What happens to your periods and what's normal

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Today's topic

Hello, and welcome to my weekly video blog. And today on A.Vogel Talks menopause, I thought I would tell you about what happens to your periods in the run-up to the menopause. And I know over the last year I’ve talked about sort of single situations, but I thought I’d just talk about them all together today. The problem is that this is a very individual thing. Each one of you out there will have a completely different menopause. It will be your own, you know, it doesn’t fit any sort of standard pattern, if you like. And this is what can confuse an awful lot of women. And I get so many of you, you know, writing in and emailing in, worried about what’s happening, is it normal what’s happening? Should it be happening? What should I do? Should I actually go to the doctors? So I thought I would just shed a little bit of light on a number of different period scenarios, if you like.

What exactly is happening?

Now, what is exactly happening at this time? This is called the peri-menopause and the average age is between 45 and 55, but a number of women will start this before 45. And there will also be a number of women who will start the menopause a little bit later. And what’s happening is that your body is just stopping and lowering down the production of oestrogen, progesterone and testosterone. And this lowering of hormones is what can affect your periods.

Now, your hormones can go up and down like a yo-yo. They can go round and round in circles. One month you might find you get this set of symptoms, another month it might be something else and then everything can completely go on its head. So it is very, very confusing and having a little bit of understanding of what’s going on will actually hopefully, help you and also and make you worry less about what’s actually going on.

So let’s have a look at all the different types of scenarios with the periods. 

Irregular periods

Now, one of the first instances that can happen is that your period starts to go missing. You might have been regular as clockwork and then suddenly, you find you just missed a period. A lot of women think that that’s it, you know the menopause is over and done with one missing period. Unfortunately not. What can happen is you can miss one period then get two or three back completely regularly. You might miss another few and then get them back again. And this missing and coming and going can actually last two or three years before your periods finally stop. Now, what do you need to do about this? Really nothing. This is a very common situation. There’s usually nothing to worry about here and it’s just a question of looking after yourself well during this particular point.

Heavier periods

For some women, they find that their periods start to get heavier. They’ll still be the same length of time but may be instead of being heavy for a couple of days, they’re heavy for the whole five days. Now, again, usually this is nothing to worry about. It’s just the fact that your oestrogens may be a little bit high compared to your progesterone. The problem is that if you keep getting heavy periods, you can get low in iron which can cause anemia and anemia can cause fatigue, can cause headaches, can cause low mood, sleep problems, joint aches and pains. So, if you find that your periods are getting heavier but they are still the same length of time, then maybe adding in a little iron tonic such as Floradix or Feroglobin would be a really good idea at this particular point.

Periods further apart

Some women find their periods get further apart. So instead of being 28 days, they’re now 30 days, they’re now 32 days but they’re still roughly the same length of time. Again, this is absolutely fine. You may find that they just get further and further apart and then they stop, and that’s it. So normally, there’s really nothing that you need to do here. Some women find that their periods start to get closer together, they’re coming every 21 days, they’re coming every fortnight. In this instance, very often this is accompanied by really heavy periods. Now, this is one that you do need to watch. It’s very common and normally nothing to worry about. But I do utter a little bit of caution here. A lot of women approaching the menopause can end up having fibroids, they can end up having cysts, they can end up having endometriosis, without even being aware of it at all. There’s no outward symptoms, there’s nothing wrong with their periods, they feel absolutely fine. But the problem is when your periods and your hormones start to change, these conditions can be aggravated and it can be the fibroids, it can be the endometriosis, it can be the cysts that are actually triggering this heavy bleeding.

So in this case, if you have had really heavy periods, if they’re really close together for more than a couple of months, you really do need to seek medical advice. And the one thing I will say here is a lot of doctors will just say, “Oh, it’s the menopause. You’re fine. You’ll be fine in a couple of months”. Please don’t take this. Because if it is fibroids, if it’s endometriosis, if it’s anything else, then you need to get this sorted now because otherwise, six months later, a year down the line, you are still going to be in exactly the same position. You’re probably gonna be very anemic, you’re probably gonna be very run down and you’re probably gonna be ill. So this is one instance where please, please, please put your foot down and ask the doctor to look into this a little bit more for you.

Flooding

Now, accompanied with this, closer together, some women find that they start to flood or even hemorrhage. This is one where you do not wait. You get straight to the doctor. If you can’t see the doctor, then you go to A&E. This is a point where you’d be changing your sanitary towels every two or three hours. If you find that, you know, your clothes are getting stained, the bed’s getting stained, wherever you’re sitting is getting stained, this is one… it can happen. You know, don’t suddenly panic because it’s just part of the way your hormones may be falling on that particular week, but you can’t sustain heavy bleeding. If you were bleeding from your eyes or your ears or your mouth or anywhere else for longer than 24 hours, the doctors would have you into the hospital. And just because this is vaginal bleeding, does not mean to say it is not any more serious. So this is one where you really…please don’t hesitate to get medical advice.

