Menopause is natural and is part of ageing. Most women go through menopause gracefully but unfortunately, it can be challenging for some.
During this perimenopausal period, the ovaries stop producing oestrogen. Thus, women may experience symptoms such as hot flushes and mood swings. These symptoms may last from few months to few years even after menopause.
What is Perimenopause Spotting? Is This Normal?
Women go through the perimenopause, which typically begins in mid-40s. Hormonal and menstrual changes begin to fluctuate during this period. Throughout this time, the ovaries shrink and produce less oestrogen, which causes irregular and lighter periods.
Medically, menopause is described as cessation of menstrual cycles for one year. In Singapore, menopause is around 50 years old. Perimenopause, which translates as "around menopause," is the period preceding menopause. It can linger for as long as a decade.
These changes are subtle and treatable. Abnormal bleeding during this period, on the other hand, is a symptom that should not be ignored.
Perimenopause Spotting instead of period: Causes and Symptoms
Ovulation can be disrupted by external hormones, substances that can be found naturally in men and women alike. Taking Phyto-oestrogens can result in perimenopause spotting.
Periods of inconsistency
Your periods may be short or long, light or heavy, and you may miss some cycles as ovulation is more unpredictable. In early perimenopause, you may notice a seven-day shift in the length of your monthly cycle. Late perimenopause is when the interval between periods is 60 days or longer.
Other issues of Menopause
Problems sleeping and hot flushes
During perimenopause, hot flushes can be a regular occurrence. However, it varies with intensity, duration, and frequency. Hot flushes and night sweats are common causes of insomnia.
Some women may have mood fluctuations or depression. Hot flushes, which are known to interrupt sleep, may be blamed for these symptoms. These symptoms are related to the low oestrogen state.
Urinary tract and bladder issue
When oestrogen falls, the lubrication and suppleness of vaginal tissues may decrease, making intercourse more uncomfortable. Infection of the urinary or vaginal tract can be exacerbated by low oestrogen level. In addition, urinary incontinence may be caused by a decrease in tissue tone.
Infertility is on the decline
Your fertility declines as your ovulation cycles get more and more erratic. However, when you're experiencing periods, pregnancy is still a remote possibility. Do consider birth control to prevent unwanted conception.
Modifications to sexual interest
During perimenopause, sexual desire and arousal may fluctuate. Sexual intimacy you enjoyed before menopause is less likely to persist into perimenopause and beyond.
You might also experience perimenopausal and post-menopausal fatigue during this time.
Bone loss and osteoporosis
Losing bone mass at a faster rate raises your risk of osteoporosis, a disease characterized by brittle bones.
Changing levels of cholesterol
Low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol — may increase as oestrogen level declines, putting you in the risk of heart disease. In addition, as women age, their levels of HDL cholesterol, or "good" cholesterol, drop, raising their risk of cardiovascular disease.
Risks during Perimenopause
Stroke and coronary artery disease are two common health problems
After menopause, your risk of heart disease and stroke increases. High cholesterol, high blood pressure, and belly fat—all of which elevate the risk of heart disease and stroke—also rise.
As you grow older, your bones gradually become thinner, which is a condition known as osteoporosis
Once the ovaries quit producing oestrogen, bone loss rises. Oestrogen helps prevent bone loss in women of childbearing age. As a result, osteoporosis becomes prevalent as women age. Weight-bearing exercise with calcium / vitamin D-rich diet, on the other hand, can help halt bone loss and reduce the risk of fractures.
Your metabolism naturally slows down as you age. However, remember that your metabolism and weight are under your control, and you can take steps to improve both. Try increasing your physical activity. Your metabolism accelerates during exercise and persists for a few hours even after exercise. Regular exercise also builds muscle over time. Therefore, increased resting metabolism is achieved with increasing muscular mass.
Age is associated with an increased chance of developing pre-diabetes and type 2 diabetes. Obesity, lack of exercise, and a family history of type 2 diabetes all increase your risk.
Hypothyroidism is more common in women. The low thyroid level may contribute to some symptoms of perimenopause.
What are the Treatments of Perimenopause and Menopause?
Perimenopause spotting does not require treatment unless symptoms become distressing. Treatments can include following:
- Hormone therapy, either with oestrogen alone or with oestrogen and progestins, is used to balance hormone levels.
- Antidepressants help maintain a positive mood.
- Do see a doctor to exclude womb cancer. An ultrasound pelvic scan may be warranted.
Your healthcare physician may also recommend the following lifestyle changes:
- Consume a balanced diet of fruits, vegetables, and whole grains.
- Consume between 1,000 milligrams of calcium daily, either through food or supplements.
- Keep track of what causes your hot flushes (for example, alcohol, coffee, or tea).
With your healthcare physician’s supervision, discuss the use of alternative treatments for symptom relief such as Traditional Chinese medicine or Phyto-oestrogens.
Menopause, Perimenopause, and Post menopause: When to see a doctor?
While menopausal symptoms are relatively common, you should visit a physician to manage your symptoms and identify which treatments may help alleviate discomfort. Along with scheduling a physical exam if you suspect you may be premenopausal, the following are further symptoms that you should see your doctor:
Extreme symptoms: If you are experiencing any of the common menopause symptoms to the point that they are interfering with your daily life, it is necessary to consult a physician. While mental and physiological changes are expected, if you find yourself unable to work or feeling constantly ill, it's always a good idea to seek medical attention.
Unexpected symptoms: Some women experience more incredible difficulty throughout menopause than most others. Suppose you observe significant weight gain, dizziness, or increased anxiety in addition to the expected adverse effects. In that case, it is critical to seek medical attention. Prolonged heavy bleeding is an unusual sign too.
The underlying cause ultimately determines the appropriate treatment for spotting or irregular bleeding. Still, they may include hormone therapy or surgical removal of polyps or endometrial lining. If you have an atypical bleeding, excessive bleeding, or bleeding that occurs more frequently than usual throughout your menstrual cycle, schedule an appointment with your gynaecologist.