Irregular Bleeding & Menopause

During the time leading up to menopause, which is the cessation of your menstrual period once and for all, you may experience irregular bleeding. This is due to the hormonal shifts that your body is experiencing as it transitions from a regular menstrual cycle to none at all. Peri-menopause, which is the precursor to menopause, can last for months or years. This is the time when you may experience erratic bleeding. The phrase "peri-menopause" means "around menopause." The average age of menopause is 51, but that can vary greatly. The definition of menopause is when a woman has gone one full year without a menstrual period.

Cycle Changes

• During this period of your life, you may miss periods or have exceptionally heavy or, conversely, light periods. Some women experience mid-cycle bleeding. This is typical for most, but not all, women in those years leading up to menopause.

Hormones

• The reason your menstrual period is no longer predictable is because of the changes that are occurring in your hormone levels. The two hormones that are instrumental in menstruation are estrogen and progesterone. When a women stops ovulating---making an egg for fertilization---she stops producing progesterone and, as a result, your hormones get out of balance. This affects your menstrual period, as well as your overall mood, and determines how much you bleed or whether you bleed at all in a given month. You can stop ovulating but still have a menstrual period.

Anovulation

• According to the American College of Obstetricians and Gynecologists, women who are in the years leading up to menopause do not release an egg every month, as they typically did when younger. This is one of the reasons women in their 40s who want to get pregnant have difficulties. Ovulation becomes sporadic. If there is no ovulation, this is called anovulation, according to Menopauserx.com. When an egg is not released, this means that the ovaries will not produce enough progesterone to signal the uterus to shed its lining (which results in a period). When there is diminished progesterone, the body keeps producing estrogen (which can lead to estrogen dominance or too much estrogen) and this make the endometrium, or uterine lining, get thicker. When the lining gets too thick, this may cause you to have spotting or irregular bleeding, at mid-cycle. This happens because the lining was not fully shed when it was supposed to be.

Fully Menopausal

• If you are fully menopausal, meaning that you have gone one year since your last period, and start bleeding again, this could mean that you have polyps, which are noncancerous growths, or are experiencing endometrial atrophy, the thinning of the uterine lining. If you are undergoing hormone therapy, this may cause you to bleed. Another condition that can cause post-menopausal bleeding occurs when the lining of the uterus grows too much, which is called endometrial hyperplasia. If this isn't treated, it may lead to cancer. A post-menopausal woman who has endometrial cancer will bleed.

Causes

• Additional conditions that can cause bleeding in menopausal women include various cancers, some medications, thyroid problems and an infection of the cervix or uterus.

See Your Doc

• If you are fully menopausal but have started bleeding again, see a doctor. Post-menopausal bleeding caused by a thinning endometrium may be treated with estrogen. If the endometrium is growing too much, your physician may suggest taking progesterone.