Spotting during perimenopause: a cause for concern?

Whether you call it spotting, staining or metrorrhagia, light bleeding between periods, or instead of them, is part of perimenopause.

Menopause and Perimenopause

Sonia Chartier

02 May 2016

When bleeding occurs at some point other than during your period, it’s never normal, but it’s usually nothing serious. If the bleeding is accompanied by pain that lasts a number of days or started after you began a new sexual relationship, it’s a good idea to see your doctor to find out what the cause could be.

During perimenopause, metrorrhagia can last a few days and may even replace a normal period or suddenly occur between periods. As spotting happens often in the months leading up to menopause, some women wouldn’t dare go out without being prepared for every eventuality. And if your cycle becomes irregular, you can say good-bye to wearing whichever kind of undies you like: avoid G-strings until menopause.

What could cause spotting during perimenopause?

Other than the hormonal ups and downs that occur during perimenopause, what else could cause spotting during perimenopause?

  • The early stages of pregnancy for one… Yup, it’s still possible during perimenopause!
  • The insertion or removal of an intrauterine device (IUD)
  • Being on the Pill or forgetting to take it
  • A uterine fibroma
  • A vaginal or cervical polyp or injury
  • An infection and/or sexually transmitted infection (STI)
  • Diseases such as endometriosis or cancer

What can be done?

If light bleeding turns out to be symptomatic of hormonal fluctuations, a few simple measures can help improve your overall health and promote regular periods:

  • Exercise regularly
  • Drink water (1.5 to 2 litres a day)
  • Sleep, if possible going to bed and waking up at the same every day—stick to a routine!
  • Don’t smoke or drink alcohol
  • Avoid stress or learn to manage it better

Vitex may also help balance your hormones, which might in turn help eliminate spotting and certainly make your periods regular again. Its effect on the menstrual cycle is gradual and can take up to three months to reach full effect. While Vitex won’t delay menopause, it will ease the transition, which is definitely something!

Once you’ve reached menopause, i.e. once your periods have stopped for at least a year, bleeding is something to take seriously. It could indicate any number of problems, some of which are serious:

  • Polyps: small benign growths that can develop around the uterus.
  • Problems with the endometrium, the inner lining of the uterus:
    • Atrophy: when the endometrium gets thinner.
    • Hyperplasia: when the endometrium thickens. Obesity may be the cause. This multiplication of cells can give rise to endometrial cancer.
  • Certain medications, such as blood thinners and hormone therapy
  • Infections

In all cases of post-menopausal bleeding, see your doctor. Once treated, you’ll be free to opt for your naughtier undies.

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