Perimenopausal Bleeding

“During the transition to menopause (called
perimenopause), it is normal to skip periods,
but very frequent or heavy bleeding episodes…”.1

Umbrella
What may the Perimenopausal Bleeding Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Abnormal Uterine Bleeding (AUB)
  • Perimenopausal Bleeding

Perimenopause

What is perimenopause?

DotS the definition of perimenopause may vary. The Australasian Menopause Society’s (AMS) definition is:

“Peri-menopause refers to the time from the onset of a change in menstrual cycle pattern or onset of menopausal symptoms, through to one year after the last menstrual period. The average duration is 4-6 years with onset in the fifth decade of life (40’s)”.2

Abnormal Uterine Bleeding

What is abnormal uterine bleeding (AUB)?

DotS the definition of AUB may vary. The International Menopause Society’s (IMS) definition is:

“Many women experience Abnormal Uterine Bleeding (AUB) during perimenopause. AUB is defined as bleeding that differs in frequency, regularity, duration or amount to your regular menstrual bleeding”.3

Perimenopause or Not

Perimenopausal BleedingIs AUB a symptom of perimenopause?

On page three in the IMS’s World Menopause Day 2017 Patient Information Leaflet Changes Before the Change: Should I Visit My GP? the IMS elaborate on:

“Changes to the menstrual cycle often carry no significant consequences; however, they could have a range of causes. So, although it may simply be a symptom of perimenopause, it is still sensible to raise the issue with your healthcare professional. In most cases, a thorough history and physical examination will indicate the cause of AUB and help discern the need for further investigation and treatment”.4

Who is a GP?

DotS and/or DotC (Depending on the Country) a GP may be a qualified and registered general practitioner, a medical practitioner, a medical doctor or a doctor.

Spotting, Perimenopause and Menopause

Does spotting mean I am not in menopause? Does spotting mean do I need to see a gynecologist or health care provider about this?

In Mayo Clinic Q and A: Spotting, Perimenopause and Menopause the (United States) Mayo Clinic elaborate on the answer to the question:

“DEAR MAYO CLINIC: I am 52 and recently had gone 10 months without a period, so I had assumed I was in menopause. But, over the past three months, I’ve noticed some light spotting. Does this mean I’m not in menopause? How do I know when I’m in menopause, and do I need to see a gynecologist or health care provider about this issue?

ANSWER: It’s possible that you haven’t reached menopause yet. Clinically, menopause is defined as going without a period for one year. At 10 months, you don’t quite meet that threshold, but it is possible that you are just beginning menopause. However, depending upon when you last saw your health care provider and had a pelvic exam, it might be worthwhile to make an appointment, as there are a number of conditions where breakthrough bleeding is the first indication of an issue…”.5

Menstrual Calendar

Where may I find a menstrual calendar to keep a record of postmenopausal bleeding?

In MenoNotes the North American Menopause Society (NAMS) include:


Menstrual Calendar

  1. Menstrual Calendar
  2. Menstrual Calendar: Calendario Menstrual [Spanish]
  3. Menstrual Calendar: Calendrier Menstruel [French]

Health Care Provider

What if I think I have perimenopausal bleeding?

If you think you have perimenopausal bleeding, it may be in your best interest to choose to talk your health care provider about this. The NAMS explain:

“During the transition to menopause (called perimenopause), it is normal to skip periods, but very frequent or heavy bleeding episodes often requires an evaluation by your healthcare provider. Any bleeding after menopause requires an evaluation by your healthcare provider”.6

In Menstrual Calendar the NAMS note:

“Call your health care provider if you experience:

  • Periods that are much heavier than usual
  • Spotting or bleeding between periods
  • Periods that last longer than 10 days
  • Bleeding after sex
  • Frequent periods (fewer than 21 days between periods)
  • Any bleeding after menopause”.7

In Perimenopause: How Do I Know If Changes In My Periods Are Normal Perimenopausal Symptoms or Something To Be Concerned About? the (United States) Cleveland Clinic elaborate on:

“Irregular periods are common and normal during perimenopause, but other conditions can cause abnormalities in menstrual bleeding. If any of the following situations apply to you, see a healthcare provider to rule out other causes.

  • Your periods are changing to become very heavy, or accompanied by blood clots
  • Your periods last several days longer than usual
  • You spot or bleed after your period
  • You experience spotting after sex
  • Your periods occur closer together”.8

In About the Menstrual Cycle the (Australian) Jean Hailes for Women’s Health explain:

“When To See Your Doctor

There are many reasons you might need to see your doctor about your periods, including:

  • Changes in the pattern of your periods
  • Increasingly heavy periods
  • Long periods of more than eight days
  • Periods that come fewer than three weeks apart
  • Periods coming more than two to three months apart
  • Painful periods that cause you to stay home
  • Bleeding between periods
  • Bleeding after intercourse

Your menstrual cycle is a normal process for your body. Each woman experiences her menstrual cycle differently, most without any difficulties. If there is any change in your cycle that worries you, see your doctor”.9

Follow up

When may follow up be required?

