From the Guidelines
Yes, it is common to experience heavier periods when approaching menopause, due to hormonal fluctuations and conditions like uterine fibroids, which can cause heavy and prolonged uterine bleeding, as noted in the 2024 study on uterine fibroids management 1. When approaching menopause, women often experience changes in their menstrual cycle, including heavier bleeding, which can be caused by the erratic estrogen levels during this phase.
- Heavier periods can be a result of the uterine lining building up more than usual before shedding, leading to heavier bleeding.
- Conditions like uterine fibroids, which are common in patients of reproductive age, can also cause heavy and prolonged uterine bleeding, as well as other symptoms like pelvic pain and bulk symptoms, as mentioned in the study 1. Some key points to consider when experiencing heavier periods during perimenopause include:
- If your periods become excessively heavy, last longer than 7 days, or contain large clots, you should consult a healthcare provider to rule out other causes of heavy menstrual bleeding.
- Treatment options may include hormonal medications, non-hormonal options like tranexamic acid or NSAIDs, or procedures such as endometrial ablation for severe bleeding.
- It's essential to note that while heavier periods are common during perimenopause, they can also indicate other conditions like fibroids or polyps, so medical evaluation is crucial to determine the underlying cause, as suggested in the study 1.
From the Research
Heavy Menstrual Bleeding and Menopause
- Heavy menstrual bleeding (HMB) is a common issue in premenopausal women, and its relationship with menopause is complex 2.
- As women approach menopause, they may experience changes in menstrual bleeding patterns, including heavier or lighter periods 3.
- Hormonal changes during the menopausal transition, such as increased follicle-stimulating hormone (FSH) and decreased inhibin B, can contribute to menstrual irregularities 2.
Bleeding Patterns and Hormonal Changes
- Studies have shown that anovulatory cycles, which are common in the menopausal transition, are associated with changes in bleeding patterns, including shorter or longer cycle intervals and shorter or longer duration of menstrual bleeding 3.
- However, heavy menstrual bleeding is not directly associated with steroid hormone concentrations, but rather with factors such as obesity and the presence of leiomyomata 3.
- The relationship between hormonal changes and bleeding patterns is complex, and more research is needed to fully understand the underlying mechanisms 2, 3.
Treatment Options for Heavy Menstrual Bleeding
- Various treatment options are available for HMB, including non-steroidal anti-inflammatory drugs (NSAIDs), tranexamic acid, and hormonal therapies such as the estradiol valerate and dienogest oral contraceptive pill 4, 5, 6.
- These treatments can help reduce menstrual blood loss and alleviate symptoms associated with HMB, but their effectiveness may vary depending on individual factors and the underlying cause of the bleeding 4, 5, 6.