The bleeding abnormalities in menopause can be horrible. Bleeding can be normal during this time of your life but, first and foremost, it must be considered a symptom. The number one thing your doctor must do is make sure that you don’t have a cancer in your vagina, cervix, uterus, fallopian tubes orovaries. An option for treating the bleeding is taking oral contraceptive pills (OCPs or birth control pills). Many women over 40 take these and do very well.
In fact, when women are on birth control pills, they tend not to have abnormal bleeding. A patient can safely start on OCPs if they do not smoke, have no other risk factors, and are under 50 years of age. A progesterone IUD is also a very good option to help with heavy bleeding. A second option for treating or stopping the bleeding is a minor surgical procedure called an endometrial ablation. The last option is a hysterectomy. This would be appropriate if you
had a big uterus full of benign fibroid tumors or precancerous or cancerous cells, but if you are having miserable peri-menopausal bleeding, you should go
through the conservative treatment first (i.e. OCPs, Mirena® IUD, or ablation).