Perimenopause is a phase wherein women experience irregularities in the menstrual cycle. Before menstruation stops completely, one may suffer from frequent periods. Sometimes, women may even experience heavy bleeding during perimenopause. Wondering what causes irregular or heavy bleeding between periods. Well, to make things clearer, let me give you a basic idea on the changes that take place in a woman's body during her reproductive years. Most girls turn pubescent between the age of 11 to 13 years. During this time, a variety of physiological changes start taking place in their body.
From the time a girl hits puberty up to the last stage of her reproductive life cycle, it is the interplay of hormones called progesterone and estrogen that leads to menstruation. Menstruation is a natural process that results from cyclical physiological changes that take place during the menstrual cycle. It makes a woman capable of supporting a pregnancy. The menstrual cycle usually lasts between 28 to 35 days. The cycle begins with the shedding of the uterine lining and the resultant menstrual bleeding.
The bleeding, which is also referred to as the 'weeping of the unfertilized egg', goes on for about 3 to 5 days. After the bleeding stops, the endometrium or the uterine lining starts thickening. After the first half of the cycle is over, ovum or egg that is released by ovary reaches the uterus. Meanwhile, the uterine lining continues to thicken so as to prepare the uterus in event of fertilization of the egg with a sperm and the resultant pregnancy. If fertilization of egg and sperm doesn't occur during this time, the levels of hormones decrease and uterine lining ruptures.
This leads to menstrual bleeding. This cycle continues, but as women hit 40s, they undergo a transitional period called perimenopause. This is a period that precedes menopause, which is the last stage of their reproductive life cycle, wherein menstruation stops completely. In this article, we will try to find out why does heavy bleeding occur during perimenopause and how to tackle heavy bleeding during this transitional period.
What Causes Heavy Menstrual Flow During Perimenopause?
If you ask any perimenopausal woman as to what happens during perimenopause, you will surely hear them complain about heavy or irregular bleeding during perimenopause. Besides the impact on the menstrual flow, women experience a host of other symptoms such as hot flashes, excessive sweating, breast tenderness, headaches, night sweats, chills, fatigue, disturbed sleep, vaginal dryness, weight gain, anxiety, reduced sex drive and mood swings. Before menstruation stops completely, one may experience frequent or irregular periods and the menstrual flow may be heavy. This is due to the change in the levels of hormones on the menstrual cycle. While estrogen is released in the first half of the menstrual cycle, progesterone is secreted once the ovum is released.
The release of ovum may or may not take place in women going through perimenopause. If ovulation does not occur, progesterone is not released and the resultant imbalance of hormones may lead to longer or shorter periods. Many women follow hormone replacement therapy in order to correct the imbalance. Though these synthetic hormones may be able to alleviate some of the symptoms, these could also lead to heavy menstrual flow. At times, abnormal bleeding could be a result of certain medical conditions. Endometrial hyperplasia, is a precancerous condition that is associated with the thickening of the uterine lining. This may lead to heavy bleeding. Development of benign or malignant cancerous growth on the uterine walls could also cause heavy bleeding.
How to Tackle Heavy Menstrual Bleeding
Now that you have a basic idea about the causes of heavy or abnormal bleeding during perimenopause, let's move on to the treatment options. Though women may experience abnormal bleeding or spotting during perimenopause, they must consult a gynecologist, if the bleeding is very heavy or lasts for more than two weeks. As mentioned earlier, heavy bleeding may also be caused due to serious medical conditions. Certain imaging procedures can help the doctors in diagnosing abnormalities or presence of any uterine growths.
Biopsy can be performed to determine if the growth is cancerous or benign. Generally, doctors can determine the best treatment option after ascertaining the underlying cause and analyzing the symptoms. Drug therapy, endometrial ablation or removal of uterus may be needed for the treatment of such conditions. If tests don't reveal the presence of such conditions, use of synthetic hormones may be recommended.
Though the use of synthetic hormones is recommended for alleviating the symptoms of perimenopause, there is a need to monitor the effects of these drugs on the overall health of perimenopausal women. One can also follow certain natural remedies. Drinking herbal tea and including foods that contain phytoestrogens to one's diet can also help in alleviating the symptoms of hormonal imbalance. Siberian ginseng, evening primrose, gingko biloba and black cohosh are some of the herbs that may prove beneficial in alleviating the symptoms.
One must, however, consult a herbalist before trying any herbal remedy. Heavy bleeding would certainly have an adverse impact on one's mental health. Women may become agitated, irritable or feel depressed due to heavy bleeding. Perimenopausal women would, therefore, benefit by following relaxation techniques such as yoga or meditation.
Perimenopause and menopause are both natural processes that every woman has to go through. It is therefore, important, that women prepare themselves mentally for the impending changes that their body would go through. Though irregularities in the menstrual cycle are inevitable, heavy menstrual flow should not be ignored. Women must make lifestyle-related changes during this time and religiously follow the advice of the gynecologist regarding drug therapy or any other treatment options that the gynecologist may recommend.