Irregular heavy bleeding during Menopause: Why it happens and what to do

Irregular, heavy, and unpredictable bleeding during periods can be one of the most frustrating aspects of the menopause transition for many women. More than just mood swings, this hormonal life stage can bring serious uterine drama in the form of abnormal uterine bleeding (AUB). Whether your periods have gone haywire with heavy flows, frequent occurrences, or a total loss of cycle predictability, AUB is extremely common but can also seriously disrupt your life. The good news is, you don't have to just grin and bear it! There are steps you can take to understand and manage these irregularities.

What qualifies as abnormal?

According to medical definitions, any of the following could be considered AUB:

• Periods lasting longer than 7 days

• Bleeding or spotting between periods

• Periods occurring more frequently than every 21 days

• Excessive menstrual flow requiring protection changes every 1-2 hours

• Losing your regular cycle pattern entirely

Essentially, anything that deviates from your personal norm and disrupts daily life likely counts as abnormal.

The potential causes

There are a few different factors that could be behind these irregular, heavy periods:

• Hormone imbalances from estrogen/progesterone fluctuations

• Uterine growths like fibroids or polyps

• Other underlying conditions like thyroid disorders, clotting issues, or polycystic ovary syndrome (PCOS)

• Some medications, such as anticoagulants or hormone therapy, can also impact menstrual flow

As your body goes through the menopausal transition, those hormonal ebbs and flows can really throw your cycle out of whack.

Diagnostic approaches

Identifying the cause of AUB often involves a series of diagnostic steps:

• Medical History and Physical Exam: To understand symptoms and any underlying health issues.

• Blood Tests: To check for hormone levels, thyroid function, and clotting disorders.

• Imaging Tests: Ultrasound or MRI to identify fibroids, polyps, or other abnormalities.

• Endometrial Biopsy: To sample the uterine lining and check for abnormal cells or conditions such as endometrial hyperplasia or cancer.

• Hysteroscopy: To directly view the inside of the uterus and identify any growths or abnormalities.

Treatment possibilities

While at one time, hysterectomy was a common solution for heavy periods, today there are several less invasive options your doctor may recommend:

• Hormonal birth control pills or IUDs to help regulate bleeding

• Tranexamic acid or NSAIDs to reduce heavy flow

• Endometrial ablation to remove the uterine lining

• Uterine artery embolization to block blood flow

• Surgery to remove fibroids or polyps

• Hormone therapy to address imbalances

• Non-hormonal medications like tranexamic acid or antifibrinolytics for heavy bleeding

Your doctor can review your symptoms, perform diagnostic tests, and identify an appropriate treatment plan to get your cycle back on track.

Take back control

Don't resign yourself to living with debilitating menstrual irregularities. Have an open and candid conversation with your doctor about any abnormal bleeding patterns you're experiencing. With their medical guidance and the latest treatment options, you can get your cycle managed and regain your quality of life.

The menopause journey comes with its share of ups and downs, but disruptive bleeding doesn't have to be an unavoidable part of that path. Pay attention to your body, advocate for your needs, and work closely with your doctor to tame those rogue periods. You've got this! Join our tribe by joining our private Facegroup group at https://www.facebook.com/groups/1553851178789294