Let’s Talk About Peri-Menopausal Bleeding
I see many women in my practice with complaints of irregular, heavy and random bleeding. In fact, this is one of the most common complaints I hear in the peri-menopausal time period. (Second only to “I now have a spare tire around my middle!”)
Whenever a woman has irregularly irregular intervals between her periods (randomly changing from short intervals, like 14 days in between, to longer intervals of 25 to 35 or even 40 days in between), there is usually some problem with the communication between the brain, the ovaries and the uterus. This pathway that has to be working properly to have what would be considered a ‘normal’ or a ‘regular’ menstrual cycle (one that comes regularly, every 28–30 days).
The brain has to signal the ovaries to produce Estrogen, the Estrogen stimulates the uterus to fill with blood. Then, after another signal from the brain, the ovary releases an egg (ovulation), and then releases Progesterone. Progesterone’s job is to keep the lining inside the uterus stable for approximately 14 days. Then, if there is no pregnancy, the lining that has built up inside the uterus will shed, creating a menstrual period.
Any one of these stimulating signals, or the production of any one of these hormones may not be working properly. When this happens the cycle becomes irregular.