When Do Periods Stop At Menopause
There can be gaps of up to 12 months between periods. You could go for 3-4 months without a period and the have a regular period for a few months
When having sex it is well advised to use contraception for up to 24 months after our last period. If you are having intermittent periods then you are most likely still ovulating and could become pregnant.
Changes in the monthly cycle are an indication that you are in perimenopause. There is no typical pattern of change – each woman can experience a combination of different symptoms.
What Are Perimenopausal Symptoms
During perimenopause, you can experience a variety of symptoms. Declining estrogen levels can keep you up at night, deflate your libido, and thin your locks. This is also the cause of hot flashes, vaginal dryness, mood swings, and many other perimenopausal symptoms.
The reason: Your ovaries have been making estrogen since your first period. During perimenopause, the estrogen production decreases substantially. Your body has to adjust to functioning with less of the hormone, putting you into estrogen withdrawals. The type and intensity of symptoms vary greatly among women some just feel a little off or don’t notice anything at all.
Others can experience perimenopausal symptoms including:
- Trouble sleeping
What Tests Or Investigations Might You Need
Dont be freaked out if your GP suggests having tests. You may not need them but, depending on your symptoms, they may be helpful
There may be no further medical investigations after your initial consultation and that is fine and normal. However, if heavy bleeding has been persistent and long-term, your doctor may be thinking about further tests. For example, a blood test is important if you have been bleeding excessively for a long time as you may be iron deficient.
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Flash Periods During Perimenopause
Posted on February 9, 2022 in Perimenopause / Menopause
Youre in perimenopause and havent had a period in months. Suddenly, you experience menstrual bleeding. What gives?
A popular television character recently called this having a flash period. Whatever choice of words you use, know that irregular bleeding during perimenopause is common and often normal.
Taking Action About Perimenopause Heavy Periods
The first thing that I tell women who come to see me is that they are not alone and they do not have to put up with this
For such a long time, heavy periods and their real impact on womens lives have been taboo subjects, with women expecting to soldier on in silence. My rule of thumb is that you should be able to do whatever you normally do in your life without your periods getting in the way. So, if your period is getting in the way of how you live and your ability to get on with your regular day-to-day activities, then its time to do something about it and see your doctor, says Dr Armstrong.
Read Amandas story on how a sub-total hysterectomy helped the exhaustion and pain of perimenopause heavy bleeding.
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Not Sure What To Do Next
If you are still concerned about bleeding after menopause, use healthdirects online Symptom Checker to get advice on when to seek medical attention.
The Symptom Checker guides you to the next appropriate healthcare steps, whether its self care, talking to a health professional, going to a hospital or calling triple zero .
What Fsh Level Means Perimenopause
FSH is a hormone produced by the pituitary gland the gland located at the base of your brain. It stimulates the ovaries to release an egg during ovulation. Testing your FSH level can help confirm menopause has started. A consistently high level of FSH can indicate menopause. However, FSH tests can be misleading because during perimenopause your hormones rise and fall erratically. Certain medications, like birth control pills or hormone therapy, interfere with hormone levels and will affect the results of any hormone tests. Overactive thyroid and high prolactin can also alter those results.
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What Happens After Menopause
After menopause you will no longer be able to get pregnant and you will no longer get a period. If you have any type of vaginal bleeding after menopause, you should see a doctor as soon as possible. Vaginal bleeding after menopause is not normal and can mean that you have a serious health problem.
You may experience any of the following after menopause:
- Low hormone levels. With menopause, your ovaries make very little of the hormones estrogen and progesterone. Because of changing hormone levels, you may develop certain health risks, including osteoporosis, heart disease, and stroke.
- Menopause symptoms instead of period problems. After menopause, most women get relief from period problems or menopause symptoms. However, you may still experience symptoms such as hot flashes because of changing estrogen levels. One recent study found that hot flashes can continue for up to 14 years after menopause.6,7
- Vaginal dryness. Vaginal dryness may be more common post-menopause. Learn more about treatments for vaginal dryness.
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.
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When To See The Doctor For Menstrual Cramps Without A Period
Whether to see your doctor for your menstrual cramps depends on the additional symptoms you may be experiencing. Although there are many natural reasons why you might have cramps without a period, enough causes for concern exist that you may wish to see a doctor anyway.
Consider the following before making your decision:
- How painful your cramps are
- How long your pain lasts
- Whether you have other symptoms in addition to cramps
- Where you are in your monthly menstrual cycle
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Common Symptoms Of Menopause And Perimenopause
Menopause and perimenopause symptoms can have a big impact on your daily life, including relationships, social life, family life and work.
It can feel different for everyone. You may have a number of symptoms or none.
