Menopause and Periods

I remember the first time I got my period and I had to find a way to tell my mother.  I was so embarrassed that I made her guess.  She ran through a list of about 25 things that might be wrong with me until she, incredulously, asked me if I had gotten my period. Bingo!  I only wish I there was such a defining moment for menopause.  But, alas, there is not.

Mommy!  I’m not bleeding!  What’s going on? What’s the deal about menopause and periods? Before you actually hit menopause, you are really in perimenopause and one of the first signals is that you get irregular periods. They come, they go, they get longer or shorter or heavier or lighter….they become as unpredictable as next month’s weather.

Menopause occurs when you go 12 months without a period. Suddenly you wonder why that tampon you’ve been carrying around in your purse is getting ratty looking and you realize that it’s been a long time since you even thought about using it for something other than an emergency coffee spill picker upper. Getting pregnant at this point is next to impossible.

Heavy Bleeding Periods – Flooding

Many women experience a really heavy period which can make them think that something is medically wrong. It’s the ‘OMG – what did I do to cause this syndrome! Dr. Jerilynn Prior, author of the article  Very Heavy Menstrual Flow writes, “Early in perimenopause, when cycles are regular, approximately 25% of women will have at least one heavy period.” Dr. Prior defines heavy menstrual flow as soaking 12 or more regular sanitary products in one period. You may think you need to build an ark for the parting of the Red Sea but hold that hammer — her first line of defense is ibuprofen, extra salty things to eat or drink (oh yea, more chips!) and supplemental iron (or more spinach).  Next, there is cyclic progesterone. When you don’t have enough progesterone to balance the estrogen, you’ll bleed a lot. And during this time, your progesterone takes off for a couple of weeks in the Bahamas — without you. Progesterone might not be the best thing for your body but if nothing else helps and you can’t wait it out, go see your doc. But only take it for a short time – 2 years or less – to get you through the transition to menopause.

Irregular Periods

After that first flooding you may begin irregular periods. One month you skip a period, the next you have three. Your periods may become more frequent or be delayed. You may have a little spotting between periods or your periods might become spotty. This can begin in the second half of your 30s but more usually begins in your early 40s. This is the ‘tear-your-hair-out’ phase when the unpredictability drives you crazier than Martini in One Flew Over the Cuckoo’s Nest.

‘Periods’ After Menopause

Once you hit menopause, all this nonsense ends. If you do bleed after not having had a period for 12 months or more, it doesn’t always mean it is something terrible. Because your mucous membranes thin as your hormones level decrease, it becomes possible to slightly tear the membranes of your vaginal walls during sex. This may cause some bleeding.  Simple dryness can cause it, too.  Always check it out with your doctor.  She/he may recommend estradiol cream which is made from the urine of pregnant mares.  Your vagina might begin to whinny or start chomping at the bit!  Whoa!  There are other alternatives like Black Cohosh, eating more soy (like 3 times a day), puncturing and squirting vitamin E into your vagina before bed (yuck!), or using bio-identical hormone replacement. Most insurance companies will not pay for bio-identical hormone replacement and it’s pretty expensive but this is a more personalized approach based on testing and then balancing your different hormone levels with more natural, plant-based hormones.

Menopause – Period Freedom

Periods are a means of marking time, of being in synch with the moon or your girlfriends and when they disappear you miss them terribly, for a while, at least.  And then you realize that you are free — free from the expense of tampons or napkins, free from the stress of wondering when your next period will come, free from getting pregnant.  Now what are you going to do with all that freedom?

References

Harvard Health PublicationsEHealth.com