This probably won’t come as a shock to most women, but there’s a big gender bias in medicine, even in 2024. As a result, there’s much we still don’t know about the female body, and that has far-reaching consequences for women of all ages.
Take menopause, for instance. This period of time is a huge shift in a woman’s life, yet 99% of studies on the biology of aging pretty much ignore it. WTF.
“It’s important for women to know about menopause symptoms and to advocate for themselves. There are currently only about 1,800 Menopause Society Certified Practitioners (MSCPs) in the U.S., which is not enough to treat all of us born with uteri,” says Sophia Yen, M.D., MPH, and cofounder and Chief Medical Officer of Pandia Health. Pandia Health is a doctor-founded and women-led online hormonal women’s health clinic. They specialize in menopause, birth control, and acne.
So today, we’re going to talk about one of the lesser-known symptoms of menopause: menopause flooding.
First up, a quick refresher on menopause:
Menopause begins 12 months after a woman’s last period. There’s also a transition period leading up to it, called perimenopause. “Perimenopause is defined as six to seven years before your final menstrual period and one year after,” Dr. Yen says. During this time, hormones like progesterone and estrogen vary a lot.
What is menopause flooding?
“Menopause flooding is when you have heavy menstrual bleeding (HMB) due to perimenopause. HMB can happen at any time, but it’s most common during puberty and perimenopause. ‘Menopause flooding’ is a layperson term for heavy menstrual bleeding around menopause,” Dr. Yen says.
What causes menopause flooding?
“Around menopause, your ovaries do not consistently pop out an egg. If the egg does not pop out, progesterone is not made, and the signal to shed the lining does not occur,” she says. “The lining accumulates, and when it sheds, there is more blood/material than usual. Also, it can be caused by the imbalance of hormones that occur during the perimenopausal years.”
Are certain people more likely to experience this than others? What are some risk factors?
“Menopausal flooding, or more accurately perimenopausal heavy menstrual bleeding (HMB), hasn’t been studied that much, but I would guess that people who have bleeding disorders such as Von Willebrand’s disease (which affects 1/100 people) and hemophilia are more likely to experience this,” Dr. Yen says. “Women who have more estrogen could also potentially be affected more, as this would result in more buildup. More research is needed.”
What can we do to treat it?
“If you have heavy menstrual bleeding, see your doctor. You should get checked for gynecologic conditions such as fibroids, polyps, and endometrial cancer, as well as thyroid issues,” Dr. Yen says.
“If those things are normal and you’re of perimenopausal age with irregular periods, you may want to consider going on a low-dose birth control pill or hormonal IUD to turn off your periods—or at least make them lighter and regular/controlled.
You can make your periods optional with hormonal birth control, specifically with the hormonal IUD (regular strength), vaginal ring, or birth control pills. And when you get to 52 or 53 years old, check if you have menopause, and switch to menopause hormonal treatment at that time, if it’s relevant.”
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