In Perimenopausal and Postmenopausal Bleeding the European Menopause and Andropause Society note:

“Women who experience perimenopausal or postmenopausal bleeding but who have no clear diagnosis or who have recurrent or persistent symptoms, should be followed up, typically after 6 months”.10

Health Topics A-Z

Where may I find Health Topics related to Perimenopausal Bleeding?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

Where may I find Links related to Perimenopausal Bleeding?

Your Country may have Links similar to:

Links

This Links List to third party websites is neither comprehensive nor exhaustive. Inclusion on this Links List does not imply endorsement or recommendation. Non-inclusion on this Links List does not imply non-endorsement or non-recommendation. Third party websites are not under the control of Meno Martha International Menopause Directory. Third party websites may contain explicit medical images and/or sexual references. Please read Meno Martha International Menopause Directory’s Links Policy before proceeding to a Link. Please contact Webmaster if you experience a problem with a Link.

New or Updated

  1. Abnormal Uterine Bleeding
  2. Abnormal Uterine Bleeding
  3. Abnormal Uterine Bleeding
  4. Abnormal Uterine Bleeding In Perimenopausal Women: The Role of Hysteroscopy and Its Impact on Quality of Life and Sexuality
  5. About Menopause
  6. About the Menstrual Cycle
  7. About the Menstrual Cycle [+ Video]
  8. About the Menstrual Cycle: When To See Your Doctor
  9. Bleeding After Sex: What You Should Know
  10. Bleeding Disorders In Women
  11. Blood Clots During Menstruation: A Concern?
  12. Blood Disorders In Women: Heavy Menstrual Bleeding
  13. Blood Disorders In Women: Heavy Menstrual Bleeding – Signs: Chart
  14. Do My Period Changes Mean Perimenopause?
  15. Dysmenorrhea: Painful Periods
  16. Endofound.org [Endometriosis Foundation of America]
  17. Endometrial/Uterine Cancer
    Gynecologic Cancer Awareness Month
  18. Endometriosis
  19. Endometriosis
  20. Endowise.org.au [Endo Wise, Australia]
  21. Everything You Should Know About Menometrorrhagia
  22. Foundation for Women’s Cancers
  23. Gynecologic Cancer Awareness Month [September, United States]
    Gynecologic Cancer Awareness Month
  24. Gynecologic Cancers
  25. Gynecologic Cancers: What Are the Symptoms?
  26. Health After Menopause: Postmenopausal Bleeding
  27. Heavy Bleeding
  28. Heavy Menstrual Bleeding
  29. Heavy Menstrual Bleeding
  30. Heavy Menstrual Bleeding – Fact Sheet
  31. Heavy Periods
  32. Heavy Periods: Overview – Heavy Periods Self-Assessment
  33. Heavy Periods: What You Need To Know
  34. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms [+ Video: Talking Menopause With Your GP]
  35. Managing Menopause: Don’t Let Symptoms of Menopause Reduce Your Quality of Life
  36. Mayo Clinic Q and A: Spotting, Perimenopause and Menopause
  37. Mayo Clinic Q and A: Understanding Endometrial Cancer
  38. Menopause
  39. Menopause
  40. Menopause
  41. Menopause
  42. Menopause Explained
  43. Menopause Explained – A British Menopause Society Video
  44. Menopause FAQs: Menopause Symptoms – Q. I am bleeding more often and with heavier periods than I used to. I’m 45 years old. What’s wrong with me?
  45. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provide
  46. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Symptom Tracker
    Perimenopausal Bleeding
  47. Menopause Map: Downloadable Resources – Stages of Menopause: Perimenopause
  48. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  49. Menopause Preparedness Toolkit Video Series: Understanding Menstrual Health and Menopause
  50. Menopause What Are the Symptoms?
  51. Menopause: Symptoms – Changes To Your Periods
  52. Menorrhagia (Heavy Menstrual Bleeding)
  53. Menstrual Calendar
  54. Menstrual Calendar: Calendario Menstrual [Spanish]
  55. Menstrual Calendar: Calendrier Menstruel [French]
  56. Menstrual Changes After Covid-19 Vaccination
  57. Menstrual Cycle
  58. Menstrual Cycle: What’s Normal, What’s Not
  59. Menstrual Cycle: What’s Normal, What’s Not – How Can I Track My Menstrual Cycle?
  60. My Periods Have Changed. Is Menopause Around the Corner?
  61. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  62. National Center for Complementary and Integrative Health: Menopausal Symptoms: In Depth
  63. Perimenopausal Bleeding and Bleeding After Menopause
  64. Perimenopausal and Postmenopausal Bleeding
  65. Perimenopause
  66. Perimenopause
  67. Perimenopause or Menopausal Transition
  68. Period Pain & Symptom Diary
  69. Periods
  70. Periods
  71. Periods – Fact Sheet
  72. Periods: Overview – Menstrual Cycle: Animation
  73. Periods: Period Problems
  74. Premenstrual Syndrome (PMS)
  75. Premenstrual Syndrome (PMS)
  76. Resources / Periods: Heavy Periods: What You Need To Know [Video]
  77. The Eve Appeal [United Kingdom]
  78. Tips To Help Manage Menopause Symptoms
  79. Tips for Tracking Bleeding
  80. Understanding Perimenopause
  81. Uterine Bleeding: Abnormal Uterine Bleeding
  82. Vaginal Bleeding
  83. Vaginal Bleeding
  84. Video Series-2022: Irregular Menstrual Cycles What’s Normal and What’s Abnormal?
  85. Video Series-2022: Perimenopause: Signs, Symptoms, and Solutions
  86. Videos and Podcasts: Videos – Interviews: Menopause and Abnormal Bleeding
  87. Webinars: Previous – Abnormal Uterine Bleeding In Perimenopausal and Postmenopausal Women
  88. What Causes Bleeding Between Periods?
  89. What Everyone Should Know About Menopause Symptoms
  90. What Is An Endometrial Biopsy?
  91. What Is Endometriosis?
  92. What Is Menopause?
  93. What Is Menopause?
  94. What Is Menopause?
  95. Perimenopausal BleedingWorld Menopause Day 2017
  96. World Menopause Day 2017: A White Paper – Abnormal Uterine Bleeding In Perimenopause [+ Multiply Languages]
  97. World Menopause Day 2017: Patient Information Leaflet – Changes Before the Change Perimenopausal Bleeding [+ Multiply Languages]
  98. Yarning About Periods (Menstrual Cycle)
  99. You Need To Know [+ Video: Bleeding After the Menopause – An Important Message You Need To Know]

