period, the following are the most common signs of menopause for the great majority of women:
- Absence of a period for one full year
- Mood swings and irritability
- Vaginal/vulvar itching
- Generalized itching
Another physical sign of menopause is bone loss . And although Hoppe says that hot flashes usually subside, she adds that “some women experience hot flashes for the rest of their life.”
Hormone Replacement Therapy For Menopause Symptoms
Hormone replacement therapy , also called hormone therapy, is sometimes prescribed during or after the menopausal transition to help relieve certain symptoms, like hot flashes, night sweats, and vaginal dryness. HRT involves taking synthetic or âbioidenticalâ forms of estrogen and often synthetic progesterone. âSystemicâ HRT goes throughout the whole body and can be taken in several forms, like pill, patch, gels, creams, and sprays. For people who are only experiencing vaginal symptoms, âlocalâ HT used inside the vagina in the form of a cream, ring, or tablet may be recommended .
Also, data suggest that systemic HRT lowers the risk of osteoporosis, coronary heart disease and overall mortality in people who take it around menopause, particularly for those who have had a hysterectomy and use estrogen-only HRT, but more information is needed (39.
Systemic HRT also carries risks, including an increased chance of developing breast cancer, stroke, and blood clots . Risks vary by whether your form of HRT contains a progestin or not . Also, the risk of negative effects increases when people begin taking it after menopause, particularly 10 or more years from menopausal onset . The U.S. Federal Drug Administration currently recommends that people who choose HRT take it âat the lowest dose that helps and for the shortest timeâ .
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Could It Be Hypothyroidism
Menstrual abnormalities, particularly menorrhagia, can be one of the first noticeable symptoms of thyroid abnormalities, particularly hypothyroidism.10 The incidence increases with age and thyroid dysfunction can be masked by menopausal symptoms.
The physiology behind menorrhagia in hypothyroidism is anovulation due to thyroid hormone deficiency. Correct levels of thyroid hormone levels are required to produce luteinising hormone which is needed to trigger ovulation. If the balance is disturbed, there can be a delay in LH production. Hypothyroidism can also alter coagulation factors which are required for blood to clot effectively, and therefore this can result in excessive bleeding.11
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.
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Other Causes For Period Changes
The regular monthly period is not the only reason why people may bleed.
Because a persons periods are often irregular during perimenopause, they should pay extra attention for any abnormal symptoms particularly as some uterus-related conditions are more common during and after perimenopause.
People may bleed because of:
- Endometrial atrophy. Low estrogen in perimenopause and menopause can cause the tissue of the uterus to get very thin, which can cause irregular bleeding.
- Uterine polyps. These are benign growths that can grow inside the uterus and cervix. Polyps do not always cause symptoms, but some people notice bleeding after sex.
- Endometrial hyperplasia. Hormonal shifts can cause the lining of the uterus to thicken in perimenopause. When the body has too much estrogen without enough progesterone, this thickness may cause bleeding. Bleeding is its most common symptom. Endometrial hyperplasia is treatable but can increase a persons risk of cancer.
- Uterine Cancer. Uterine cancer happens when abnormal or atypical cells progress into cancer. Though rare, it generally presents with heavy bleeding or postmenopausal bleeding.
Perimenopause is not a disease and does not require treatment. It can, however, increase peoples risk of developing certain diseases. Moreover, the menstrual cycle can change for reasons other than perimenopause.
Anyone experiencing changes in their menstrual cycle should see a doctor for a diagnosis.
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?
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When To See The Doctor For Bleeding Between Periods
Never hesitate to make an appointment with your doctor if youre worried about bleeding between periods. Dr. McDonald and Dr. Wilson provide comprehensive exams to diagnose potential causes of spotting, so we can recommend an appropriate treatment plan.
Light bleeding between periods typically isnt an indication of something more serious, but its important to recognize signs that something isnt right. Make an appointment with your gynecologist if you have spotting along with lower abdominal pain, pelvic pain, or fever.
If bleeding between periods gets worse or starts happening more often, it could indicate an underlying health condition. If you experience bleeding between periods that isnt light or doesnt stop within a few days, make an appointment with your doctor.
After youve entered menopause, see the doctor if you experience vaginal bleeding at any point. Even if its light bleeding, bleeding after menopause could be a sign of cancer or other serious health condition.
Listening to your body is important. If youre concerned about spotting or bleeding between periods, schedule a check-up at OB/GYN Specialists. Call our team at 940-202-0566 or send us a message online.
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How Is Perimenopause Diagnosed
You dont always need to see a healthcare provider for a perimenopause diagnosis. Many people notice and tolerate the changes in their bodies without a formal diagnosis. If you have symptoms that interfere with your daily activities, see a healthcare provider.
You should reach out to your healthcare provider right away if you have:
- Blood clots in menstrual discharge.
- Spotting between periods.
- Emotional symptoms interfering with your ability to function on a daily basis.
