How do menstruation behave with, after, before menopause (abundant, long)

The onset of menopause is characterized by the complete extinction of ovarian functions and the cessation of estrogen production, therefore menstruation with menopause is a normal variant only during premenopause. Usually, a woman passes this life stage at the age of 50, but there are frequent cases of an early onset of menopause (up to 40 years) and late (after 60). Changes in the nature, duration and accompanying menstruation signs are a natural process indicating the aging of the reproductive function.

What is menopause

Climax is an intense hormonal change in the body, in which the supply of female reproductive organs dries up. cells and the production of the hormone estrogen, which is responsible for reproductive function and the ability to conception. Menopause can last from two to fifteen years, during which time the menstrual cycle increases, and then menstruation ceases completely, which is characteristic of the complete extinction of reproductive ability ladies.

There are several stages of menopause, because menstruation during menopause does not end immediately:

1. Premenopause - normally should begin at the age of 45, but cases of an earlier or later onset are not excluded. It consists in reducing the production of estrogen when the ovaries and pituitary gland stop producing it. The period can last from 2 to 10 years.
2. Menopause is the last critical days, after which the fertility of the female body finally ends.
3. Postmenopause - the time following the last coming menstruation. Early menopause can last 5–8 years.

Gynecologists distinguish an early menopause that occurs in women under the age of 40 and late, the manifestations of which occur at 60 years of age and later.

Causes of the early and late menopause

The reasons for the early (up to 40 years) onset of menopause include:

• hormonal disorders - manifested by such pathologies as diabetes mellitus, obesity, thyroid diseases (hyperthyroidism, hypothyroidism);
• a large number of abortions performed;
• regular transfer of gynecological pathologies and their long-term treatment;
• self-prescribing oral contraceptives and their incorrect use;
• smoking and alcohol abuse;
• frequent stress, physical and psycho-emotional overload;
• poor environmental conditions in a place of long residence;
• hereditary predisposition, if cases of early onset of menopause were regularly recorded along the female line.

Doctors believe that the late onset of menopause is more favorable for the female body. There are cases of belated menopause in women who consume seafood for a long time, monitor their health and do not have bad habits.

Pathologically, late extinction of reproductive function is observed in patients with health problems:

• serious pathologies of the gynecological sphere;
• the presence of tumors that provoke the release of estrogen;
• oncology that has undergone chemotherapy and radiotherapy;
• uncontrolled use of antibacterial drugs.

Since uterine bleeding should not normally occur after the last menstrual period and subside, premenopause and menstruation are closely related, only this period is characterized by the onset of critical days.

If spotting appears after 1.5-2 years from the onset of menopause, this indicates an excessive proliferation the endometrial layer of the uterus, characteristic of serious pathologies of the reproductive sphere, which requires immediate treatment to the doctor.

How to determine that the climax will begin soon

It is possible to determine that menopause is approaching by the characteristics of menstruation, manifested before menopause - these are changes in the frequency of their arrival and characteristic symptoms:

• gradual lengthening of the interval between the onset of menstrual bleeding;
• decrease in the duration of the menstruation themselves;
• change in the amount of menstrual flow - they become scarce or, conversely, abundant, intense and smearing bleeding can alternate;
• emergence of the weak bleeding in the middle of the cycle.

Premenopause, during which the active production of estrogen gradually decreases, can last two years or all ten years, it depends on the individual characteristics of the organism.

The usual monthly cycle for a woman lasts from 21 to 35 days, on average - 28 days and includes three phases:

1. Follicular, during which the formation of follicles occurs in the appendages. One of them becomes dominant over time and displaces the rest - an egg, preparing to become fertilized, matures in it.
2. Ovulatory, during which the mature gamete leaves the ruptured follicle and moves into the cavity of the fallopian tube, where it prepares for fusion with the sperm.
3. Luteal, in which, against the background of the absence of pregnancy, the egg that has not fused with the sperm dies later two days and goes outside together with menstrual bleeding, containing the remnants of the rejected mucous layer uterus.

During the premenopausal period, cycles without ovulation, associated with a lack of hormones necessary for the maturation of the oocyte, are increasingly manifested, but menstruation occurs as usual. Against the background of changes in the amount of production of estrogen and progesterone by the body, the egg grows slowly. It enters the uterine cavity late, a violation of the standard duration of cyclic phases is observed - this is the reason for the regular delays of menstruation with the onset of menopause.

Concomitant symptoms

The signs of an approaching menopause in each woman may differ, depending on the individual characteristics of the organism, age, heredity and other factors.

It has been established that every third lady feels hot flashes before the complete cessation of the functioning of the reproductive system - this symptom is the most common. The rest are detailed in the table below.

