Written by: Dr. Cara Syth OB/GYN
Have you noticed that your periods are changing as you age? Are they getting heavier? Longer? More irregular?
You are not alone. Abnormal uterine bleeding is a common finding for people approaching menopause. There are many reasons why this happens. Luckily, there are many treatment options.
Thyroid disease is more common as you age, and thyroid disease can affect bleeding. Therefore, one of the first tests recommended in the workup of abnormal uterine bleeding is a thyroid test. This is a simple blood test that can rule out thyroid disease as a cause of irregular bleeding.
Growths within the uterus (fibroids or polyps) are also a common cause of abnormal uterine bleeding. These are non-cancerous, but can cause heavy, prolonged, or sometimes irregular bleeding. A pelvic ultrasound is the first step in determining if this is the cause of bleeding.
Gynecologic cancers can cause abnormal bleeding. In the workup of bleeding, it is important to be sure you are up to date on your cervical cancer screening. In addition, cancer of the uterus can cause abnormal bleeding during perimenopause and can also cause bleeding after menopause. It is very important to note that ANY bleeding after menopause should be evaluated due to the concern for cancer of the uterus. While this is not the most common cause of bleeding after menopause, it is certainly the one you don’t want to miss. An assessment of the uterus, either with ultrasound, biopsy, or both, can be performed to rule out cancer of the uterus.
If no cause is found for the abnormal bleeding, then the likely cause is the changing of your hormones as you approach menopause. Many people get irregular bleeding during the first few years of their menstrual cycles, and the same thing can happen at the end of their menstrual years.
If you are experiencing changing periods as you age, know you do not need to just live with it. There are hormonal and non-hormonal treatment options, as well as surgical and non-surgical treatment options.
One treatment is the use of a pill that lightens bleeding by affecting blood clotting factors. This is a non-hormonal option. There are also hormonal options that are birth control and hormonal options that are not birth control. It is important to note that while the risk of pregnancy decreases as you age, it does not go down to zero until after you are through menopause. It is important to use a form of birth control until you are through menopause if you do not want to become pregnant.
There are also many surgical options for treatment. Endometrial ablation is an outpatient procedure where the lining of the uterus (the part that bleeds) is treated to lighten or stop bleeding. There are also procedures to remove or stop polyps and fibroids from causing abnormal bleeding. Hysterectomy is also a surgical option that stops abnormal uterine bleeding.
There are many treatment options to improve quality of life if you are dealing with abnormal uterine bleeding leading up to menopause. The most important first step is to speak up and advocate for your health. We are here to help.
At Western Wisconsin Health, we are committed to helping patients navigate every stage of life with compassionate, personalized care. By providing access to expert women’s health services close to home, we continue our mission of building a healthier tomorrow, together. To schedule an appointment or learn more about treatment options, please call Western Wisconsin Health at 715-684-1111.