Heavy Bleeding Flooding And Perimenopause
Very heavy bleeding occurs when your oestrogen levels are high relative to progesterone causing the lining of your womb to thicken more than usual. During perimenopause, your body’s main systems are working hard to adjust to the changing hormone levels that are taking place in advance of full menopause. The most difficult situation to handle is probably very heavy, extended bleeding, or flooding cycles. Some women find they are changing tampons every hour, sometimes having a very heavy bleed during inopportune times for example, at a formal dinner. This often happens at night as well as during the day. Make sure to wear liners and change tampons or pads very regularly.
If you have recurrent heavy and prolonged periods you may become anaemic as the body doesnt have time to make up for blood loss before the next period. You can end up feeling weak, exhausted, and maybe even depressed as a result of the anaemia, which then becomes associated with the menopause. Make sure to get help early on and don’t the situation develop.
Very heavy bleeding can also be caused by fibroids. If you experience prolonged heavy bleeding, seek professional advice from your GP, homoeopath or another health expert. Vaginal bleeding is not normal after the menopause so again get professional advice if this occurs.
Missed Periods Intermittent Spotting Heavy Bleeding And Flooding
Changes in periods vary widely as hormones adjust. As mentioned in other parts of this site this is a time to really tune into your body and trust your instincts. As you can see from this list it’s hard to define what perimenopause periods are like:
Periods can disappear for a year and then return.
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What Is The Average Age A Woman Stops Menstruating
The average age of menopause among US women is 51. Most women stop menstruation completely around 4 years after their periods become irregular. Certain factors can increase your risk of early menopause, such as genetics, smoking, type 1 diabetes, a family history of early menopause, and shorter cycles during your youth.
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What Are Periods Like During Perimenopause
Your body is producing less of the hormones that help you ovulate, so your periods can become irregular. Your menstrual cycle could become longer or shorter than usual. Your bleeding could also be heavier or lighter than normal. Some people also notice a change in their premenstrual syndrome symptoms.
Treating Cramps After Menopause
Treatment for postmenopausal cramps will vary depending on the underlying cause. Some possible treatment options may include:
Fibroids: If you do have pain caused by fibroids, painkillers will usually be recommended first.
There are medications available to help shrink fibroids. If these prove ineffective, surgery, such as a myomectomy or hysterectomy, may be recommended.
Endometriosis: There’s no cure for endometriosis and it can be difficult to treat. Treatment aims to ease symptoms so the condition does not interfere with your daily life.
- Medication: Pain medication may be prescribed to ease discomfort.
- Surgery: Surgery is usually reserved for severe symptoms when hormones are not providing relief. During the operation, the surgeon can locate the sites of your endometriosis and may remove the endometrial patches.
Irritable Bowel Syndrome: Treatment for IBS can include changes to diet and lifestyle, mind/body therapies , and medications. Often, a combination of treatments will provide the most relief. There is still much that is not understood about IBS, so it may take some experimentation with different therapies to achieve positive results.
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Hormone Therapy And Uterine Fibroids
The use of hormone therapy after menopause is associated with a greater risk for a fibroids diagnosis, as reported in a 2017 peer-review article of most studies to date. The risk of surgically confirmed fibroids increased up to sixfold in people using estrogen or combined estrogen-progestin therapy compared with nonusers.
What Causes Bleeding After Menopause
Bleeding after menopause is rarely cause for concern. It does need to be investigated, however, because in very few cases it will be an indicator of something more serious.
In about 90 per cent of cases, a particular cause for bleeding after menopause will not be found. This is not a cause for alarm, if there is a serious problem it will be identified through investigations. Most of the time, postmenopausal bleeding is caused by:
- inflammation and thinning of the lining of your vagina
- thinning of the lining of your uterus
- growths in the cervix or uterus which are usually not cancerous
- thickened endometrium often because of hormone replacement therapy
- abnormalities in the cervix or uterus.
These are generally not serious problems and can be cured relatively easily.
However, about 10 per cent of the time, post-menopausal bleeding is linked to cancer of the cervix or uterus and so it is very important to have it investigated.
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What Is Perimenopause Or The Transition To Menopause
Perimenopause , or the menopausal transition, is the time leading up to your last period. Perimenopause means around menopause.
Perimenopause is a long transition to menopause, or the time when your periods stop permanently and you can no longer get pregnant. As your body transitions to menopause, your hormone levels may change randomly, causing menopause symptoms unexpectedly. During this transition, your ovaries make different amounts of the hormones estrogen and progesterone than usual.