Sign	Characteristics and causes
Tides	On the face and body of a woman, areas of redness suddenly appear, and the temperature rises. Hot flashes are not associated with the arrival of menstruation, the attack can last up to half an hour
Fragility of bones	Against the background of a sharp decrease in the production of estrogen from the bones, calcium begins to actively wash out - a deficiency of the substance not eliminated on its own, during the premenopausal period it is necessary to take calcium and vitamin supplements complexes. Fracture-related injuries increase in women aged 45–55
Skin changes	The skin loses its previous elasticity and smoothness, wrinkles are aggravated, folds in the area of ​​the nasolabial triangle become more visible
Emotional condition	A woman becomes prone to stress and depression, tearfulness and suspiciousness are manifested. Uncontrolled outbursts of aggression and irritability, anxiety attacks are possible. More sensitive women develop psychosomatic diseases against the background of emotional instability
Chronic fatigue	During the period of the approaching menopause, a lady may feel weak and tired even after a long night's rest
Sleep disturbances	Sleep is characterized by superficiality and sensitivity, and difficulties in falling asleep are manifested. Immediately after waking up, a woman feels completely powerless and overwhelmed, especially when getting up early.
Sweating	Increased sweating is triggered by hormonal imbalances. Fluid secretion becomes stronger at the time of hot flashes, but it is observed even with not intense loads and physical activity
Decreased sex drive	Decreased libido is also due to hormonal changes. The mucous tissue of the vagina no longer produces physiological lubricant in the required amount, which makes intimate contacts unpleasant and painful

The listed symptoms may not appear simultaneously, but alternately, change each other, often the lady is worried only about hot flashes and sleep disturbances.

To determine exactly what the signs say exactly about the onset of premenopause, you should consult a doctor and conduct a hormonal blood test. Routine visits to the doctor should be made by every woman at the age of 45.

Changes in the monthly cycle

To understand how menstruation behaves before the onset of menopause, it is necessary to regularly record the dates of the next menstruation and monitor the duration of the cycle.

If in patients of reproductive age the standard cyclical duration is 28-30 days, then in women during the premenopausal period it changes:

1. Bleeding becomes spontaneous - menstruation comes at different intervals, sometimes they return twice a month.
2. Often, instead of critical days, only hot flashes come, and the bleeding itself is not observed.
3. The duration of the cycle changes dramatically - sometimes it reaches 5 months or six months, when going to the doctor, the patient complains that there was no menstruation for a long time and suddenly it began abruptly.
4. Signs of premenstrual syndrome (PMS) intensify - the lady feels severe pain in the lower abdomen, radiating to the lower back, nausea with urge to vomit, headaches.
5. The duration of the course of spotting changes - they can be observed for 7-9 days, or poorly smeared throughout the month.

Since the menstrual cycle becomes irregular with menopause, it is not always possible to determine the nature of the bloody discharge on our own. If there was no menstruation for a long time, and then the woman suddenly started bleeding with clots of an unusual scarlet color, this can become a symptom of uterine bleeding. Its causes are uterine fibroids and endometriosis.

Pathological signs of menstruation before menopause

Usually, menopause at the onset of menopause in women after 45 years practically does not differ from the usual ones - they have the same consistency and duration. Only the duration of the cycle undergoes pronounced changes. Against the background of unstable ovulation, the sudden onset of menstruation suggests that the egg has matured this month.

Do not hope that it is no longer possible to become pregnant in premenopausal women. Since critical days are not regular, but nevertheless come, it is worth, together with your doctor, to choose the appropriate method of contraception and apply it until the onset of menopause.

It is important to remember that the reasons for the absence of menstruation, in addition to pregnancy and the onset of menopause, can be chronic diseases of the small pelvis, growing tumors, uterine polyps and other pathologies. That is why, with a prolonged absence of menstruation, if a woman knows that there is no pregnancy, but the menopause has not yet come, she urgently needs to visit a specialist.

Every woman who has symptoms of premenopause should observe menstruation in order to detect the existing disease in time. Possible reasons for the change in the nature of bleeding are shown in the table.

Features of menstruation	Causes of occurrence
The presence of a large number of clots	Serious thyroid disease, uterine bleeding
Dark brown color of discharge	Uterine fibroids, growing polyps, genital infections
Abundant spotting between periods	Irrational use of hormone-based drugs, inflammation of the vaginal mucosa
Long-term, more than 7 days, the volume is insignificant	High blood pressure, blood clotting problems
Scanty discharge with bloody streaks	Injuries to the vaginal mucosa as a result of rough intercourse and due to lack of natural lubrication, erosion of the cervix
Rebleeding after critical days that have already ended	The onset of ectopic conception, anovulatory cycle preceding the current

Painful periods

If menopause at the onset of menopause in women after 50 years is characterized by severe pain, frequent causes of the syndrome are:

• depletion of appendages;
• dying off of the endometrial uterine layer;
• trauma to the vaginal mucosa due to a sharp hormonal disruption.

The reason may be hidden not in the menstruation itself, but in the presence of concomitant diseases - adhesions in the small pelvis, inflammation of the urethra or the walls of the bladder (cystitis). When the intensity of pain is much higher than usual, accompanied by a drop in pressure, fainting and nausea, you should seek first aid yourself or call an ambulance.

