Prolonged, Heavy, Flooding Bleeding During Menopause is a Normal Occurrence

During menopause, it is common for a majority of women to experience prolonged, heavy and flooding periods, according to a new finding.  

Researchers at the University of Michigan conducted a long-term study on menstrual bleeding patterns in women and found that women do experience an increase in the amount and duration of bleeding episodes that occurs during the menopausal transition. This normal occurrence should not be considered as a major health concern.

"For most women in their 30s, menstrual periods are highly predictable. With the onset of the menopausal transition in their 40s, women's menstrual periods can change dramatically. These dramatic changes can be disconcerting and often provoke questions about whether something is wrong," Sioban Harlow, U-M professor of epidemiology, said in a statement. "Women need more descriptive information about the bleeding changes they can expect. We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention."

For this study, the researchers reviewed data taken from Women's Health Across the Nation. The participants had reported their menstrual experiences over a period, from 1996-2006. The participants consisted of African-American, Japanese, Chinese and whites.  Though earlier studies have focused on this issue, most of them were short and included only white women.

The researchers saw that it is not uncommon for women to experience a prolonged bleeding episode that extended up to 10 days or more, spotting (light bleeding from vagina) for six or more days and heavy bleeding for three or more days during the phase of transition. 

Out of over 1,300 study participants of age 42-52, 91 percent of them reported having 1-3 occurrence of prolonged bleeding in a three year period that lasted for 10 days or more.  Close to 88 percent of the women had six or more days or spotting and 78 percent of them had heavy flow for three or more days.  Over a quarter of women had as many as three episodes of 10 and more days of bleeding in a six month period.

The researchers spotted a few difference among race/ethnicities.  Most women from all groups reported bleeding after one or more of the three patterns.

The researchers highlight the need for further study in order to determine whether this normal occurrence during menopausal transition would impact diagnostic or therapeutic interventions.

"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," said Dr. John Randolph Jr., U-M professor of obstetrics and gynecology. "This finding calls for further clinical research to determine the optimal diagnostic and therapeutic approaches for evaluating alterations in bleeding during the midlife. It forms the basis from which appropriate clinical trials can be designed, and may be reassuring to some clinicians at the initial presentation of any of these patterns that watchful waiting is an acceptable option."

The finding was documented in the issue of BJOG: An International Journal of Obstetrics and Gynaecology.