Is Bleeding in Menopause Normal?

Heavy bleeding during menopause can be frightening, but it is not uncommon, explains Dr. Diane Francoeur, CEO of the Society of Obstetricians and Gynaecologists of Canada. "Menopause is like puberty. So it starts slow, and it ends slow. So most of the time, it's not like an 'on-off switch.'"

Women may experience significant bleeding after months of no periods. It's crucial to consult a physician if this occurs. "Sometimes they can bleed enough to need a blood transfusion," Francoeur noted. Additionally, fertile women can still get pregnant for at least a year after their last period, leading to potential miscarriages.

Francoeur emphasizes the importance of an endometrial biopsy to rule out cancer. "Those can be treated very easily, so it's important not to wait for too long."

What Causes Bleeding in Menopause?

Several factors can lead to bleeding during menopause, including hormone imbalances, thyroid problems, infections or STDs, miscarriage, and (pre)cancerous cells. About 15 to 20 percent of women will experience bleeding in menopause after not having a period for a while.

Even for women who had "easy" periods before menopause, the last few periods can feel intense. It's essential to check with a doctor to ensure there's no underlying issue.

Determining Normal vs. Abnormal Bleeding

Tracking blood flow during menopause is vital. More than a cup of blood an hour for several hours is "way too much." Large clots or soaking through clothes and bed sheets indicate excessive bleeding.