What Changes In Menstruation Can You Expect
During perimenopause, your body undergoes a shift in progesterone and estrogen levels. Estrogen, specifically, rises and falls in an arbitrary manner, which in turn affects ovulation and menstrual cycles. Expect to see irregular periods, spotting, missed periods, and certain perimenopausal bleeding patterns.
Major hormonal changes are largely to blame for symptoms, such as night sweats, hot flashes, sleep disturbances, and perimenopausal bleeding.
Occasionally, youll notice heavier and longer periods , while at other times, youll notice lighter and shorter periods . Early perimenopause tends to produce shortened menstrual cycles as well as periods lasting 2 to 3 days less. In contrast, late perimenopause creates longer cycles , often associated with anovulatory menstruation .
Furthermore, missed periods might sometimes be followed by normal periods as perimenopausal bleeding patterns and cycles are highly irregular. In this phase, menstrual blood ranges in color from dark brown to bright red. You might notice brown discharge or perimenopause brown spotting throughout the month. The texture of your discharge will also vary from thin and watery to thick and clumpy.
You Have Bacterial Vaginosis Or A Yeast Infection
These two infections are so common its estimated that three out of four women will experience at least one in her lifetime. Any kind of infection can cause inflammation and irritation, which can result in bleeding during sex, says Dr. Mahnert.
That said, bleeding isnt the most common symptom with bacterial vaginosis or a yeast infection. Theyre typically characterized by changes in the color or odor of vaginal discharge as well as vaginal discomfort like prolonged itching, she explains. But if the cervix is infected and becomes inflamed , there could be some small amounts of blood seen after sex, due to the rubbing, says Dr. Gersh.
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Anticoagulants, often referred to as blood thinners, are often taken to help people reduce and break up potentially dangerous blood clots. While anticoagulants like aspirin allow blood to flow through your body more easily, thus decreasing the risk of a heart attack or stroke, they also allow blood to flow more freely down there, according to research from the Royal Free Hospital in London. Your M.D. could help you figure out what meds might be best to prevent this from happening.
Watch 5 women share their first period stories:
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What Is A Miscarriage
A miscarriage, also called a spontaneous abortion, is the unexpected ending of a pregnancy. About 1/3 to 1/2 of all pregnancies end in miscarriage before a person misses a menstrual period or even knows they are pregnant. About 10 to 20% of people who know they are pregnant will miscarry.
A miscarriage is most likely to occur within the first 3 three months of pregnancy, before 20 weeks gestation. Only 1% of miscarriages occur after 20 weeks gestation. These are termed late miscarriages.
What Tests Will Be Done To Diagnose Anovulation
Tests for diagnosing anovulation depend on what your healthcare provider suspects are causing your anovulation. Tests that can help diagnose anovulation, include:
- Blood progesterone levels.
- Blood prolactin levels.
- An ultrasound exam of your pelvic organs.
Many of the hormone imbalances that cause anovulation have other symptoms, so your provider may have you undergo other tests if youre experiencing symptoms of a certain hormone imbalance condition.
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Your Period Decides To Ghost You For A While
While its true that you can sometimes randomly miss a period for reasons like stress, you shouldnt just ignore a long-term missing period. Missing at least three menstrual cycles in a row qualifies as amenorrhea, the Mayo Clinic explains, and its usually very much worth bringing up to your doctor.
If your period randomly disappears and you have even the smallest chance of being pregnant, first and foremost, you should find out if you are, Alyssa Dweck, M.D., a gynecologist in Westchester, New York, and assistant clinical professor of obstetrics and gynecology at Mount Sinai School of Medicine, tells SELF. Sometimes people miss the obvious, she notes.
If youre not pregnant, talking to a doctor can help you make sure theres not another health issue going on, like PCOS. . Here are a few other things that could be making you miss your period:
When To See A Healthcare Provider
- If your menstrual bleeding is heavy and requires you to change your tampon or pad every couple of hours
- If the bleeding lasts longer than seven days
- If blood clots are larger than a quarter
- If there is an excessive amount of blood clots
- If you have extreme abdominal pain with nausea or vomiting
- If you have bleeding or clots while pregnant
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When Should I Be Concerned About A Heavy Period
If you experience any of these signs and symptoms of a heavy period, you may want to schedule an appointment with your primary care doctor or gynecologist.
