Hello,
Thank you for your query.
The perimenopausal period is often under diagnosed.
This period consists of the
hormonal & physical changes that your body undergoes when your ovaries begins to shut down. This may span over a few months to even years.
Ovaries are responsible for ovulation and development of the endometrium by release of hormones throughout the menstrual cycle. When approaching
menopause, ovulation tends to become less frequent, but the hormones are still being produced.
These still act on the
uterus to develop an endometrial lining.The amount of hormones reduce with time and takes longer to develop to a stage where it is shed of as a period. Since ovulation is absent, the hormone
progesterone whose withdrawal, causes a period, is absent.
the growth of the endometrium ( by
estrogen produced from the remaining follicles) remains unchecked and uncountered and continues to thicken the endometrium . When the lining is too heavy, it is passed out in clots and heavy bleeding.
In this cases, there in nothing to worry about. however, it should be confirmed that the bleeding is due to this and due to other reasons. For this, I would do an
ultrasound and take a tissue sample from within your uterus and send it for histopathology analysis.
This will tell us what type of development the endometrium had undergone and we can plan a course of action based on that.
If bleeding is too much, you will need hemostatic agents in addition to a dilatation and curettage.
Removal of uterus and ovaries are not indicated unless there is any positive indication to do so. That we dont need it anymore and is causing discomfort is not reason enough, unless you opt to do so.
I would recommend you see your
OBGYN right away. Don't be scared. Thi is most likely a bleed associated with hormonal changes in the the perimenopausal period.
please note that once menopause (no period for 12 months) is attained, it is not normal for any bleeding to occur.
on the other hand, bleeding may occur as part of the physiological process in the perimenopausal period.
Hope this helps.
Wish you good health and please get back to us if you need further clarification