Cyst disorders as a symptom of menopause
Cycle disturbances are the most important sign of the onset of menopause. Behind this are changes in hormone production: the ovaries produce less estrogen and progesterone. Due to the decreasing production of these sex hormones, ovulation fails to occur more and more frequently. An irregular cycle and altered bleeding are the result.
Discharge also changes during menopause
The lack of estrogen not only causes menstrual irregularities, but also vaginal dryness in many women: the vaginal secretion decreases, which affects the discharge during and after menopause: The milky-white, odorless discharge sometimes becomes less.
The hormonal change often alters the vaginal environment, which can promote infections by fungi, bacteria or viruses. The discharge then becomes noticeably discolored, often becomes friable and smells unpleasant. In this case, consult your gynecologist.
Bleeding during menopause
Before menopause, bleeding may vary in frequency and/or intensity. These irregularities in menstrual bleeding vary greatly from woman to woman. Some women also feel like the bleeding doesn’t stop at all.
Finally, the last menstrual period occurs. Doctors call this time menopause. If there is no further bleeding for twelve months after this, women can usually assume that the last phase of menopause, known as postmenopause, has begun.
However, as long as bleeding still occurs, ovulation during menopause cannot be ruled out. Therefore, as a precaution, women should continue to use contraception for a year after their supposed last menstrual period to make sure that the fertile period has actually ended.
The main cycle disorders before menopause are:
More frequent bleeding.
For many women, menstrual bleeding becomes more frequent at the onset of menopause. The cycle is often shortened. In addition, there may be recurrent brownish spotting during menopause. If the interval between two menstrual periods is less than 25 days, doctors call it polymenorrhea.
Less frequent bleeding
With the onset of menopause, however, the menstrual cycle can also become longer. This means that menstrual periods now occur at longer intervals. So-called oligomenorrhea occurs when the interval between two periods is more than 35 but less than 45 days.
Bleeding sometimes stops
Bleeding is very light
Often, menopausal cycle disorders present as light, bright red bleeding. Brown spotting is also unusually weak bleeding that can occur independently of the regular menstrual cycle.
Bleeding is very heavy
In some women, on the other hand, menopausal bleeding is strikingly heavy. Such hypermenorrhea can occur, for example, when the intervals between bleeding periods become longer.
The endometrium then has longer to build up. Accordingly, more tissue must be shed. Heavy bleeding, sometimes with bloody clots, then occurs.
Heavy bleeding, however, does not necessarily have to be related to menopause. There are many other possible causes. For example, fibroids, benign tumors in the uterine muscles, are often associated with heavy, lumpy, gushing bleeding. This bleeding can last extremely long – 14 days or more is not uncommon.
Bleeding lasts for a long time
Some women have relatively long periods during menopause. Doctors call this form of cycle disorder menorrhagia.
Complaints before bleeding
Before the start of menstruation, some women complain of unpleasant symptoms such as headaches, breast tenderness, water retention and mild irritability. Even those who never had problems with premenstrual syndrome (PMS) before menopause may now suffer from it.
Menopause: bleeding after menopause
Even a year after the last menstrual period (menopause), vaginal bleeding can occur. It is possible, for example, for light, bright red bleeding to follow menopause after three, five or more years.
Postmenopausal or post-menopausal bleeding is a warning sign and should be evaluated by a doctor.
Causes of post-menopausal bleeding include:
- Hormone replacement therapy (HRT): Vaginal bleeding occurs regularly as part of estrogen treatment with the addition of progestin. This is because the hormones stimulate the uterine lining to build up. During the break in use, the lining is shed again – just like during “normal” menstrual bleeding. Even if a pure estrogen preparation is used, spotting may occur, which is usually no cause for concern.
- Cervical polyps: These tissue growths are located directly on the cervix. They can bleed especially after sexual intercourse.
- Endometrial carcinoma: Cancer of the uterine cavity is also often associated with bleeding.
- Myomas: The growths in the smooth muscle of the uterus are benign, but can be associated with bleeding, sometimes heavy and painful.
- Cervical cancer: Cervical cancer is often associated with spontaneous bleeding. So-called contact bleeding is also possible, for example during or after sexual intercourse.
- Ovarian cancer: Ovarian cancer occurs very rarely, but is then also often associated with vaginal bleeding.
Bleeding after menopause should always be a reason to see a doctor. It is true that bleeding can also be harmless in postmenopause or after menopause and may possibly be triggered by stress. Nevertheless, the cause should ideally be clarified quickly.
The earlier a serious condition is detected, the better the chances of successful treatment. So do not hesitate to visit your gynecologist during and after menopause. You should seek medical advice especially in case of bleeding in the postmenopause.
