July 23, 204 – Nicole Pauzano’s perimenopausal bleeding can turn out to be so heavy that she just isn't at all times capable of go to work on the day it starts.
“For me, the Ultra tampon bleeds so heavily in less than two hours that it is completely soaked, and the bleeding goes beyond the reserve pads and gets on my clothes,” said Pauzano, a 49-year-old school psychologist.
Perimenopause – the period 6 or 7 years before and one yr after the tip of menstruation – is a time for mood swings, sleep disturbances, hot flashes, night sweats and, in some women, excessive heavy menstrual bleeding (also called abnormal uterine bleeding or “menopausal peak”). Aside from sitting on a towel within the automotive, taking extra clothes to the office or a gathering, or staying home and waiting, there are steps you possibly can take.
The problem is that perhaps a 3rd of ladies never find their approach to a health care provider and even know that it's an option. This is a vital reason why the actual number of ladies who excessive bleeding is unclear. Nevertheless, the horror stories are omnipresent.
Susie Parker, a 49-year-old public relations consultant, said she had very heavy and painful periods from around age 40 until she underwent an ablation (a procedure that destroys or removes the liner of the uterus).
“They were very debilitating in the sense that I couldn't really leave the house without feeling like I might have an accident in public,” she said. “It affected my quality of life, where I could go and what I could do in terms of my lifestyle, and I was also anemic.”
#StopMessingIt
From a medical perspective, excessive menstrual bleeding describes menstrual bleeding that's outside the “norm” by way of amount, duration, regularity, or frequency. This might be debilitating and frustrating, especially when searching for medical help.
“Just a month ago, I treated a patient … who unfortunately had been suffering from heavy bleeding for eight months; she was literally bleeding menstrual fluid into her shoes,” said Lisa Taylor-Swanson, PhD, an integrative health specialist, acupuncturist and assistant professor on the University of Utah College of Nursing in Salt Lake City. “She went to her primary care doctor and he said, 'this happens during perimenopause,' and didn't treat her,” Taylor-Swanson said.
This experience might not be unusual. “For so long, women have been told that this is just the way it is,” said Sophia Yen, MD, MPH, co-founder and chief medical officer of Pandia Healtha Sunnyvale, California-based telemedicine company that provides contraceptives and menopause Care. She said that as a lady going through menopause who has been turned to by close friends for help, “women should be using the hashtag 'stop acting like this.'”
Your advice?
“If you see huge blood clots that are bigger than a quarter, if you're using more than one pad (or tampon) per hour, if that's unusual for you, then that's definitely cause for concern. If you're having heavy bleeding, please go to the doctor to get it checked out,” Yen said.
Marisa Messore MD, a licensed menopause therapist and girls's sexual health counselor based in Miami Beach, FL, agreed.
“Excessive bleeding during menopause can have many causes – it could be related to hormonal changes or fluctuations, but there could also be other causes that need to be investigated, such as structural problems with the uterus, polyps, etc.,” she said. It's also necessary to rule out pregnancy.
Other possible causes include bleeding disorders, thyroid problems and even cancer, so a radical evaluation is significant. Excessive blood loss can even result in anemia (low red blood cell count), which affects about 58% of ladies who experience perimenopausal bleeding.
If possible, it's best to see someone trained and specialized in menopause and gynecology for a diagnostic evaluation – starting with lab work – but these people are usually not at all times easy to search out. According to the Menopause Society (formerly the North American Menopause Society), there are 3,000 certified menopause practitioners worldwide. Although the organization now not counts the variety of practitioners by country, last countlower than half lived within the USA. In addition, the outcomes of a Survey 2023 A survey of obstetrics and gynecology residency program directors found that only 31% included menopause of their curriculum.
Yen suggested that before seeing a health care provider, you need to note the variety of days of excessive bleeding, in addition to the variety of pads or tampons used per day and the kind (light, super, ultra). The information might be recorded in phone notes or on one among the Menopause Society's free and accessible online portals. Menstrual bleeding calendar.
Another consideration is: How much blood is just too much?
“There is a lot of data showing that women aged 50 bleed 6 milliliters more than women aged 20 to 45; some bleed as much as 133 milliliters (the accepted definition is 80 milliliters or more),” Taylor-Swanson said.
Stop the flood
Treatment goals for menopausal symptoms range from regulating the menstrual cycle and reducing blood loss to improving overall quality of life. The selection is commonly based on aspects akin to fertility desire and the presence of other medical conditions.
Hormonal options are sometimes the primary treatment option.
“We live in a time where medicine is becoming more and more individualized. We want to tailor treatments to patients and their specific symptoms, take into account their entire medical history and determine whether they are a candidate for hormone therapy,” said Messore.
“I believe in options, so it's important to know that stopping periods is an option when you're going into this difficult time, especially if you're bleeding heavily,” Yen said. “Many doctors themselves use IUDs, which cause 30% of periods to stop and 70% of periods to become lighter.”
Her strategy is to “go into menopause with hormones so you don't have to go through these irregular bleedings,” she said.
IUDs are also used to release progesterone in women who may not have taken preventive measures.
Another option is progestin-only pills or estrogen/progestin pills (higher often known as oral contraceptives), which Yen says not only help with heavy periods, but can even help with conditions akin to endometriosis, polycystic ovarian syndrome and pimples, and may provide a more stable mood.
Other medical options aim to cut back inflammation, akin to over-the-counter medications, agents to slow bleeding (tranexamic acid), and endometrial ablation.
Taylor-Swanson also supports acupuncture.
“The role of acupuncture therapy is to help the body stay in the middle ground in terms of cycle regulation – not too heavy, too light, too frequent, not too far apart,” she said, adding, “I can say without hesitation that acupuncture is a very safe procedure with minimal side effects.”
Although acupuncture takes an individualized approach that considers the entire body and person, Taylor-Swanson shared that in periods specifically, she typically offers acupuncture weekly until periods are normal, then every other week, after which see the way it goes until the subsequent cycle. If that's acceptable, “I'll then try a treatment over the course of a month, especially if pain is also occurring,” she said.
Regardless of which treatment you select, it's necessary to search out a health care provider who can't only discuss your symptoms but additionally create a plan for all the transition, Messore said. “It may take a few years; it's not something you do all at once; it's a process,” she said.