Women who experience heavy and extended menstrual bleeding as a result of entering menopause should not be concerned as it is a common occurrence, a study has found.
The findings at the University of Michigan should provide assurance to women worried about what is a normal symptom of menopause and what is not, the study's author says.
"For most women in their 30s, menstrual periods are highly predictable," UM epidemiology Professor Sioban Harlow says.
"[But] with the onset of the menopausal transition in their 40s, women's menstrual periods can change dramatically."
While most women consider menopause as the age when predictable monthly periods come to an end, it's normal to experience increase in the duration and amount of bleeding at different times as a women transitions through menopause.
The study, considered to be the first to take a long-term look at bleeding patterns of women of different racial and ethnic backgrounds, may lead to improvements in patient treatment and help women understand what they can expect during the menopause stage of their lives, which can occupy two to 10 years.
Menopause, which usually commence after around age 45, is the result of the cessation of the production of the hormones progesterone and estrogen in a woman's ovaries.
"Women need more descriptive information about the bleeding changes they can expect," Harlow says. "We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention."
Prolonged bleeding lasting 10 days or more, six or more days of observed spotting and heavy bleeding episodes lasting around three days are not uncommon.
Women from Los Angeles, northern California and southeast Michigan participated in the study, recording their menstrual experiences from 1996 up to 2006.
Women in the study were identified as white, Chinese, Japanese and African-American. Very few differences were found between the groups. Most of the women in all of the studied groups recorded bleeding experiences that fell into one of the three patterns, and sometimes more than one.
"We think this paper will be helpful to professionals, both clinical and investigational, as it describes in much more quantitative terms the range of bleeding patterns women may normally experience through the menopausal transition," Dr. John Randolph Jr., UM professor of gynecology and obstetrics says.
"Watchful waiting is an acceptable option," Randolph said when queried about changes in bleeding patterns.
