There have been many questions on the HealthCentral menopause site lately about the definition of when a woman reaches menopause as well as what happens if a woman has an abnormal period after going one year or more without one.
So first of all, let’s get to the definition. Dr. Holly Thacker, the director of Cleveland Clinic’s Center for Specialized Women’s Health, who wrote The Cleveland Clinic Guide to Menopause explained that a woman is medically defined as menopausal when she stops having a menstrual period and hasn’t experienced one at all for 12 months.
Now for the second question –w hat if you’ve gone a year without a period and suddenly experience bleeding. In their book The No-Nonsense Guide to Menopause, Barbara Seaman and Laura Eldridge wrote, “Many women describe the experience of a heavy period after months or years of not having one; most late or –post menopausal bleeds are nothing to be concerned about. Your body doesn’t abruptly stop making hormones; it continues to produce estrogen well past menopause. Since bleeding is caused by hormone fluctuation, it remains a possibility even after you think menopause is over.”
Still, if you have had a recurrence of your period after a year or more without one, it is best to get it checked out. “If a woman is over 50 years old , has gone even six months without a period (an indication of the onset of menopause), and then bleeds or spots, she should see a doctor within that month,” Dr. Thacker urged. “This kind of postmenopausal bleeding is often caused by treatable and relatively benign conditions. But in some cases – perhaps up to 5 percent – postmenopausal bleeding can indicate uterine cancer or a precursor, such as hyperplasia (an abnormal increase in cells.” Procedures that the doctor may use to determine what is going on include a Pap smear, pelvic exam, special saline-infusion sonogram, and an endometrial sampling.
Dr. Robin Phillips described the treatments for various types of abnormal bleeding in The Menopause Bible: The Complete Practical Guide to Managing Your Menopause. These treatments include:
- Uterine bleeding – most of the time, this type of bleeding is lined to hormonal sources. The treatment is low-dose birth control pills, either combination or progestogen alone. Also,, progestogen can be given by injection and is increasingly popular in the interuterine system, which is inserted into the uterus and slowly release progestogen for about three years.
- Polyps and fibroids – These can be destroyed or removed by curettage, by freezing or with cautery. Although fibroids tend to shrink after menopause and thus cause fewer problems, if the condition warrants it, the doctor may recommend a surgical operation called myomectomy.
- Cervical bleeding – This type of bleeding is treated through a colposcopy and biopsy that uses laser electrocautery, freezing or excising the abnormal tissue.
Dr. Phillips added, “When the cause of abnormal bleeding has been diagnosed and serious disease excluded, there are many complimentary treatments and self-help alternatives to help deal with different bleeding patterns.” These include eating a healthy diet rich in vitamin B that can help strengthen blood vessel walls. You should also aim to have foods that include vitamin E, vitamin C, and vitamin A.
So if you're having any abnormal bleeding (especially after not having a period for a year), it could be due to hormones. However, it also could be due to something else, so just to be safe, check with your doctor.
Published On: April 29, 2011