If you are in the second stage of your reproductive cycle, also known as the premenopausal stage, you may notice that your periods have become less regular with different amounts of bleeding.

If you ate premenopausal and experiencing a change in pattern of bleeding or time of periods, ask yourself the following questions:

1. When did my periods start to change?

2. Are my periods more or less frequent than they used to be?

3. Do I have a smaller or larger amount of bleeding than usual? For instance, how many pads or tampons am I using?

4. Have I started to take a new medication or stopped taking one?

5. Do I have vaginal bleeding during or after intercourse?

Vaginal bleeding during the premenopausal stage can range from mild spotting to a flow that approaches what you experienced during the heavy days of your period. It’s important that you see your doctor if you’re spotting and head for the emergency room if the bleeding is heavy. It’s not certain what causes premenopausal bleeding, but it’s likely that it’s related to the sudden and extreme hormonal changes that occur as the body prepares for menopause.

In some cases, usually in younger women who are sexually active, polyps and/or cervical lesions may be the reason for vaginal bleeding. Even though they are still menstruating, they may confuse the bleeding with the spotting that sometimes occurs between periods and delay seeking medical treatment because they don’t think anything is wrong.

Fibroid tumors, which are growths on the uterine wall, are another common cause of irregular bleeding episodes in premenopausal women. They can be responsible for pain during intercourse, a sensation of abdominal fullness, and overall discomfort. In my practice, I have seen women with fibroid tumors who looked as though they were four months pregnant.


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