Irregular periods happen during this time because you may not ovulate every month. Your periods may be longer or shorter than usual. You might skip a few months or have unusually long or short menstrual cycles. Your period may be heavier or lighter than before. Many women also have hot flashes and other menopause symptoms during this transition.
How Can I Reduce My Risk Of Perimenopause Complications
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.
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When To See A Gp
It’s worth talking to a GP if you have menopausal symptoms that are troubling you or if you’re experiencing symptoms of the menopause before 45 years of age.
They can usually confirm whether you’re menopausal based on your symptoms, but a blood test to measure your hormone levels may be carried out if you’re under 45.
Frequently Asked Questionsexpand All
Yes. Although its normal for periods to change as you near menopause, you should still talk with your obstetriciangynecologist about bleeding changes. Abnormal bleeding sometimes can be a sign of health problems. Its especially important to tell your ob-gyn if you have bleeding after menopause.
If you have any bleeding after menopause, or if you have any of the abnormal changes in your monthly cycle listed above, its important to see your ob-gyn to find out the cause. Many things can cause abnormal bleeding, including
Polyps are noncancerous growths that attach to the wall of the uterus. They also may develop on the endometrium . These growths may cause irregular or heavy bleeding. Polyps also can grow on the cervix or inside the cervical canal. Polyps on the cervix may cause bleeding after sex.
After menopause, the uterine lining may become too thin. This can happen when a woman has low levels of estrogen. The condition is called endometrial atrophy. As the lining thins, a woman may have abnormal bleeding.
The risk factors for endometrial cancer include
early age when periods started
older age at menopause
long-term use of medications containing high doses of estrogen
treatment with a drug called tamoxifen
certain tumors of the ovaries
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How Do You Lose Weight During Menopause
Maintaining a healthy weight is one of the most effective ways to improve symptoms of menopause. Try low-impact exercises that don’t hurt your joints, eat lean protein, drink plenty of water, and get enough sleep. Although it’s tempting, restricting your caloric intake too severely can lead to muscle loss and a decrease in metabolic rate.
What Are Menopause Symptoms And Signs
It is important to remember that each woman’s experience is highly individual. Some women may experience few or no symptoms of menopause, while others experience multiple physical and psychological symptoms. The extent and severity of symptoms varies significantly among women. It is also important to remember that symptoms may come and go over an extended period for some women. This, too, is highly individual. These symptoms of menopause and perimenopause are discussed in detail below.
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Hormone Treatment And Therapy
Estrogen and progesterone therapy
Hormone therapy , or menopausal hormone therapy , consists of estrogens or a combination of estrogens and progesterone . This was formerly referred to as hormone replacement therapy . Hormone therapy controls the symptoms of menopause-related to declining estrogen levels , and HT is still the most effective way to treat these symptoms. But long-term studies of women receiving combined hormone therapy with both estrogen and progesterone were halted when it was discovered that these women had an increased risk for heart attack, stroke, and breast cancer when compared with women who did not receive HT. These risks were most pronounced in women over 60 taking hormone therapy. Later studies of women taking estrogen therapy alone showed that estrogen was associated with an increased risk for stroke, but not for heart attack or breast cancer. Estrogen therapy alone, however, is associated with an increased risk of developing endometrial cancer in postmenopausal women who have not had their uterus surgically removed.
Hormone therapy is available in oral , transdermal forms . Transdermal hormone products are already in their active form without the need for “first pass” metabolism in the liver to be converted to an active form. Since transdermal hormone products do not have effects on the liver, this route of administration has become the preferred form for most women.
How Long Does Premature Menopause Last
Perimenopausal symptoms can last four years on average. The symptoms associated with this phase will gradually ease during menopause and postmenopause. Women whove gone an entire year without a period are considered postmenopausal. Hot flashes, also known as hot flushes, are a common symptom of perimenopause.
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General Recommendations For Ht
Current guidelines support the use of HT for the treatment of severe hot flashes that do not respond to non-hormonal therapies. General recommendations include:
- HT may be started in women who have recently entered menopause.
- HT should not be used in women who have started menopause many years ago.
- Women should not take HT if they have risks for stroke, heart disease, blood clots, and breast cancer.
