bleeding again

[kyhep2005]

I am soon to be 52. I had not had a period in about 9 mos. Then suddenly I had one that lasted about 3 days, then another one  2 weeks later. This one is heavier with some clots. It has lasted for 6 days now. Should I be concerned or is this normal during menopause.

[Machelle Seibel, MD]

A.  Menopause is defined as one year after the last period.  So technically, you are not in menopause but near the end of perimenopause, the window around menopause that can last up to 10 years. This type of bleeding is not uncommon as hormone levels wax and wane. Most likely this is a normal bleeding experience.  But it isn’t possible to be sure from your history.  If it happens again or if it continues for another day or so, I would suggest making an appointment with your doctor.  He or she may want to do an endometrial biopsy which is a simple office procedure that involves placing a thin tube into the uterus and scraping off a few cells to look at under the microscope to see if everything is OK. It causes mild cramping that usually goes away in a short while. Sometimes an ultrasound of the uterus is done to see the thickness of the lining.  Less than 5 mm is considered normal. A thickness of 5 mm or more usually requires a biopsy. Sometimes a thin telescope called a hysteroscope is used to look inside the uterus.  This can be done either in the office or the operating room.
Machelle M. Seibel, MD