Heavy or Prolonged Bleeding in Menopause – Dangerous or Normal?”

Recently on one of the health websites where I am privileged to be an "expert" on Menopause, www. wellsphere. com,
a member raised a question about bleeding for over a month solid. Of peri- menopausal age, she was under- standably worried. Most of us think of menopause as a time of skipping or diminishing periods until they cease altogether. Because this question comes up frequently and because it was the case in my perimenopausal transition, I’m reprinting my answer to her for all concerned goddesses.

"Actually, it CAN be normal. Heavy and/or prolonged bleeding during perimenopause can be a normal variant. I had my period every other week (and heavy flows) for a little over a year. Because prolonged bleeding (called dysfunctional uterine bleeding) can be a symptom of more serious conditions, it is important to be checked out by a physician. A pelvic ultrasound and/or endometrial biopsy can rule out pathology. Even if no serious condition is found, you must be monitored for anemia. Regular red blood cell and hemoglobin counts are recommended. I simply increased my intake of red meat and took iron supplements and was never anemic.

Even in the absence of disease, if bleeding persists, your MD may recommend a "simple" D & C (dilation and curettage) or even hysterectomy. I’d get a second opinion or even a third. Remember that NO surgical procedure is simple – each has risks, including that of general anesthesia. A good rule of thumb is to always try the least interventional remedy first.

It took me three tries to find an enlightened gynecologist who felt that heavy bleeding was a normal variant. After ultrasounds and an endometrial biopsy (performed in her office) returned as "normal with menopausal thickening of uterine lining), together we monitored me for anemia and eventually I began skipping periods as I continued on my menopause journey.

Hope this helps – let me know if you have further questions. For more info – check out our blogsite at www.menopausegoddessblog.org. Good luck. Lynette Sheppard RN."

On a further note: I cannot tell you how many of my nurse-friends had D & C’s or hysterectomies after three weeks of bleeding. When they went to their OB-GYN’s, understandably a little freaked out, those were usually the only recommendations. While a surgical procedure may end up being the right choice for you, it is not necessarily the only or best one. I’ve said it before and I’ll say it again. You MUST be in charge of your own health care education and decisions. Still have questions? Click on the "Contact Us" button at the top right of the page or visit me at www.wellsphere.com in the Menopause Community.

"The Big M", the long awaited chronicle of the real-life adventures, musings, wit, and wisdom of the Venus group of Menopause Goddesses is available now. Check out our girlfriend’s special: buy one at regular price and get the second for HALF PRICE. Click here to buy or for free download of Chapter One The Big M

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3 Responses to Heavy or Prolonged Bleeding in Menopause – Dangerous or Normal?”

  1. Geoffrey Rutledge, MD, PhD September 23, 2009 at 7:43 am #

    Lynette, Fabulous answer to a question that affects and concerns many. Thanks!

    You are right on the money when you say that women with this problem should first get the proper evaluation, and then consider the options (and seriously consider getting more than one opinion before proceeding with an elective operation).

    And I must say your Top Health Blogger and Health Maven badges look great on your blog too! Geoff

  2. Linnea January 28, 2010 at 3:45 pm #

    I had this too! My gynecologist DID say it was a normal part of peri-menopause, though I did have an ultrasound.

    However, I became severely anemic. Because I eat lots of red meat, I didn’t think this would be a problem. I began to have tremendous memory problems and trouble with my organizational faculties, as well as fatigue. I couldn’t figure out how to do simple tasks like sorting papers and drawing up an outline. Because I was entering menopause, I thought that IT was the problem. (I couldn’t believe my mother never told me about this side effect!)

    I was tested for anemia but my blood tests were “normal” for hemoglobin, just on the low end. When I still felt rotten I asked a doctor friend in another state what to suggest and she said I needed my ferritin levels checked to find out how my body was storing iron. When I got those results back, my internist said, “I’m surprised you’re still walking around. I’ve only seen levels that low in people who are seriously ill or recovering from multiple surgeries.” Yet he had not suggested this test.

    It took 2 years of iron supplements to become normal.


  1. Menopause Mailbag: Readers Q & A | Menopause Goddess Blog dot com - August 21, 2012

    […] First of all, heavy bleeding can be a normal variant. (See previous blog entry: Heavy or Prolonged Bleeding in Menopause – Dangerous or Normal?  That said, if this is driving you crazy on a day to day basis, you might want to ask your MD […]

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