April 2023
Few health concerns cause as much panic as blood where you don’t expect it. At some point, about 33% of women will bleed abnormally during—or outside of—their monthly periods. And some may continue bleeding after menopause.
Usually, hormones cause these irregularities. But it’s important to check with your healthcare provider. Abnormal bleeding can also signal a serious disease.
Your flow through the years
Most women get their first periods at age 12 and enter menopause around age 52. At either end of this spectrum, your cycle may be less stable than during your middle years.
Other common reasons for abnormal bleeding also change with the phases of your life. When you’re:
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In your teens, 20s, and 30s: Pregnancy, miscarriage, birth control pills, or noncancerous growths such as fibroids or polyps are often to blame.
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In your 40s and early 50s: Heavy bleeding signals the approach of menopause in many cases. But it can also serve as a warning sign of uterine cancer.
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Past menopause: Using hormone replacement therapy can trigger blood flow. So can endometrial and uterine cancers, which are more common in older women.
Pinpointing the problem
If your periods are heavier than usual, or you bleed between them or after menopause, see your provider. They may use one of several tests to determine the cause. These include:
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Taking images of your uterus and ovaries using an ultrasound
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Hysteroscopy, or looking inside your uterus using a thin, camera-tipped tube
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Doing a biopsy to remove and check a small portion of uterine lining
Choosing a solution
Treatment depends on the cause of your bleeding, your age, and whether you want to have children soon or in the future. Options include:
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Birth control pills. If hormone shifts cause your bleeding, some formulas of pills can correct them.
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Intrauterine device (IUD). This small, plastic device releases hormones directly into your uterus. This can ease bleeding.
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Hysteroscopy. In addition to diagnosing the cause, this tool can be used to remove adhesions from infections or past surgeries.
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Endometrial ablation. This surgical procedure destroys the lining of the uterus, making pregnancy unlikely.
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Hysterectomy. Some women require complete removal of the uterus. This will make periods stop.
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