Symptoms usually start months or years before your periods stop. This is called the perimenopause.
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How Will I Know If I Am Starting The Transition To Menopause
Sometimes it can be hard for you and your doctor to tell whether you are in perimenopause, the transition to menopause:
- Symptoms: Tell your doctor or nurse about any menopause symptoms, such as hot flashes or trouble sleeping.
- Irregular periods: Track your periods. Irregular periods may be your first sign of menopause.
- Hormone levels: Your doctor may test the amount of hormones in your blood if your periods stopped at an early age . Doctors dont usually recommend this test unless there is a medical reason to do so. This is because, for most women, hormone levels go up and down in an unpredictable way during the transition to menopause. So it is difficult to tell for sure whether you have gone through menopause or are getting close to it based on this blood test.
How Do I Manage Bleeding After Menopause
Your doctor will want to do some investigations to find the cause of your bleeding. Let them know if you have noticed any changes going to the toilet, whether you have pain, have lost weight or whether you are on HRT. You may also want to check whether you need a cervical screening test.
Some women may need to have an ultrasound, blood test or may be referred to a gynaecologist for further tests.
Treatment will depend on what is causing the bleeding. It may involve medicines to control problems with the lining of the uterus, or surgery to remove polyps.
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How Spotting During Menopause Is Treated
Once the cause for your menopausal bleeding is established, there are a number of options if you have menopausal spotting, including removing polyps if present via a hysteroscopy, adjusting the dose and type of hormone therapy if you are on it or adding topical estrogen if thinning tissue is the culprit. Sometimes a hysteroscopy and D& C is performed if the spotting is continuing and is annoying. Once endometrial cancer is ruled out, sometimes tincture of time is in order.
If youre concerned by your spotting during menopause, talk to your healthcare provider and get the information thats right for you.
“Hysteroscopy”. Johns Hopkins. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hysteroscopy
“What Is Menopause?”. National Institute of Aging. https://www.nia.nih.gov/health/what-menopause
Tamika C. Auguste. “Bleeding After Menopause Could Be a Problem. Here’s What to Know”. ACOG. https://www.acog.org/womens-health/experts-and-stories/the-latest/bleeding-after-menopause-could-be-a-problem-heres-what-to-know
“Perimenopausal Bleeding and Bleeding After Menopause”. ACOG. https://www.acog.org/womens-health/faqs/perimenopausal-bleeding-and-bleeding-after-menopause
Wheeler, Karen C, and Steven R Goldstein. Transvaginal Ultrasound for the Diagnosis of Abnormal Uterine Bleeding. Clinical obstetrics and gynecology vol. 60,1 : 11-17. doi:10.1097/GRF.0000000000000257
“Hysterectomy”. Office on Woman’s Health. https://www.womenshealth.gov/a-z-topics/hysterectomy
Treating Post Menopause Bleeding
If you have postmenopausal bleeding it is important to have it investigated.
You will most likely be referred to a gynaecologist who may:
- ask you questions about the history of your health
- examine you
- do a blood test
- look at the inside of your vagina and cervix using special tongs . At the same time, they may take a tiny sample of your cervix for testing .
The kind of treatment you have will depend on what is causing the bleeding.
- Atrophic vaginitis and thinning of the endometrium are usually treated with drugs that work like the hormone oestrogen. These can come as a tablet, vaginal gel or creams, skin patches, or a soft flexible ring which is put inside your vagina and slowly releases the medication.
- Polyps are usually removed with surgery. Depending on their size and location, they may be removed in a day clinic using a local anaesthetic or you may need to go to hospital to have a general anaesthetic.
- Thickening of the endometrium is usually treated with medications that work like the hormone progesterone and/or surgery to remove the thickening.
Before treatment there are a number of tests and investigations your gynaecologist may recommend.
All treatments should be discussed with you so that you know why a particular treatment or test is being done over another.
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What Are The First Signs Of Perimenopause
Generally, the first sign of perimenopause is irregular periods. Most people will go from having fairly predictable menstrual cycles to unpredictable cycles. A lot of people also experience the most common signs of menopause like hot flashes and vaginal dryness fairly early into the menopause transition.
Getting To The Bottom Of It
Postmenopausal bleeding can range from light spotting that is pinkish-gray or brown, all the way to a heavy flow, like a regular period. Most of the time, there is no pain with the bleeding. No matter your exact symptoms, youll want to get in touch with your ob-gyn right away if this happens to you.
Any evaluation should start with a detailed conversation, either in person or via telehealth . Your ob-gyn should ask questions such as:
- When did you go through menopause? The longer its been, the greater cause for concern and the more testing we might need to do.
- Are you taking any new medications? Some drugs, such as blood thinners and some mental health medications, can have vaginal bleeding as a side effect.