- Currently, there is no consensus on how long HT should be used or at what age it should be discontinued. Treatment should be individualized for a woman’s specific health profile.
- HT should be used only for menopause symptom management, not for chronic disease prevention.
Before starting HT, your doctor should give you a comprehensive physical exam and take your medical history to evaluate your risks for:
- Heart disease
- Breast cancer
While taking HT, you should have regular mammograms and pelvic exams and Pap smears. Current guidelines recommend that if HT is needed, it should be initiated around the time of menopause. Studies indicate that the risk of serious side effects is lower for women who use HT while in their 50s. Women who start HT past the age of 60 appear to have a higher risk for side effects such as heart attack, stroke, blood clots, or breast cancer. HT should be used with care in this age group.
Women who should not take hormone therapy include those with the following conditions:
Symptoms Of The Menopause
As the decline in hormones oestrogen and progesterone during the menopause is typically quite a gradual progress, it often involves fluctuations along the way. As a result of these fluctuations, a number of symptoms can arise:
- Heavy periods, with a shorter cycle As a result of the fluctuating hormones, and higher levels of oestrogen your periods might become heavier and come more often than every 28 days.
- Irregular periods, lighter flow Irregular periods are common in the lead up to the menopause. Your periods may become lighter and disappear for weeks or months at a time
- Hot flushes and night sweats Hot flushes and night sweats are common symptoms in the menopause. It isnt exactly clear why this happens but it is thought that fluctuating levels of hormones somehow interact with the temperature control centre in the brain, the hypothalamus
- Low libido A combination of mood swings and vaginal dryness as a result of low levels of hormones can affect your libido in the lead up to the menopause
- Weight changes Sex hormones can influence other hormones which are important for regulating your body weight stress hormones and metabolism regulating hormones can easily come under fire
- Mood swings Decreasing levels of hormones can affect your mood mood swings or episodes of low mood arent uncommon.
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What Is The Effect On Your Body If You Remove Your Ovary After Menopause
In the United States, 600,000 hysterectomies are performed each year. And about 50% of those also choose to remove their ovaries electively. The argument for the removal of ovaries after menopause believes that since the ovaries have fulfilled their primary role in a womans life, theyre no longer necessary. Additionally, proponents of postmenopausal oophorectomy say that the 1.3% lifetime risk for ovarian cancer is not worth keeping ovaries in place. The newer line of reasoning states that the ovaries, despite the cessation of their reproductive roles, still secrete some hormones and may serve important roles for the later stages of life.
Removing ovaries as a preventative measure for ovarian cancer may deprive the body of the hormones released from postmenoapausal ovaries, causing decreased libido, lower energy, cardiovascular issues, and cognitive decline. Thus, although the probability of ovarian cancer is eliminated with oophorectomy, it may not reduce overall cancer risk.
What Are The Symptoms Of Perimenopause
Your body has been producing estrogen since puberty. Once your estrogen levels begin to decline, your body has to adjust to the changes in hormones.
The symptoms vary, but most people experience at least one of the following:
- Sleep problems .
- Changes in mood like irritability, depression or mood swings.
The length of time you have symptoms of perimenopause can vary between a few months to many years. The decrease in estrogen also can lead to bone thinning or changing cholesterol levels. Continue to have regular checkups with your healthcare provider to keep an eye on your health.
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Henpicked: First And Foremost Why Do Periods Change Around Menopause
Dr Karen Morton: To answer this, we need to understand what a period is. Essentially, from when you were in your mothers womb and less than a cm tall from head to toe, your body put into your ovaries all the eggs youre ever going to have. There are millions of them to start with and theyre just microscopic dots.
From about seven years of age onwards, you start to make a bit of oestrogen. And from nine onwards your body starts to choose an egg to be brought to maturity or sometimes two. The egg is brought to maturity within a follicle and when its mature the follicle will pop and the egg is released. The area on the ovary where the egg started will swell and make a hormone called progesterone.
The role of progesterone is to prepare your body for pregnancy. If the egg isnt fertilised, the area making progesterone realises its not needed any more and stops.. The progesterone level falls and our womb lining falls away as a period.
So a period is a result of cyclical ovarian activity. All of that is under the guidance of the pituitary gland. This is our master gland, located behind the bridge of our nose, which tells our ovaries what to do.
However, its important for women not to ignore odd bleeding. If theres a strange pattern or no pattern we do need to check theres not a polyp or something worse going on in the womb.
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.
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