Study: Heavy Bleeding Very Common As Women Approach Menopause

 By Jennifer Huber

I could hear the fear and panic in my friend’s voice over the phone. She was having her period, but bleeding so heavily that she was debating whether to go to the emergency room. Yet she wasn't sure. She wondered if she might be over-reacting, if her experience was simply what happened as a woman approached menopause.

As women get older, their periods can begin to change. This perimenopausal time typically starts when a woman is in her 40s and lasts about four years. (The average age of menopause, when periods stop, is 51.) For some women, the transition means unpredictable, prolonged or heavy bleeding, and that can be frightening. Now new research shows that these changes may be quite normal.

In the study, researchers from across the country, including UC Davis and UCLA, reviewed data from 1,320 women ages 42-52 who kept detailed records of their menstrual cycles over time. The researchers found that instances of heavy or prolonged bleeding were very common.

Researchers found the following rates reported at least three times during the 10-year study period:

• 78 percent of women: periods lasted at least 10 days
• 67 percent: spotting lasted six or more days
• 35 percent: heavy bleeding lasted three or more days

The report was recently published in BJOG: An International Journal of Obstetrics and Gynaeocology.

"These data confirm that two types of bleeding, longer menses with more days of spotting and heavier menses, occur in most women during the (transition to menopause)," the authors noted.

The researchers used data from the Study of Women’s Health Across the Nation (SWAN), a study of middle-aged women living in the U.S.

The participating women completed daily menstrual calendars and provided information monthly on hormone therapy, gynecological procedures, smoking and physical activity.

First Major Multi-Racial Study of Its Kind

This was the first long-term study to include a large population of women of multiple races: African-American, Japanese, Chinese and white. More than half the women in the study were not white. Previous studies were short and mostly limited to white women.

Very few differences were seen between races. African-American women were less likely to bleed for 10 or more days or to spot for six or more days compared to white women. And Japanese women were less likely to have three or more days of heavy bleeding compared to white women.

The researchers hope that their study will help guide both clinicians and patients, by defining “normal” bleeding patterns for women during midlife.

“Women need more descriptive information about the bleeding changes they can expect,” said author and University of Michigan professor Sioban Harlow in a statement. “We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention.”

The study was funded by the National Institutes of Health and other federal government health agencies.

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