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How Can You Alleviate Perimenopausal Symptoms
Some women deal with the symptoms of perimenopause, and some women seek treatment for specific health concerns. Women with heavy bleeding, periods that last longer than seven days, spotting between periods or cycles that are less than 21 days should contact a doctor.
Typically, perimenopause is a gradual transition, and no particular test indicates what is happening to the body. Hormone therapy, vaginal estrogen treatments and antidepressants can help treat perimenopausal symptoms.
Start by identifying what’s bothering you most and then working with your doctor to address it. There are steps you can take to feel better. Lifestyle changes that can make a big impact in easing perimenopausal symptoms and improving your overall health include:
What Are The Hormonal Changes During Perimenopause
The hormonal changes you experience during perimenopause are mostly caused by declining estrogen levels. Your ovaries make estrogen, which plays a vital role in maintaining the reproductive system. Once you enter perimenopause, your estrogen levels start to decrease. As estrogen decreases, it throws off the balance with progesterone, another hormone produces by the ovaries. These two hormones together are responsible for ovulation and menstruation. Its common for hormone levels to fluctuate during perimenopause to go up and down like a rollercoaster.
When you reach menopause, your body makes so little estrogen that your ovaries no longer release eggs. At this point, you stop having your period.
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Starting Or Changing Birth Control Methods
In this particular case, you may see spotting throughout your cycle or right before your period, which is also known as breakthrough bleeding. All types of birth control can cause this situation including the pill, IUD, the patch, a vaginal ring, or an implant.
This sporadic spotting between periods is caused by the introduction of estrogen present in the birth control medication. It will usually resolve itself within a few months time. Should you continue to have spotting beyond that time, see Pacific Gynecology Surgical Group for a diagnosis.
Many women first discover they have fibroids when they see their provider for spotting or extended heavy periods. These benign cysts occur in the uterus and can cause these bleeding symptoms.
What Are The Stages Leading Up To Menopause
After puberty, there are three other phases of female fertility:
- Pre-menopause: Women have full ovarian function, regularly produce estrogen and ovulate.
- Perimenopause: The ovaries begin to fluctuate in their ovulation and production of estrogen, which can result in unpredictable menstrual cycles and symptoms.
- Menopause: When the ovaries have shut down. Someone would be in menopause after 12 months without menses.
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Should You Get Tested For Perimenopause
The short answer: No.
The blood tests that measure your ovarian reserve are rarely accurate during perimenopause. FSH and estrogen change by the day and throughout the day so they are generally not helpful.
We do consider testing these hormones if you experience perimenopausal symptoms under the age of 45. We generally will also check other pituitary hormones, like TSH and prolactin, if you are experiencing these symptoms prematurely.
Keeping a menstrual diary is generally the best test you can do. This will give you and your OBGYN insight into what your body is doing and for how long.
Any time you experience abnormal uterine bleeding , checking in with your doctor is a good idea to make sure it is normal and that no other work-up is needed.
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.
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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 Is Postmenopausal Bleeding Treated
Treatment for postmenopausal bleeding depends on its cause. Medication and surgery are the most common treatments.
- Antibiotics can treat most infections of the cervix or uterus.
- Estrogen may help bleeding due to vaginal dryness. You can apply estrogen directly to your vagina as a cream, ring or insertable tablet. Systemic estrogen therapy may come as a pill or patch. When estrogen therapy is systemic, it means the hormone travels throughout the body.
- Progestin is a synthetic form of the hormone progesterone. It can treat endometrial hyperplasia by triggering the uterus to shed its lining. You may receive progestin as a pill, shot, cream or intrauterine device .
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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.
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.
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Other Bleeding During Perimenopause And Menopause
Sometimes spotting can occur due to vaginal dryness and/or pain with intercourse and a woman may notice spotting after sexual intercourse, says Dr. Hoppe.
If bleeding occurs with/after sex for perimenopausal women, Dr. Hoppe explains that this may be due to vaginal atrophy. A gynecological exam should be done to make sure there are no vaginal lesions, lacerations or cervical polyps, which might be causing bleeding with sexual intercourse.
Another thing to be aware of? Thinning of the vulvar and/or vaginal tissue is very common during menopause, and even during perimenopause, says Dr. Swica.
During this time, she explains, the tissue can become more fragile and, therefore, more vulnerable to injury from contact that previously caused no injury. This can be treated with estrogen, Dr. Swica notes, as well as other non-hormonal options.
This is notable because, as Dr. Hoppe explains, Sometimes a woman may experience vaginal bleeding or spotting when starting hormone therapy. This should be managed by a physician well-versed on types, routes, and dosages of hormone therapy to help adjust for correct dose, she adds.
Symptoms Of Spotting Between Periods
Irregular periods are often the first symptom of perimenopause. Women may find that their periods are shorter or longer than normal, and they might arrive at unpredictable times.
However, intermenstrual spotting is clearly different from a period as it occurs outside of a woman’s menstrual patterns, and she does not need tampons or pads to contain it.
Typically, a woman finds just a few drops of blood on her underwear, not enough to soak through a panty liner. Spotting generally lasts for one or two days and may have a light pink, red, or brown color.
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