Shorter periods

Some women find that their periods after a little while, they start to get shorter. They maybe only last two or three days instead of four or five days. Again, this is just your oestrogen lowering down perfectly normal and usually there’s certainly nothing that you have to worry about and nothing that you actually have to do.

Spotting

Now, we’ve got spotting and a lot of women find that one of the first symptoms is they’ll have a normal period but then in the middle of the month, they’ll get a little bit of spotting and so on. Again, this is perfectly normal, it’s just the fact that your oestrogen hasn’t actually possibly fallen enough or your progesterone has fallen too far. So it’s slightly unbalanced the hormones and your body thinks it’s actually time for another period. All I will say with spotting is if the spotting happens every day during the month, if you don’t get a break or if you find that you’re starting to get pain with the spotting, then just get that checked out by the doctor. Because again, it could be an indication you’ve got fibroids going on.

Painful periods

Now, we have painful periods and a lot of women at this point find that they start to get an awful lot of cramping. Now, this can be due to several factors. We know that as you approach the menopause, your levels of magnesium go down. And low levels of magnesium will cause cramping, it will cause muscle spasms. So if you’re just getting the cramping when you’re having your periods, very often you’ll find that all you really need to do is to take a good magnesium supplement and that should ease the cramping. You may find adding in a vitamin B complex as well can be really good.

The other issue here is that if you’re getting a lot of pain and cramping with the periods and that’s associated with digestive problems such as constipation or IBS or bloating or wind, then the two can actually be linked together. And in which case, it’s very important to make sure your bowels are working well. Don’t get constipated and remember to drink loads of water because very often that can help to get things moving a bit more.

Phantom periods

Now, we can also have phantom periods and some women find that, you know, they’ve missed periods for five or six months but each month when they would have got a period, they get all the usual symptoms. This is absolutely fine. It just means that although your hormones are falling, there is still a bit of a monthly cycle going on. But your hormones are just not high enough to actually trigger a bleed. In most instances, with this, you might find adding in your B vits and your magnesium absolutely fine and just make sure you’re drinking plenty of water again, especially if you’re getting sort of phantom cramping as well.

Periods that come back after a long period of time

Now, we’re nearly there so thank you for your patience. A number of women will find that they can miss their periods for over a year, maybe even up to 18 months and then they suddenly get one back again. Now, this can be due to a whole load of issues. It can be one last fling by your hormones. They just go, “Oh, I just want to do this one more time” so that they can bring one period back or maybe even two or three and then everything stops and that’s it. It could be due to a lot of stress and anxiety. It could be due to really heavy physical activity. If you suddenly decide to go all out at the gym and you’ve never been before, that can actually stir up the hormones. If you improve your diet, and it’s amazing an awful lot of women find that at some point in the menopause they say, “Right, I’m going to really look after myself well.” If you’ve improved your diet, you’ve suddenly given all this extra nutrition to your body and your hormones just go, “Oh, yipee! We’ve got some extra nutrients here. Let’s have another bash”. So again, normally, this is absolutely fine. One last thing, falling in love, if you’re lucky enough to be in a new situation, if you’re in a new relationship, that can actually set your periods off again. So just be aware of that one. In most instances, with this situation, it’s absolutely fine. But because there is the possibility of fibroids and other issues, we just say, get this checked out by the doctor as well just to be on the safe side and just to put your mind at rest.

Now, there are a few women who will get a period back after two years. Now, in the majority of cases when you haven’t had a period for two years, that’s you through the menopause. So if you have any kind of bleeding after that point, although it can happen and again, it can be the same issues as, you know, getting periods back after one year, but it’s really important that you don’t hang about and you get this checked out by your doctor as well.

Periods that change colour and smell

Now, last but not least, is that a lot of women get puzzled because their periods can change color. You can suddenly get bright red blood, you might get very dark red blood. Some women can actually get a lot of clots as well. And that’s one thing just be aware, if you get a lot of clotting just get that checked out by your doctor as well. The smell can change as well. And remember too that when you’re in the menopause, your own sense of smell can actually be heightened quite a bit. So, you know, don’t suddenly panic that you think that, you know, you’re beginning to smell very often, it’s just your own sense of smell. So the change of color, the change of smell of your period and also the consistency. Some women find that their periods get a lot more runny, others find it gets a lot thicker. These are all perfectly normal and normally nothing to worry about. However, if you’re getting a bit of pain, if you find that the smell is starting to get a bit offensive, then that usually means that there’s an underlying infection, it maybe thrush or candida. And in which case just get that checked out by your doctor.

How long will it last and when to see the doctor?

So hopefully, this has given you a little bit of an idea of all the different scenarios that you can actually go through as you make your way towards the menopause. And this particular period in the menopause, which I forgot to mention earlier, can last from several months for up to about five years before your periods actually stop altogether. So one of the main things here, if you have any worries about your periods at all, please just discuss them with the doctor because we know if you’re continually worrying about things month after month, that’s not going to help your general well-being. So I hope you enjoyed this one and I will look forward to seeing you again next week on A.Vogel Talks Menopause.