Dr. Magtibay describes when a woman with irregular menstrual cycle bleeding should see a specialist, particularly while going through perimenopause and menopause. Dr. Magtibay is a gynecologic cancer specialist at Mayo Clinic in Phoenix, Arizona.
We talked about the fact that women in menopause, who have stopped having periods for some time, who develop some bleeding, certainly need evaluation and workup. But there are also other women who have abnormal bleeding patterns that we need to think about and evaluate, as well.
These particularly include women who are in perimenopause, meaning they are in between menopause when they stop having periods altogether and premenopause when they are still regularly cycling and having regular menstrual cycles.
In perimenopause women will sometimes have infrequent or more irregular bleeding, and it’s hard to know if that’s normal or abnormal. But in general we say that as a woman transitions from premenopausal state to a menopausal state her bleeding should get less and less, meaning if they occurred every 28 days, now they should get further and further apart, greater than 28 days.
That, anytime where your periods get closer and closer your bleeding pattern gets closer than what that used to be on a regular basis, that’s abnormal and should be evaluated.
Also, periods should get lighter and lighter as a woman progresses through perimenopause. A woman’s flow and number of days of flow should get less and less, and if all of a sudden a woman starts developing very heavy flow that should be evaluated, as well.