Dear L.M.: A change in the menstrual cycle is usually the first sign that menopause is approaching. That change can take many forms.
Heavy bleeding can be both annoying and troubling, especially for women who experienced only mild periods during their twenties and thirties. If you begin to experience more bleeding during your periods than in past years, try to keep in mind that some amount of heavy bleeding is normal and common during the years leading up to menopause.
It is usually the result of prolonged secretion of estrogen without ovulation. As a result, the lining of the uterus becomes extra thick and releases unusually high amounts of blood when it is shed. As you proceed through menopause and your estrogen levels drop, heavy menstrual bleeding will become less and less of a problem.
Never assume that heavy menstrual bleeding is a definite sign of menopause. The bleeding may be the system of a condition that requires medical attention. It may be a benign condition, such as vaginitis (a vaginal infection) cervicitis (inflammation of the cervix), or cervical or endometrial polyps (non cancerous growths that protrude from the cervix or from the lining of the uterus.
Fibroids (benign muscular outgrowths of the uterine wall) can also cause heavy bleeding. Unusually heavy menstrual bleeding can also be a symptom of a much more serious condition such as cancer. See your physician. He or she will put you through a battery of tests to determine the cause of bleeding. Be alert to pressure from your physician to have surgery for the bleeding. Before agreeing to a hysterectomy, you should always get a second or third opinion. Other less drastic options may be more appropriate for the situation.
Meanwhile, here are some self -help tips: Exercise: Regular strenuous exercise lowers the amount of estrogen produced by the ovaries. Avoid alcohol and aspirin: Heavy drinking and or the use of aspirin increases flow by inhibiting the clotting ability of blood platelets.
Avoid hot showers: Heat increases bleeding by dilating blood vessels. Have your blood checked regularly for signs of anemia. Eat more iron rich foods.