- Your period lasts more than seven days.
- You soak through one or more tampons or pads an hour for several hours in a row.
- You need to double up on sanitary protection.
- You wake up during the night to change your sanitary products.
- You experience painful menstrual cramps.
- You pass menstrual blood clots that are larger than the size of a quarter.
- You lose so much blood that you feel tired, fatigued, or short of breath, which are signs of anemia, or low iron in the blood.
- You cancel or scale back activities due to heavy menstrual flow.
What Steps To Take
Dont panic. Most women with light period may not indicate a problem if its occurring for the first time. Depending on your age, you would want to start preparing for menopause or getting used to light flow after menarche.
Improved physical fitness and eating healthy may also help.
If you are finding difficult to get pregnant, a light period could be due to polycystic ovarian syndrome. Talk to your doctor about possible options. Samples from your urine and discharge will be cultured for possible infections.
Depending on what pills you are currently taking, you will be counseled adequately by your health physician. Still confused, talk to him/her again.
Finally, unprotected sex weeks ago and scanty early period may mean pregnancy. Take a home pregnancy test. If pregnant, inform your doctor.
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Bleeding In Perimenopause And Menopause
Heavy bleeding during a period becomes more common amongst women in their late 40s and early 50s as they move through perimenopause and menopause. While the hormonal ups and downs during this time can be the culprit behind the heavier bleeding, it is always a good idea to bring it up with your doctor. They may run a hormone blood test as well as do a pelvic examination and an ultrasound to check that there is nothing wrong. They may also want to check your iron levels for anemia if you are losing more blood than usual during your period.
Reasons Your Period Is Heavier Than Usual
From no-biggie birth control changes to serious medical problems.
When it comes to menstruation, not all periods are created equal. Any Mean Girls fan knows that some women just have a heavy flow and wide-set vagina! And while you shouldnt worry if you typically use super tampons while your friends always grabbing the light ones, something might be up if your flow has dramatically changed and is now heavier than it usually is.
Women are definitely aware of whats normal for them, says ob-gyn Jennifer Ashton, M.D. If one of my patients is experiencing something irregular and it happens three months in a row, I like to see her.
From no-biggie birth control changes to serious medical problems, here are seven reasons why you might be bleeding more than usual.
Considering that hormonal birth-control pills often regulate and lessen periodsin fact, some doctors prescribe it specifically to lighten up heavy flowsit makes sense that if you switch to a non-hormonal pill or stop taking oral contraception completely, youre going to be going through your tampons faster. And although IUDs like Mirena also lighten periods, Ashton says that non-hormonal IUDs tend to cause heavier periods in most women. While this is generally normal, see a healthcare professional if your heavy bleeding continues three months after insertion.
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You Are Taking Contraceptive Pills
Most women take birth control medication to lighten their period or stop it. These pills contain synthetic hormones estrogen and progestin, produced during the menstrual cycle.
These hormones work by blocking ovulation and making cervical mucus unfavorable for sperm to swim through.
However, some women have complained of spotting while on these pills. Though, these symptoms clear in few months after starting the pill.
On the other hand, you can get pregnant while on these pills. This may happen for many reasons. The commonest reason is not taking your medication every day as prescribed.
How To Treat Abnormal Bleeding And Spotting During Perimenopause
How to effectively manage heavy bleeding and perimenopause spotting is generally determined according to whats causing it.
Various medications, such as nonsteroidal anti-inflammatory drugs , are available to decrease vaginal bleeding and provide pain relief. Tranexamic acid, for example, is known to significantly reduce menstrual flow. Additionally, oral contraceptives have the potential to regulate your cycles while also addressing bleeding problems. However, the use of contraceptives to inhibit perimenopausal bleeding is widely debated.
When prescription drugs prove insufficient, a more advanced medical procedure may be necessary. If endometrial polyps are to blame for heavy bleeding, your doctor will likely advise surgical removal. Endometrial hyperplasia, on the other hand, is treated with progestin therapy to shed the endometrium. Thickened areas of the endometrium can also be eliminated by dilatation and curettage, which is the surgical removal of the lining or contents of the uterus.
