DEAR DR. GOTT: I am 51 years old and stopped getting my period 21 months ago. All of a sudden this last month I had excruciating lower back pain and then started bleeding lightly. My gynecologist said it was probably just because I was a little heavy but did extensive testing only to find nothing abnormal.
In your opinion is being a little heavy cause for me to get my period after 21 months? I have never heard of anyone going through this before.
DEAR READER: You have gone through menopause, the end of menstruation and fertility that occurs to every woman, generally between the ages of 45 and 55. During the stages of menopause a woman produces less estrogen and progesterone. Cycles occur less frequently, irregularly and ultimately cease altogether. This phase in a woman’s life is considered complete when a woman has not had a period for one year or longer and can last as long as five years. During that time a woman may experience hot flashes, insomnia, palpitations, headaches, urinary leakage, joint pain, and more.
Some women experience vaginal bleeding which likely isn’t a concern but should be reported to a physician or gynecologist as it can represent other health issues. There are times when because of the decline in estrogen levels the lining of the vagina becomes thin, dry and less elastic which can lead to inflamed tissue that may cause the blood. Then too, perhaps it occurred during sex or following a pelvic examination or the result of hormone therapy.
Your physician likely checked you for benign growths in the uterine lining, a hormonal imbalance and uterine fibroid tumors. If uterine polyps or uterine fibroids are present, they may require surgical removal because in rare cases, they can create a site for future cancerous growths.
Endometrial hyperplasia (overgrowth of the uterine lining) is yet another possible cause of post-menopausal bleed. Women in your age bracket are at increased risk for this to occur, particularly if they are either obese, began menstruating at an early age, have not had children, have polycystic ovary syndrome, or have had prolonged exposure to estrogen earlier in life as they might also be at an increased risk for developing endometrial cancer. While the hyperplasia may require surgery, there are instances when it can be managed with medication and close follow-up. That would be a decision best left between a woman and her gynecologist.
It is, in my opinion, recommended that all women nearing or at the age of menopause see their physicians annually for a full examination, mammogram, bone density, lab testing, screening for cervical cancer, Pap and pelvic, and EKG. A chest X-ray may be appropriate for those with a history of smoking or a strong family history of lung cancer. The bone density test can zero in on possible osteoporosis which is linked with advancing age. You might address the issue of your extra pounds by reviewing your diet, reducing the size of your meals, eliminating snacks unless they are fresh fruits and vegetables, and increasing your exercise regimen.
Readers who would like related information can order my Health Reports “Menopause” and “Osteoporosis” by sending a self-addressed, stamped number 10 envelope and a US check or money order ($2 per report) to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) when writing or print out an order form from my website www.AskDrGottMD.com.
