The menopause is when a woman’s periods stop for good. It is a normal process, and it happens when a woman’s body makes much less of two important hormones, called oestrogen and progesterone. In the UK, the average age that women go through the menopause is 51 years.
Women can get symptoms of the menopause long before their periods stop. This is because the changes in the body that lead to the menopause can start as early as 10 years before a final period. Often one of the first signs of changing hormone levels is when a woman notices a change in the patterns of her monthly periods. The menstrual cycle, which is controlled by oestrogen and progesterone, might get shorter or longer. Women may bleed for more days or fewer days than before, or their bleeding may be lighter or heavier.
In the new study researchers wanted to find out more about the changes in bleeding patterns around the menopause. The study included 1,320 women in the US, who were aged 46 years, on average, when the study started in 1996. For 10 years the women kept a diary of their periods, recording each time they had bleeding, how long the bleeding lasted, and how heavy the bleeding was. The researchers used this information to work out, on average, how many times women had spotting and very heavy periods, and how long periods lasted.
What does the new study say?
On average, periods lasted for six days. But it wasn’t uncommon for women to have longer periods, to have spotting on days between periods, or to have heavy bleeding. The researchers found that during the 10-year study:
About 78 in 100 women had bleeding for 10 days or more during three or more periods
About 35 in 100 women had three or more days of heavy bleeding during three or more periods
About 67 in 100 women had spotting for six or more days, on three or more occasions.
Women were more likely to have long periods, spotting, and heavy bleeding the closer they got to the menopause.
How reliable is the research?
Many previous studies on this topic have been small and only included white women. This study was larger and also included black and Asian women, so this should make its findings more useful.
The researchers didn’t know which women had already started the menopause at the beginning of the study, or which women entered the menopause during the study. This could have affected the results, as how close women were to the menopause may have affected how heavy their periods were or how long they lasted. It might have been more reliable to look separately at the women who had already started the menopause and those who hadn’t.
What does this mean for me?
If you’re a woman going through the menopause, it can be difficult to adjust to the changes in your periods, but you may find it reassuring to know you’re not alone. It’s common for periods to become irregular and less predictable during the menopause, and this study gives insight into the range of bleeding patterns that you may experience.
Paramsothy P, Harlow SD, Greendale GA, et al. Bleeding patterns during the menopausal transition in the multi-ethnic Study of Women’s Health Across the Nation (SWAN): a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. Published online 16 April 2014.
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