Be sure to consult your doctor immediately should you experience any of the following symptoms:
- Very heavy perimenopausal bleeding
- Menstrual bleeding that lasts for more than a week
- Bleeding which occurs more often than every three weeks
The stage prior to menopause is known as perimenopause and is characterized by sharply fluctuating hormone levels each month. This hormonal shift has a major impact on ovulation and your menstrual cycle.
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Just After You Had Your First Period Menarche
If you just had menstruation flow for the first time, you may get worried when you experience a delayed period or a light bleeding during your menstruation. This is not abnormal as your reproductive and sexual hormones take some time to normalize.
However, most women get normal flow six years after menarche. Yours could be earlier.
Frequently Asked Questionsexpand All
- How common is heavy menstrual bleeding?
Heavy menstrual bleeding is very common. About one third of women seek treatment for it. Heavy menstrual bleeding is not normal. It can disrupt your life and may be a sign of a more serious health problem. If you are worried that your menstrual bleeding is too heavy, tell your obstetriciangynecologist .
- When is menstrual bleeding considered heavy?
Any of the following can be a sign of heavy menstrual bleeding:
Bleeding that lasts more than 7 days.
Bleeding that soaks through one or more tampons or pads every hour for several hours in a row.
Needing to wear more than one pad at a time to control menstrual flow.
Needing to change pads or tampons during the night.
Menstrual flow with blood clots that are as big as a quarter or larger.
Heavy menstrual bleeding may be a sign of an underlying health problem that needs treatment. Blood loss from heavy periods also can lead to a condition called iron-deficiency anemia. Severe anemia can cause shortness of breath and increase the risk of heart problems.
Many things can cause heavy menstrual bleeding. Some of the causes include the following:
Bleeding disordersWhen the blood does not clot properly, it can cause heavy bleeding.
When you see your ob-gyn about heavy menstrual bleeding, you may be asked about
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Is Every Heavy Flow Considered To Be Hmb
Heavy menstrual bleeding is also known as menorrhagia. This medical term refers to abnormally heavy or prolonged bleeding. Although its quite difficult to estimate the incidence of HMB, its somewhere in the range of 5 to 30 percent, according to different sources.
It can be challenging to maintain your normal daily activities with HMB because of significant blood loss. And some bleeding can be very heavy, leading to the need to change your tampon or pad frequently . If you think your periods are like this, talk with your health care provider about possible treatment options.
Various things can cause heavy menstrual bleeding. Here are some of the causes:
Is Heavy Menstrual Bleeding Serious
Heavy menstrual bleeding can be serious if you lose so much blood that you show signs of anemia. Anemia is a condition arising from having too little iron in your body. Anemia can be life-threatening without treatment.
Also, some of the conditions that can cause heavy period bleeding, like cancer, require early medical intervention. Speak with your healthcare provider to discuss any risks related to your period bleeding.
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You Have Debilitating Mood Issues Before Your Period
When your estrogen and progesterone drop before your period, you may experience the typical mood swings that can come with premenstrual syndrome .
But if you deal with severe mood swings, irritability, anger, a lack of enjoyment in things you usually enjoy, and other symptoms that affect your life, you may have premenstrual dysphoric disorder . PMDD happens when you experience these symptoms in the week before your period, then they start getting better in the first few days of bleeding, and disappear in the weeks after your period. Its listed in the DSM-5, the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, for good reason: This psychological issue can be devastating.
If you suspect you have PMDD, the one thing I would encourage is keeping a daily record of the severity of your symptoms, Dr. Minkin says. If you notice these symptoms only appearing the week before your period, PMDD might be your issue. If you realize youre constantly dealing with these symptoms and your period just makes them worse, it could be premenstrual exacerbation, which is another way of saying you have a mental illness like depression that gets worse during your period thanks to hormonal changes.
Either way, talking to a doctor may help. If you have PMDD, your doctor may have you take antidepressants in the timeframe when you usually experience symptoms, then stop once your period starts, Dr. Minkin says.