Profuse blood loss and prolonged periods

Bursts of estrogen release provoke long and heavy periods in premenopausal women - in order to slow down the decline of reproductive function, the body tries to start all available stimulation methods. For this reason, the volume of hormones in the blood for a short time, but sharply increases, an increase in the endometrium occurs.

As more and more cycles occur without ovulation, there is a noticeable lack of progesterone, which causes not only changes in the amount of rejected endometrium, but also structural changes. In women aged 40–47 years, the risk of developing the following diseases increases:

• uterine fibroids;
• the growth of polyps;
• changes in the endometrium of a precancerous nature;
• hormone-dependent neoplasms in the chest and neck.

How to stop heavy periods when menopause begins - for many women to eliminate blood loss, which is not stops prescribing hemostatic drugs, and if there is no effect from their use, they are removed uterus.

In addition to hormonal changes normal for premenopause, the following leads to an increase in the volume of secreted blood:

• obesity;
• improper functioning of the thyroid gland;
• intrauterine device;
• tuberculosis;
• serious liver and kidney disease;
• a sharp decrease in the body's immune defense;
• gynecological pathologies - glandular hyperplasia of the endometrium, polycystic, fibroids, vaginitis, malignant tumor in the uterus or cervix.

Patients who have previously undergone numerous abortions, chronic inflammatory processes in the small pelvis, operations on the uterus and ovaries are prone to such a development of events.

Menstruating too often

During premenopause, there is another type of violation - too frequent menstruation. It develops due to hormonal disruption and the occurrence of more and more frequent anovulatory cycles.

In rare cases, re-bleeding manifests itself when conception occurs, when it is in this cycle that an egg has matured in the ovary and has been fertilized with a sperm during unprotected intercourse.

The appearance of scanty, but frequent bleeding may indicate the development of endometriosis.

Discharge of dark-colored blood

The bloody contents acquire a brown tint when their genitals exit, mixing with vaginal secretions, therefore, it does not always indicate pathology. It is necessary to consult a doctor without delaying if brown blood leaks against the background of accompanying signs:

• sharp pains in the lower abdomen;
• the presence of watery or yellowish blotches in the discharge;
• increased urination;
• itching;
• discomfort with intimate contact;
• burning sensation on the surface of the vaginal mucosa;
• the appearance of ulcers and erosion in the mouth;
• lack of appetite.

Brown menstrual flow in combination with the listed symptoms can occur with sexually transmitted diseases (gonorrhea, trichomoniasis, chlamydia) and growing uterine polyps.

Diagnostics

Before deciding how to stop heavy periods, if they go on for a long time with the onset of menopause, you need to visit a gynecologist and undergo an examination, including:

• examination in a gynecological chair;
• ultrasound;
• blood test - how much hCG, FSH, LH, estradiol, thyroid hormones, progesterone are contained;
• a smear for the degree of purity;
• coagulation analysis;
• biochemical study with liver function tests.

To exclude the tumor process, diagnostic curettage is performed (during which you can remove polyps and excess endometrium), and the resulting material is sent to the histological study.

What can be done to stabilize the menstrual cycle

If a woman is less than 50 years old and she wants to extend her reproductive period as long as possible, she needs to visit a doctor and find methods to eliminate the painful signs of the onset of menopause. How can you stop prolonged periods at home before the onset of menopause - take hormonal drugs prescribed by a doctor, use herbal supplements and change the image life.

To normalize the production of female hormones, the doctor may prescribe one of the medicines:

• Mercilon;
• Marvelon;
• Three-merci.

Hormonal pills are taken daily, one at a time, for 21 days, then take a break for 7 days. Reception helps to restore reproductive function and eliminate the second wave of menopause symptoms.

If the doctor believes that it is not necessary to prescribe hormonal drugs, you can try Feminal and Besser Alter. - the herbs contained in them reduce hot flashes, sweating, irritability and other negative signs of an approaching menopause.

The following are used as adjunctive therapy:

• sedatives - with increased excitability and a tendency to depression;
• calcium supplements - help to return the required level of the substance and prevent bone fragility;
• hypotensive - prescribed to patients with high blood pressure;
• vitamins - necessary to increase immunity, maintain the general tone of the body;
• painkillers - will help with severe pain syndrome during menstruation;
• hemostatic - are needed to stop heavy bleeding that causes anemia.

All premenopausal women are advised to fully rest and eat, avoid stress, do not smoke and exclude alcohol, go in for swimming, jogging, yoga, and continue their sex life.

In order to notice the signs of pathologies in time, you should regularly visit a gynecologist.

Since regular bleeding is allowed only during premenopause, and menstruation after menopause is not are normal, it is important not to write off the sudden onset of bleeding for overwork, hormones and others factors. If there was no menstruation for a long time, the doctor established the onset of menopause, and the woman suddenly notes that uterine bleeding has returned, she should immediately consult a specialist.