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Post menopause bleeding
debr1012 posted:
Dr Gass

I haven't had a period for over 14 months until yesterday. My periods have always been heavy especially the last few years. I was very surprised by this since I have always been told that if you haven't had a cycle for over a year you won't have anymore. If it were just some spotting I probably wouldn't be concerned but I am having very heavy bleeding and quite a bit of clotting.
Mary Jane Minkin, MD responded:
Dear Debr1012,
It's Mary Jane Minkin answering; Dr. Gass is so busy these days as director of the North American Menopause Society, I've taken over to try to help answer questions. Indeed, once you go a full year without a period, you are considered fully menopausal, and in general you won't get any more bleeding. That being said, given that you are only 2 months past that "magic mark" it is still most likely this bleed is related to spontaneous ovarian activity; but since you haven't been ovulating and making progesterone throughout this year, it's not unusual for the bleeding to be heavy (as it was not regulated by progesterone.) Alas, though, I do have to recommend that you check in with your health care provider, because any bleeding over a year after the last menstrual period usually bears some investigation; your health care provider will most likely ask you to come in for a pelvic ultrasound after the bleeding stops, or a sampling of the lining of the uterus (an endometrial biopsy).
Good luck,
Mary Jane

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