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What Kind of Bleeding Abnormalities Might I Expect in Peri-Menopause?


Any combination of bleeding abnormalities is normal from age 40 until menopause.  In studies involving many peri-menopausal patients, the investigators found that 12% of women have an abrupt stop to their menstrual periods.  Don’t get excited…that means that this will not happen to 88% of us. 

The rest of us go through a wide variety of bleeding patterns:

1.  Sometimes, the bleeding will be infrequent (such as every 3-4 months) but when it comes, it is wickedly heavy and painful.  

2.  Some women bleed frequently and lightly and may have only a little spotting every two weeks or so. 

3.  The most unfortunate of women have heavy, painful bleeding more than once a month.  These are the women that usually come into their physician’s office for help.  They pass large clots that come out and they even tell me that they feel like they are “laying eggs!”  It is very embarrassing and can be socially humiliating.  Women sometimes come right to the office after having bled through their clothes at the grocery store of the mall.

If this is the case, Dr. Pam will first make sure that there are no abnormalities in the vagina, on the cervix, or in the pelvis.  This will be assured by her doing a thorough pelvic exam and a trans-vaginal ultrasound.  It is imperative that cancer is ruled out first before it is assumed that the changes are associated with the menopausal transition.