Cause Of The Menopause
A number of hormones are responsible for initiating your menstrual cycle each month. These are controlled by other hormones which are released from the pituitary gland in the brain. When a woman reaches a certain age, your pituitary hormones begin to decline, which in turn means that the ovaries stop producing their sex hormones as efficiently this means ovulation will stop. As ovulation stops, so do your periods.
However, this process often happens very gradually and hormone fluctuations along the way are common this means the irregular periods and other symptoms as described below are often a part of the experience.
Mood Swings And Depression
Studies indicate that mood swings are more common during perimenopause, when hormonal fluctuations are most erratic, than during the postmenopausal years, when ovarian hormones stabilize at a low level. No direct link between mood and diminished estrogen has been proved, but it is possible that mood changes result when hormonal shifts disrupt the established patterns of a woman’s life. These changes can be stressful and may bring on “the blues.” Mood swings can mean laughing one minute and crying the next, and feeling anxious or depressed. These changes are transient, however, and do not usually meet the criteria for a diagnosis of clinical depression, a more profound dysfunctional emotional state.
Over their lifespan, women have more depression than men. But there is no evidence that decreased estrogen alone causes clinical depression. Although women who have had previous episodes of depression may be vulnerable to a recurrence during perimenopause, menopause in and of itself does not cause clinical depression. The incidence of depression in postmenopausal women is not any higher than at any other time in life.
Hot Flashes & Night Sweats
Hot flashes and night sweats are common symptoms of perimenopause and menopause, with over 85% of women reporting hot flashes. Hormone changes affect your bodys internal thermostat. A hot flash feels like a wave or sensation of heat across your face, neck, and chest. It can last for several minutes. Hot flashes can happen a few times a day, a few times a week, or less often.
Hot flashes that happen at night are called night sweats, which can cause women to wake up drenched in sweat and disturb sleep. Women are more likely to report hot flashes at night.
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What Are Light Periods
Light periods are menstrual periods that have an unusually light flow or a very short duration of blood loss. Although the menstrual cycle varies from person to person, most women have a normal period approximately every 28 days. Each period typically lasts from four to seven days. The amount of blood lost during a menstrual period ranges from 20 to 80 milliliters . Blood loss of less than 20 mL may be considered a light period.
A shift or imbalance in hormone levels is the main cause of light periods. Light periods most commonly affect women who are approaching menopause because at that time in their lives women produce less estrogen, one of the hormones that regulates menstrual periods. Light periods can also occur in girls who have just begun to menstruate. An eating disorder, excessive exercise, or a thyroid condition can also cause a woman to have light periods. Women who use hormonal contraceptives, including oral contraceptives, may also experience lighter periods.
Light periods are not the same as the complete absence of menstrual periods, medically known as .
Seek immediate medical care if you, or someone you are with, are pregnant and experience . If you are not pregnant, your health care provider will determine the cause of your light periods through a pelvic examination and other tests. If your light periods are persistent or cause you concern, seek prompt medical care.
Lifestyle Factors To Support You During The Menopause
There are a number of easy self-help tips that you can try at home to help keep the symptoms of menopause under control:
- Diet During the menopause even very small changes in lifestyle factors can make a big difference for better or for worse! Try to reduce refined carbohydrates and sugary sweet treats as you can risk throwing your hormones off further, exacerbating cravings and encouraging weight gain. Eat plenty of fresh fruit and vegetables rich in vitamins and minerals, opt for whole grain sources of carbohydrates, up your intake of omega-3 with lots of oily fish and include a source of protein in every meal
- Think about drinks Its not just what you eat, but also what you drink that matters. Ensure you drink at least 1.5 litres of plain, still water a day to keep you hydrated and your bowels moving regularly. Also, try to avoid sugary drinks, alcohol and caffeine as much as possible as these can put a strain on the endocrine system and make you feel anxious or jittery
- Stress Stress can be exacerbated during the menopause so its important to not let it get on top of you. Practice breathing exercises, or try taking part in a yoga class after work, above all else make sure you take time out to do things you enjoy and take your mind off the stresses of modern life
- Exercise – Regular moderate exercise can help with many of the symptoms of menopause. It can help support your mood, sleep, body weight and often helps to keep pesky food cravings under control too!
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Heavy Periods And Flooding During Perimenopause
Alongside changes in regularity, you may notice your period is heavier than usual. Before the perimenopause, your ovaries secreted oestrogen to thicken the lining of the womb. Once the ovaries released the egg, they produced progesterone.The synergetic relationship between oestrogen and progesterone ensured your periods werent too heavy or light. However, as you enter the menopause, ovulation becomes more sporadic, even though your ovaries continue to secrete oestrogen. Since there isnt enough progesterone to stabilise the effects of oestrogen, you may experience heavier periods.Some perimenopausal women can experience extremely heavy periods with flooding, medically known as Perimenopausal Dysfunction Bleeding . In this, bleeding can be so heavy that sheets or seating become soaked with blood when lying or sitting down.1 Naturally, this can interfere with your everyday life.Though heavy bleeding is common during the menopause, you shouldnt ignore it. We recommend discussing this with your GP.
