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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 2029
Experience:  29 years of experience and an award-winning educator.
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HI , I am 52 years old and still have regular periods every

Resolved Question:

HI , I am 52 years old and still have regular periods every 28-30 days. I started spotting about a week ago. It is 2 weeks after my normal period. It has lasted for 7 days now. Should I be concerned?
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. C. replied 2 years ago.

Dr. C. :

I am glad to help you. Answers are intended to provide general medical information only.

Dr. C. :

Not necessary but there are some things that need to be watched.

Customer:

I have no signs of menopause (unfornately). What should be watched?

Dr. C. :

Average age of menpause is 51 so anytime a women is over that age we need to be careful. The risk of uterine precancer and cancers increase about that time. Because of that, we have to take special care to be sure there is nothing concerning going on. It is very common to have hormonal imbalances that cause abnormal bleeding patterns at this time as well. That is by far the most common reason for abnormal bleeding around this time.

Dr. C. :

If it's a one time episode it would be safe to watch for now. But if there is a recurrence of abnormal bleeding, a thyroid should be checked and an ultrasound ordered.

Customer:

this has happened before but never lasted this long

Dr. C. :

Let me get you a document that I wrote for women at this age group as to what is normal during transition regarding bleeding pattern.

Customer:

thanks

Dr. C. :

Stand by while I cut and paste it in. Then we can continue chatting about your situation.

Dr. C. :

HOW DOES YOUR PERIOD CHANGE AS YOU GET OLDER?
Many women experience changes in their menstrual bleeding pattern as they approach the
menopausal transition. These changes can start as early as the late 30s and can last for many years.
The average age of menopause is ~51 but there is a very wide variation in what changes women may
experience during this transition time. This handout tells you what to expect, what is normal and what
may signal a problem that you may need help with.
Some women continue to have periods that are predictable in start-time, amount of flow and length of
bleeding time, up until menopause. However, it is very common and normal for women to begin to
have more variation and irregularity in their flow pattern as they get older.
· Cycle length: Cycle length is the number of days from the first day of your period, until the
first day of the next period. Most women have cycle lengths of about 28 days. As women get
older, it is typical to have more cycle length variation. For example, some months your
period may come in 28 days but other months may come in 25 days or 32 days. Your period
may be less predictable in onset.
If your cycle length drops below 24 days or is longer than 90 days, it is a good idea to seek
professional advice.
· Duration of flow: Similarly, there may be increasing variation in the number of days you flow.
Duration of flow includes all the spotty days that come at the start or end of your period. If
the duration of your flow is greater than 10 days, it could be an indication that you need
evaluation.
· Amount of flow: You can also expect changes in the amount of flow from month to month.
Some periods will be typical for you while others may be lighter or heavier.
o Very heavy flow, especially if it lasts more than 1 day can be a sign of a problem. If you
are altering your plans for the day, needing to double up on protection and still soaking
through with blood, or going to sleep with a towel, please call us.
Officially, menopause is defined as “one year without menstruation.” At that point you can
feel confident discontinuing birth control. Any bleeding after you have already entered
menopause needs evaluation.
We can provide you with a calendar card to track your blood flow. This information, recorded
on the card, is a very helpful way for us to figure out if your pattern is in the normal range or
is the sign of a problem. If you’d like such a card, please ask us for one.

Dr. C. :

If it's a one time event there is no need to respond but it would be a good idea to begin tracking the bleeding on a calendar.

Dr. C. :

This will help your doctor tell if the pattern is in the normal range or not.

Dr. C. :

If the bleeding falls out of the normal range, he/she may want to do a biopsy just to be on the safe side.

Dr. C. :

Most often the irregular pattern is because of hormonal changes common as a woman approaches menopausal transition.

Dr. C. :

But we have to be cautious not to miss a possible precancer or cancer developing.

Dr. C. :

Both have an abnormal bleeding pattern.

Customer:

that is my concern - I spot at the beginning of my cycle - but this is differnet and shows no sign of stopping

Dr. C. :

The details of the bleeding pattern help us tell them apart. The ultrasound can also be helpful since the lining of the uterus can be seen on ultrasound. Virtually all uterine cancers (few exceptions) begin on the lining of the uterus. The lining is measured and if it is thick, he/she will want to be a biopsy to be sure.

Dr. C. :

Sometimes women will develop polyps along the lining around this time. Those can cause spotting.

Dr. C. :

do not be type above

Dr. C. :

typo

Customer:

Thanks for your help - so you are recommending contacting a doctor?

Dr. C. :

Risk factors for uterine cancer are: family history of uterine and related cancers, obesity, diabetes, history of skipping period over many years

Customer:

I have no risk factors at all

Dr. C. :

Tracking for now would be fine but if it recurs into next month then yes.

Dr. C. :

It is most likely related to hormonal imbalances related to menopausal transition.

Dr. C. :

By far.

Dr. C. :

But the risk of precancer is not zero so it is always a good idea to have a doctor involved monitoring the transition if the bleeding pattern is abnormal.

Dr. C. :

Use the guide above that I wrote.

Customer:

ok that is what I thought and would not have been concerned if it would stop

Dr. C. :

Is the plan clear than?

Customer:

OK cool thanks - yes

Dr. C. :

ok, glad to help.

Dr. C. :

Please click accept so I get credited from your deposit and be sure to ask follow-up questions if you think of any.

Customer:

Ok - will I be able to save this conversation?

Dr. C. :

Yes you will and you can go back into the post to ask additional questions.

Dr. C. :

It will be in your email.

Customer:

have a great night!

Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 2029
Experience: 29 years of experience and an award-winning educator.
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