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Perimenopause can throw you for a loop. We know that symptoms during this phase can be significant. In fact, nearly 90% of women find themselves seeking advice from their healthcare provider on how to navigate it.
One common symptom that can raise a lot of questions is perimenopause spotting when wiping.
So what’s the deal with this seemingly irregular bleeding? Let’s explore.
Key takeaways
- Spotting (light bleeding that occurs outside of your period) is a common symptom during perimenopause. This is thanks to fluctuating hormones.
- Perimenopause is marked by significant hormonal fluctuations, especially estrogen and progesterone. This can lead to unpredictable bleeding patterns and irregular periods.
- While spotting is often normal, things like postmenopausal bleeding, heavy menstrual bleeding, and spotting after sex are not. They require immediate medical attention.
- Monitoring your bleeding patterns and other symptoms can help you and your doctor identify any potential issues.
- If you have concerns about your bleeding patterns (especially if accompanied by other symptoms), talk to your doctor.
- Spotting can sometimes indicate an underlying condition like uterine fibroids, polyps, infections, or even endometrial cancer (in rare cases).
- To help manage spotting, you can use panty liners, wear dark-colored underwear, track symptoms and consider hormonal birth control (if advised by your doctor).
What is spotting?
Spotting is essentially light bleeding that happens outside of your normal period. It’s a type of intermenstrual bleeding. It’s usually just a few drops of blood you might notice when wiping or on your underwear.
Sometimes it shows up as pink or brown discharge. The key thing is that it’s minimal. You won’t need a pad, tampon, or menstrual cup for spotting.
Is spotting during perimenopause normal?
“Peri” means “around.” So, perimenopause is the transition period leading up to menopause. Perimenopause starts with your first menstrual irregularity and ends when you’ve gone a full year without a period.
Spotting during the perimenopausal period (aka perimenopause spotting) is a common symptom. It’s not considered irregular bleeding (as long as it’s light).
What causes perimenopause spotting?
Causes of spotting during perimenopause include:
Hormonal fluctuations
Perimenopause is a hormonal rollercoaster. Your estrogen and progesterone levels start declining while your FSH and LH levels increase.
These hormonal changes are a natural result of your ovaries gradually running out of eggs. As those eggs decrease, things change. Your body stops estrogen and progesterone production in the same cyclical way it did during your reproductive years.
Spotting occurs during these hormonal changes. Fluctuations in estrogen (between high and low levels) can also lead to abnormal bleeding patterns.
Anovulation
Perimenopause is also characterized by anovulation. This is when your ovaries don’t release an egg. This is linked to variability in the timing of menstrual bleeding.
Studies show that anovulatory cycles are a major contributor to abnormal bleeding during the menopausal transition.
Know more: Can You Get Pregnant During Perimenopause?
Hormone therapy
Did you recently begin hormone replacement therapy (HRT) for menopause symptoms like hot flashes or vaginal dryness? Then you might experience breakthrough bleeding.
HRT can cause irregular bleeding or spotting, particularly in women who have just started HRT or modified their dosage. The good news is that this is usually harmless and settles down on its own in about 3-6 months.
What can you do about perimenopause spotting?
Okay, so you’re spotting during perimenopause. What can you do?
1. Use panty liners
Keep some panty liners handy. They’ll help you feel more comfortable and avoid staining your underwear.
2. Wear dark-colored underwear
Stick to dark-colored underwear to avoid any visible stains.
3. Track your cycles and symptoms
Keeping tabs on your symptoms can be really helpful. Tools like the Inito Fertility Monitor and app can help you track your fertility hormones and keep tabs on your symptoms. This allows you to identify your unique hormone trends and gives you a better understanding of when spotting happens and how it correlates with your menstrual cycle.
4. Consider hormonal birth control
Is the spotting accompanied by other troublesome perimenopause symptoms? Is it interfering with your daily life? Ask your doctor about hormonal birth control. It can help regulate your cycles and reduce bleeding.
When to see a doctor
Spotting during perimenopause is typically a normal part of the menopausal transition. But there are specific situations where it’s key to talk to a doc.
Recognizing these signs can help ensure your health and safety.
Immediate consultation required
1. Postmenopausal bleeding: Any vaginal bleeding after you’re reached menopause is abnormal. This could be a sign of endometrial cancer or other underlying conditions.
2. Spotting after sex: Bleeding following sexual intercourse is not typical. It should be evaluated to help rule out potential causes like cervical polyps, infections, or cervical cancer.
3. Heavy menstrual bleeding: Significantly more heavy bleeding than usual during perimenopause should be discussed with your doctor. This heavy bleeding could indicate underlying issues such as uterine fibroids or hormonal imbalances.
4. Concerning vaginal discharge: Any vaginal discharge accompanied by a foul odor, fever, or pelvic pain requires immediate medical attention. It may signal an infection like an STI or pelvic inflammatory disease (PID).
Consultation recommended
1. Persistent or unexplained spotting: If you notice consistent or unexplained spotting (even if it’s light), talk with your doctor. This is especially important if the spotting disrupts your daily life or causes anxiety.
2. Spotting alongside other concerning symptoms: If you have spotting during perimenopause along with other symptoms like:
- Severe pelvic pain
- Unexplained weight loss
- Persistent fatigue,
Consult your healthcare provider.
3. History of related conditions: Women with a history of uterine fibroids and polyps or thyroid conditons should discuss any changes in vaginal bleeding patterns with their doctors.
4. During hormone therapy: Are you on hormone replacement therapy (HRT) or hormonal birth control for menopause symptoms? And are you experiencing breakthrough bleeding that is worrying you? Speak with your doctor. They may need to make adjustments to your medication.
It’s important to see your doctor when you have any questions or concerns. Also, identifying and managing underlying conditions like uterine fibroids or polyps can alleviate symptoms and prevent complications.
And when you get things checked out early, you can address hormonal imbalances and get the right strategies to get your body back on track.
FAQs
If your bleeding patterns change drastically, or you notice unexpected bleeding that just doesn’t feel right, get it checked.
Also, if you’re experiencing heavy bleeding during perimenopause or spotting after sex, those are reasons to talk to your doctor.
And if you’re noticing postmenopausal bleeding (any vaginal bleeding after you’ve reached menopause), that’s a red flag as well.
In the context of perimenopause, yes, spotting is often normal.
Those few drops of blood or brown spotting that you might see? That’s often just your body response to the hormonal fluctuations that come with the menopause transition. Your estrogen levels are all over the place, which can lead to irregular periods and spotting.
While nausea isn’t one of the classic perimenopause symptoms like hot flashes or vaginal dryness, some women do experience it.
Hormonal imbalances can affect your whole body, and some women may find they get perimenopause cramps and nausea along with spotting during perimenopause.
Know more: Can Perimenopause Cause Nausea?
Yes, you can spot during ovulation due to changes in your hormone levels. This spotting is usually very light, just a few drops of blood, and it’s often followed by other ovulation symptoms like egg-white cervical mucus, a high and soft cervix, and increased sex drive.
