Heavy perimenopausal flow may not require intervention

Heavy menstrual bleeding in the years leading up to menopause may resolve spontaneously without treatment with surgery or drugs, according to a British study of more than 2,000 women.

The 2-year prospective cohort study identified 2,051 women aged 40 to 54 from 7 general practices who reported heavy menstrual bleeding and who had not received medical intervention for it. The women completed questionnaires at baseline and at 24 months follow-up.

Spontaneous resolution of heavy bleeding ranged from 8.1% (95% CI, 5.3%-12%) among women aged 45 to 49 who had had no recurrence of bleeding within 24 months to 35% (95% CI, 30%-41% in women aged 50 to 54 who had not had recurrent bleeding within 6 months. Spontaneous resolution was strongly associated with skipped periods in women older than 45; the connection between spontaneous resolution and an irregular menstrual cycle was significant but weaker, the authors write.

Shapley M, Blagojevic M, Jordan K, Croft P. The spontaneous resolution of heavy menstrual bleeding in the perimenopausal years. BJOG. February 8, 2012. [E-pub ahead of print.]