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.
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.