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Changes Before the Change: Should I Visit My GP? 2017:3. International Menopause Society https://www.imsociety.org/wp-content/uploads/2020/07/wmpd-2017-leaflet-english.pdf Accessed: 17 February 2023
  2. Glossary of Terms: Peri-menopause. Content Updated February 2022. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/381-glossary-of-terms Accessed: 17 February 2023
  3. Changes Before the Change: Should I Visit My GP? 2017:3. International Menopause Society https://www.imsociety.org/wp-content/uploads/2020/07/wmpd-2017-leaflet-english.pdf Accessed: 17 February 2023
  4. Changes Before the Change: Should I Visit My GP? 2017:3. International Menopause Society https://www.imsociety.org/wp-content/uploads/2020/07/wmpd-2017-leaflet-english.pdf Accessed: 17 February 2023
  5. Mayo Clinic Q and A: Spotting, Perimenopause and Menopause. 21 December 2020. Mayo Clinic https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-spotting-perimenopause-and-menopause/ Accessed: 17 February 2023
  6. Menstrual Calendar. 2015. North American Menopause Society https://www.menopause.org/docs/default-source/2015/menonote-menstrual-calendar-english.pdf Accessed: 17 February 2023
  7. Menstrual Calendar. 2015. North American Menopause Society https://www.menopause.org/docs/default-source/2015/menonote-menstrual-calendar-english.pdf Accessed: 17 February 2023
  8. Perimenopause: How Do I Know If Changes In My Periods Are Normal Perimenopausal Symptoms or Something To Be Concerned About? This Document Was Last Reviewed on: 05 October 2021. Cleveland Clinic https://my.clevelandclinic.org/health/diseases/21608-perimenopause Accessed: 17 February 2023
  9. About the Menstrual Cycle: When To See Your Doctor. Last Updated: 10 February 2022 | Last Reviewed: 10 July 2018. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/periods/about-the-menstrual-cycle Accessed: 17 February 2023
  10. Perimenopausal and Postmenopausal Bleeding. 2022. European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/05/Perimenopausal-and-postmenopausal-bleeding.pdf Accessed: 17 February 2023
Topic Last Updated: 09 March 2023 – Topic Last Reviewed: 17 February 2023

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