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.
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When To Seek Assistance And Advice
If you are experiencing symptoms that are causing physical discomfort, or impacting on your daily life, we encourage you to seek professional advice about ways best to support you. Any abnormal symptoms or concerns should be discussed with your health care professional.
If you are experiencing any of the following, we advise you to speak with a trusted healthcare professional as soon as possible:
Changing tampons or pads every hour for several hours in a row
Bleeding that lasts for more than eight days
Bleeding that occurs more frequently than every three weeks
Understanding The Menopausal Transition
Menopause is a point in time 12 months after a woman’s last period. The years leading up to that point, when women may have changes in their monthly cycles, hot flashes, or other symptoms, are called the menopausal transition or perimenopause.
The menopausal transition most often begins between ages 45 and 55. It usually lasts about seven years but can be as long as 14 years. The duration can depend on lifestyle factors such as smoking, age it begins, and race and ethnicity. During perimenopause, the body’s production of estrogen and progesterone, two hormones made by the ovaries, varies greatly.
The menopausal transition affects each woman uniquely and in various ways. The body begins to use energy differently, fat cells change, and women may gain weight more easily. You may experience changes in your bone or heart health, your body shape and composition, or your physical function.
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Q When Should I Call A Doctor About My Perimenopausal Symptoms
If you have not had a period for 12 months and then experience vaginal bleeding, contact your doctor. It is not normal for bleeding to recur after this period of time. Read our article about when you should see your OBGYN.
Remember, perimenopause and menopause are natural and normal transitions, but they can be stressful. Many symptoms can be managed which can help you regain a sense of control, well-being, and confidence to thrive in your next stage of life.
We want you to feel supported, heard, and cared for as you go through this change.
Sometimes, the biggest help is simply confirmation that what youre experiencing is normal!
Dr. Ashley Durward has been providing healthcare to women in Madison since 2015 and joined Madison Womens Health in 2019, specializing in high and low risk obstetrics, contraception and preconception counseling, management of abnormal uterine bleeding, pelvic floor disorders, and minimally invasive gynecologic surgery.
Hot Flashes During Perimenopause
Most women don’t expect to have hot flashes until , so it can be a big surprise when they show up earlier, during perimenopause. Hot flashes sometimes called hot flushes and given the scientific name of vasomotor symptoms are the most commonly reported symptom of perimenopause. They’re also a regular feature of sudden menopause due to surgery or treatment with certain medications, such as chemotherapy drugs.
Hot flashes tend to come on rapidly and can last from one to five minutes. They range in severity from a fleeting sense of warmth to a feeling of being consumed by fire “from the inside out.” A major hot flash can induce facial and upper-body flushing, sweating, chills, and sometimes confusion. Having one of these at an inconvenient time can be quite disconcerting. Hot flash frequency varies widely. Some women have a few over the course of a week others may experience 10 or more in the daytime, plus some at night.
Most American women have hot flashes around the time of menopause, but studies of other cultures suggest this experience is not universal. Far fewer Japanese, Korean, and Southeast Asian women report having hot flashes. In Mexico’s Yucatan peninsula, women appear not to have any at all. These differences may reflect cultural variations in perceptions, semantics, and lifestyle factors, such as diet.
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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.
During Perimenopause And Menopause Talk To Your Healthcare Provider If:
You begin to bleed between periods, especially if you have a history of polycystic ovary syndrome , are higher weight, have a family history of uterine cancer, or have taken estrogen-only hormone therapy or certain medications to prevent breast cancer .
You experience any spotting or bleeding after reaching full menopause
You experience bleeding during penetrative sex
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You Have An Overactive Thyroid
An overactive thyroidalso known as hyperthyroidismbegins producing too many thyroid hormones, which can cause serious issues for your heart, blood pressure, muscles, and more. Abnormally light periods and missing periods are also a symptom of hyperthyroidism. If youre experiencing some of the other symptoms of an overactive thyroid, make an appointment to see your doctor.
Are You Headed For Menopause
You won’t know exactly when your menopause will hit. All you can do is pay attention to how you’re feeling and notice changes. Keep in mind that symptoms vary greatly from woman to woman. Some women have no symptoms at all.
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How Can Your Doctor Help
If your symptoms are becoming unbearable and self-help tips and herbal remedies havent helped, it might be time to pay a visit to your doctor.
Traditionally doctors would recommend HRT for the menopause. HRT involves the introduction of medication that provides synthetic forms of the sex hormone oestrogen and progesterone. This can help with some symptoms of the menopause initially but for many women coming off of
HRT, they experience symptoms of the menopause all over again as a similar drop in hormones is apparent. HRT has also has some bad publication in recent years due to some of the associated side effects and health risks.
In some situations HRT might be necessary or recommended speak to your doctor for more information and in order to carefully discuss and consider your options.
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