Heavy or prolonged bleeding in menopause is not uncommon

Women undergoing the menopausal transition may be prone to prolonged bleeding with periods of heaviness, according to a new study in BJOG.

Researchers from the University of Michigan School of Public Health and the University of Michigan Health System looked at 1320 midlife women from a variety of races who had participated in the Study of Women’s Health Across the Nation Menstrual Calendar Substudy. Each woman completed a daily menstrual calendar from 1996 to 2006 that included information about hormone therapy, smoking status, and the level of physical activities. Height and weight were measured every year. Primary outcomes examined included menses of 10-plus days, spotting of 6-plus days, and heavy bleeding of 3-plus days. Multivariable regression and Kaplan-Meier survival analysis were used to analyze the data.

In the cohort, 77.7% (95% confidence interval [CI] 56.7-93.2) reported at least 3 occurrences of menses of 10-plus days. At least 3 occurrences of 6-plus days of spotting were reported by 66.8% (95% CI 55.2 – 78.0) of the women and 34.5% (95% CI 30.2 – 39.2) reported at least 3 occurrences of 3-plus days of heavy bleeding. Each primary outcome was associated with uterine fibroids, hormone use, and ethnicity. Body mass index was associated with 3-plus days of heavy bleeding.

The investigators concluded that the study provided important information about how frequent spotting, prolonged bleeding, and heavy bleeding can be during the menopausal transition. They felt the data could help facilitate clinical decision-making during that time.

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