Perimenopause and Irregular Bleeding

 

 

 

Dr Steven R. Goldstein is a Perimenopause Specialist in NYC. A top gynecologist, he is the co-author of the book “Could it be….Perimenopause?” which was one of the first books ever written on the topic. Dr Goldstein is a past President of the International Menopause Society, past President of the North American Menopause Society and a Certified Menopause Practitioner.

 When it comes to Perimenopause, it affects many women in their thirties or forties, but many are unaware of what is going on with their bodies. One of the areas that is affected is a woman’s period or the advent of irregular bleeding.

 Perimenopause can occur in women in their late thirties to forties and last for four to seven years before menopause begins. Destabilizing estrogen levels and a lack of ovulation are common during Perimenopause. When a woman doesn’t ovulate, no progesterone is produced. The presence of estrogen without progesterone to balance it out can cause a variety of symptoms unrelated to a woman’s menstrual cycle.

 For instance, fairly constant estrogen levels without progesterone (due to the lack of ovulation in Perimenopause) in a woman will cause her not to bleed at all for weeks or months. Secondly, this condition of estrogen without progesterone to balance it (which occurs during Perimenopause) can result in these other symptoms as well such as Salt and Fluid retention, Low blood sugar levels, blood clotting, fibroid tumor enhancement, altered thyroid hormone function (leading to weight gain or feelings of exhaustion), increased production of body fat, feelings of sluggishness and low energy.

 Another symptom is perimenopausal bleeding or spotting. Dr Goldstein, a Perimenopause Specialist in NYC says that if one does not ovulate but is making estrogen, when and how much one bleeds is related to the stability of the estrogen levels without progesterone. When there is fluctuation, it destabilizes the uterine lining, and it can be shed, causing bleeding. The hallmark of cycles without ovulation is being potentially “all over the map.” They can be heavy, they can be light, they can be continuous or intermittent. As they are in perimenopause.  The hallmark is the inconsistency, whereas pre-menopausal ovulatory cycles are characterized by predictability, consistency, and regularity.

 That’s not to say that if a woman is experiencing any of the above that Perimenopause is definitely the cause, but it should certainly be considered. Doctors need to see a “family” of symptoms that occur following a specific pattern of events in order to make a preliminary diagnosis.

 If you have been told you have Perimenopause or you are in your thirties or forties and have irregular bleeding, spotting, not bleeding for weeks or any of the aforementioned symptoms, then a consultation with Dr Goldstein, a Perimenopause Specialist in NYC  may be appropriate.