womens guide
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Osteoporosis
Menopause
Overview
Symptoms Overview
Menstruation Changes
Hot Flashes
Sleep Disturbances
Cognitive Symptoms
Vaginal Dryness
Urinary Incontinence
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Menopause Symptoms: Menstruation Changes

Irregular periods are often the first sign of menopause. While 10% of women simply stop menstruating one day and never have another period again, the remaining 90% of women experience 4 to 8 years of irregular periods. These irregularities are characterized by a wide variety of changes to the duration, frequency, and overall physical characteristics of your period. You may have longer or short periods, lighter or heavier discharge, and may even miss periods entirely.

 

For most perimenopausal women, these menstruation changes are completely natural and normal. Normal menstrual irregularities due to oncoming menopause require no treatment. It’s important to note however, that not all menstrual changes during midlife are normal.

Abnormal Bleeding

The general term for this is called abnormal bleeding, and if it is diagnosed, the cause must be determined prior to treatment.

Abnormal bleeding in generally characterized by:

  • Vaginal bleeding after intercourse
  • Bleeding or spotting between menstrual periods
  • Too frequent periods – generally periods of shorter length than 21 days
  • Abnormally long periods – periods lasting 7 days or more
  • Abnormally heavy periods, particularly when you have never experienced such a discharge before

There a variety of tests and procedures your doctor may use to help diagnose the cause of your abnormal uterine bleeding. These options include ultrasound or sonohysteroscopy, endometrial biopsy, hysteroscopy, and dilation & curettage.

Causes of Abnormal Bleeding

Possible causes of abnormal uterine bleeding during perimenopause include:

  • Fibroids are non-cancerous growths that occur in or around the uterus. Scientists do not know what causes fibroids to grow, but they do know that their growth can be stimulated and accelerated by estrogen surges that occur during perimenopause. The most common treatment, if deemed necessary, is surgical removal. 
  • Uterine lining abnormalities such as polyps and hyperplasia can result in abnormal uterine bleeding.
  • Hormonal Contraceptives, usually used for birth control, can trigger breakthrough bleeding.
  • Hormonal Imbalance, particularly between the production of estrogen and progesterone and trigger irregular and heavy bleeding. Other hormonal imbalances, such as low thyroid hormone levels can also trigger abnormal bleeding.
  • Pregnancy can also exhibit abnormal bleeding, regardless of whether the pregnancy is proceeding normally or is an ectopic pregnancy.
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