Irregular bleeding in later life

Irregular bleeding is common in the time when women are coming up to the menopause due to cycles which occur when no egg is released, which are called anovulatory. This leads a change in progesterone and oestradiol levels and women can bleed for longer and more frequently. They can also have progressively larger gaps between periods.

For some women they need to be seen by a gynaecologist as periods become troublesome and very heavy. All women would be advised to have a gynaecology ultrasound scan to assess for any problems. There are different treatments which can improve this bleeding such as medicines to help thin the lining of the womb. However it is always important to exclude more serious reasons for abnormal bleeding such as endometrial hyperplasia (overgrowth of the lining of the womb).

Risk factors for endometrial hyperplasia and cancer  include-

  • Polycystic ovarian syndrome
  • Obesity
  • Nulliparity ( never pregnant)
  • Diabetes
  • Tamoxifen therapy
  • Family history of endometrial cancer
  • Exposure to unopposed oestrogeng. HRT with oestrogen alone

A simple test can be performed called a hysteroscopy, where the lining of the womb is directly visualised and any abnormal areas are a biopsied or removed. This can be performed under local anaesthetic or general anaesthetic. Never ignore irregular bleeding. It is always important to seek advice and get help early. Most conditions are easily treatable and can change your life.