How to Stop Perimenopausal Bleeding

March 16, 2020.
A woman’s menstrual cycle stops permanently during menopause. Generally, menopause begins between the ages of 45 to 55 years, with 51 being the average menopause age. However, a woman can enter menopause earlier or later than those ages. Perimenopause is a transitional time before menopause. The word itself means “around menopause.” The perimenopause years can last anywhere from 1 to 10 years. During perimenopause, women can experience fluctuations in their hormones.
Hormonal fluctuations impact ovulation, leading to changes in your menstrual cycle. So, how long can perimenopausal bleeding last? Shorter cycles can be two or three days shorter than a normal cycle while longer cycles go beyond 36 days. Generally, perimenopausal bleeding can last 1 to 10 years before menopause. 

Changes That Occur in the Menstrual Cycle During Perimenopause

Estrogen and progesterone hormone levels in the body naturally fluctuate during the normal menstrual cycle. Ovulation takes place in the middle of the menstrual cycle while menstruation ensues about two weeks after.
Hormone fluctuations during perimenopause menstrual cycles do follow a typical pattern, which often results in irregular spotting or bleeding. Also, it means your period may be shorter and lighter one month and longer and heavier the next month. Additionally, you’re likely to miss your periods some months, with the number of days between periods decreasing or increasing. 

Signs of Abnormal Perimenopausal Bleeding Patterns

If you notice any bleeding after menopause, it’s abnormal. Seek medical attention for a remedy. Although perimenopause comes with irregular periods, abnormal perimenopausal bleeding points to an underlying health problem. Here’re signs that signify abnormal bleeding in your menstrual cycle to look out for:

  1. Bleedings that’s longer than normal; for instance, perimenopausal bleeding for 2 months 
  2. Heavy bleeding
  3. Bleeding that is more regular than every 3 weeks
  4. Bleeding post sexual intercourse or between menstrual periods 


What Causes Abnormal Perimenopausal Bleeding?

The three major causes of abnormal perimenopausal bleeding patterns include:
  • Polyps – These are noncancerous growths from endometrial-like tissues lining the uterus. They attach to the endometrial surface or uterine wall, leading to heavy or irregular bleeding. Polyps growing in the cervical canal or on the cervix can cause bleeding after sex.
  • Endometrial atrophy – This is caused by low estrogen levels, which can cause endometrial thinning after menopause.  Further thinning of the lining may result in abnormal bleeding. 
  • Endometrial hyperplasia –Unlike endometrial atrophy, hyperplasia results from high levels of estrogen and low levels of progesterone. The uterine lining thickens, leading to heavy or irregular bleeding. In atypical hyperplasia, the cells lining the uterus become abnormal. Thus, your risk of uterine cancer increases. However, early diagnosis and treatment prevents the cells from becoming cancerous. Bleeding can signify endometrial cancer post-menopause. 


Treatment: How to Stop Perimenopausal Bleeding

The following tests are used to diagnose perimenopausal bleeding:
  • Pelvic ultrasound
  • Endometrial biopsy
  • Hysteroscopy 
  • Sonohysterography
  • Dilation and curettage (D&C)
Some interventions can stop perimenopausal bleeding. However, treatment depends on the cause of the bleeding.
  • Surgery – Polyps or growths are removed through a surgical procedure.
  • Medication – Medication is often an ideal option for treating endometrial atrophy.
  • Progestin Therapy – The therapy is ideal for endometrial hyperplasia treatment. It involves shedding of the endometrium to stop bleeding. 
  • Hysteroscopy or D&C  can be used for the removal of the thickened endometrial lining in endometrial hyperplasia. 
  • Endometrial biopsies – The biopsy can identify if cancerous cells are present in the lining of your uterus. If cancerous cells are detected, your doctor may perform surgery to remove cancerous lymph nodes and endometrial cancerous cells or growths.

How to Stop Perimenopausal Bleeding Naturally

According to, you can keep yourself hydrated. Also, make sure to eat foods rich in vitamin C (broccoli, red and green peppers, etc.) and iron (lean beef, spinach, chicken, and turkey, etc.). Cooking in cast-iron pots may also help to stop heavy bleeding naturally. Finally, supplements such as vitamin C, iron, and blackstrap molasses can help stop perimenopausal bleeding.

Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.  

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Julia Walker
perry expert Julia (RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations. She specializes in helping women optimize their health during perimenopause and beyond.

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