- What else is going on with your health? Other medical conditions could be relevant.
A pelvic exam usually is needed when were talking about unexplained vaginal bleeding. During the exam, your ob-gyn may look at your vagina and cervix and feel the size of your uterus.
The next steps will depend on your age, how long it has been since you reached menopause, and how much bleeding youre experiencing. Your ob-gyn might suggest a pelvic ultrasound to look at your uterus more closely or a biopsy to take a tissue sample from the lining of your uterus. You might even need both.
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No Period For Over A Year
Now, for some women, they might find that they have got to a year or even a year and a bit without a period, and suddenly they get one back again. And this is very often the time when they can get a little bit worried. Some schools of thought say that you are through the menopause once you have not had a period for a year. In our experience, we find that a number of women will get periods back, or they’ll get the odd one back after a year or more.
Is Spotting Normal During Menopause
3 minute read
Menopause, which happens on average at the age of 51, marks the end of your menstrual cycle, as in you havent had one for 12 consecutive months. And yet, even after your periods have come to a complete stop, there could be more fun in store as many women continue to experience spotting, or light vaginal bleeding.
So, whats going on? Is spotting normal during menopause?
Heres what happens: You might notice a bit of blood on the toilet paper that you wipe yourself with after urinating. It might appear in your underwear, or if you wear one, your pantyliner. The color of the bleeding from spotting during menopause can range from light to brown or even resemble a regular period. No matter the color, it usually does not involve any pain.
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How Long Does The Transition To Menopause Last
Perimenopause, the transition to menopause, can last between two and eight years before your periods stop permanently. For most women, this transition to menopause lasts about four years. You will know you have reached menopause only after it has been a full year since your last period. This means you have not had any bleeding, including spotting, for 12 months in a row.
Can Periods Come Back After They Have Stopped
This is another question which we are often asked. The answer is yes. Your hormones don’t fall nicely and neatly as you go through the menopause. You can have times where your hormones are falling, so you’ll get these particular symptoms I mentioned above. But then your oestrogen can start to go up again, so it can end up peaking to the point where it could trigger your periods to start back up again.
So, as I said before, there are quite a few different scenarios where this can happen.
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How Can I Treat The Symptoms
There are a bunch of ways.
Lifestyle changes. A healthy diet and regular exercise program will help manage your symptoms and boost your health. This is a great time to finally kick any old, unhealthy habits like smoking or drinking too much alcohol. To help with hot flashes, dress lightly and in layers. Avoid triggers like caffeine and spicy foods. And if you stay sexually active, that may help preserve your vaginal lining.
Prescription medication for hot flashes. If you still have your uterus, your doctor might prescribe treatment with estrogen and progesterone. This is called combination hormone therapy or hormone replacement therapy . It helps with hot flashes and night sweats, and it may help prevent osteoporosis. If you donât have a uterus, you might get estrogen alone.
Hormone therapy isnât for everyone. Donât take it if you’ve ever had breast cancer, uterine or “endometrial” cancer, blood clots, liver disease, or a stroke. Also don’t take it if you might be pregnant or you have undiagnosed vaginal bleeding.
If you can’t or don’t want to take hormones, other medications can ease symptoms. They include antidepressants, antiseizure drugs, or blood pressure medications to help with hot flashes and mood swings.
Prescription and OTC medication for vaginal dryness and sleep problems. You can try topical estrogen, lubricants, and non-estrogen prescriptions for dryness and painful sex. OTC or prescription sleep aids can help if you have trouble falling asleep.
When Is The Point You Should Contact Your Doctor
If you’re experiencing pain and cramping to the point where you have to take painkillers, then definitely go and see your doctor. If it’s debilitating or affecting your daily regime in any way, please go and see a doctor.
And, if the bloating you’re getting is constant , then please go and just get these checked out by your doctor as well.
I hope you found this one interesting, and I will look forward to next week for another edition of A.Vogel Talks Menopause.
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Two Years Or More Without A Period
There are also a few women that will go for two years or more and find that they get a period back. This is not really very common. And as far as we’re concerned, once you have not had a period for two years, then that’s…you’re well and truly through the menopause.
So if you get any kind of bleeding, either a proper period, or you just get a little bit of smearing, or you get a little bit of spotting, then it really is important that you just get this checked out by your doctor just to make sure that there isn’t anything else going on.
So I hope this has given you a little bit of a better picture of one of the more puzzling aspects of what can happen to your periods as you approach the menopause.
If any of you have any other questions on this or you’ve had a slightly different combination, then please do get in touch, and I’ll be happy to answer your questions. And I will see you next week for another A.Vogel Talks Menopause.