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All Posts in Category: Hormone and Menopause Resource Center

Perimenopausal Menstrual Irregularities

Perimenopausal Menstrual Irregularities

Perimenopausal Menstrual Irregularities

By Dr. Bridgett Casadaban 

As women approach menopause, there are many changes that can happen in the body including changes in the menstrual cycle. Most women experience several years of changes in the cycle before they completely stop. This transition into the period stopping is called perimenopause.  And menopause is retrospectively defined as 12 months without a period. The average age for menopause is 51 years old but this varies for each woman and is influenced by several factors including genetics, smoking, weight, activity level, and previous surgeries. There is no reliable testing that can accurately predict when a woman will become menopausal but on average, perimenopausal changes begin 4 years before the period completely stops.

During perimenopause, because of changes in hormones, periods may become erratic, such as:

  • Coming more or less often
  • Bleeding that lasts for fewer or more days
  • Flow that fluctuates from heavy to light
  • Skipping periods

Even though these changes can be normal, there are times when medical evaluation is recommended, such as:

  • Vaginal bleeding more often than every 3 weeks
  • Excessive bleeding (e.g. changing heavy pad or tampon more than every hour or passing large clots)
  • Prolonged bleeding (e.g. >10 days)
  • Spotting between periods

Medical evaluation for irregular bleeding can include blood work, a pelvic ultrasound, a biopsy of the tissue inside the uterus (ie: an endometrial biopsy) and/or using a camera to look inside the uterus (ie: a hysteroscopy).  All of this can conveniently be performed in our office when deemed necessary.

Depending on the severity of the menstrual changes and the results of the evaluation, treatment may be optional or recommended.  Treatment options vary widely but may include: birth control pills, IUDs, non-hormonal medications to slow menstrual bleeding, endometrial ablation, or hysterectomy.

At Healthcare For Women and our Hormone Menopause Resource Center, we have a special interest in promoting hormonal wellness and healthy aging. Perimenopause can be a challenging and confusing time and we want to educate our patients on their bodies – what are normal expectations and when there should be a reason for concern. 

Please contact us to learn more, ask questions about Perimenopausal Menstrual Irregularities and work together to make this transition easier.

Written By Dr. Bridgett Casadaban

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Hormone and Menopause Resource Center – Painful Sex?

From the Healthcare For Women Hormone and Menopause Resource Center – Is sex painful?

By Dr. Winterling

Do you think, or have you been told, that this is just what happens when you go into menopause and there is nothing that can be done about it?

While, yes, painful sex is quite often a result of declining estrogen levels with menopause, there actually are many treatment options available.

First, some education, because here at the Healthcare For Women Hormone and Menopause Resource Center we believe that it is important to understand the changes that are happening in our bodies, causing the symptoms that we feel, and to be able to make more informed decisions about treatment options.

The genitourinary syndrome of menopause is defined as a collection of signs and symptoms associated with estrogen deficiency that can involve changes to the labia, introitus, vagina, clitoris, bladder, and urethra.  The syndrome includes genital symptoms of dryness, irritation, and burning; urinary symptoms of dysuria, urgency, and recurrent urinary tract infections; and sexual symptoms of dryness and pain.

There are receptors for estrogen throughout the vagina, vulva, urethra, and even in the bladder.  Estrogen maintains blood flow to the vulvovaginal tissue, the collagen within the epithelium, and the hyaluronic acid and mucopolysaccharides within the moistened epithelial surfaces.  Estrogen also plays a role in supporting the microbiome and protecting the tissue from pathogens. A decrease in estrogen leads to a thinning of the vaginal epithelial tissue, and a subsequent loss in elasticity, leading to a narrowing of the vaginal canal.

All of these changes can lead to painful sex, vaginal dryness, and urinary symptoms.

Many treatments are available including non-hormonal over-the-counter lubricants and vaginal moisturizers, local vaginal estrogen therapy, intravaginal DHEA, oral estrogen agonist/antagonist, and the fractional CO2 laser.

Come visit us at the Healthcare For Women Hormone and Menopause Resource Center for an evaluation and discussion about the best treatment for you.

Contact us today and set up your appointment.

Written by Dr. Winterling

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