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    Mamaedie posted:
    I am 51 years old and my doctor has told me that I am in menopause. Joy, right? Well she has put me on a regiman of Provera for the next three months and the first month I had no bleeding. This month however, I do have bleeding and so I called the doctors office and her staff acted like I was crazy for calling. They told me that i should have bleeding which is exactly opposite of what the doctor told me that a menopausal woman should have. Does anyone know the answer? Should a menopausal (not peri menopausal) woman have bleeding and be perfectly ok? I'm at my wits end.
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    Mary Jane Minkin, MD responded:
    Dear Mamaedie,
    Sorry for the confusion. Here's the scoop: until you go one year without a period, you are not fully menopausal; all bets are off on bleeding. If you have enough estrogen on board to stimulate the buildup of lining of the uterus (think of estrogen as fertilizer), then when you take progesterone (think lawn mower) the lining of the uterus will come out. If at that time (the previous month(s)) there wasn't a significant build up of the lining, nothing will come out when you take the progesterone. Progesterone does not prolong the menopause process; if there is stuff in the uterus, it will come out; if the estrogen levels are sufficiently low, there will not be build up).
    Now all that being said: if a woman is heavy, even if her ovaries aren't making much estrogen, her fat tissue can be, and that can stimulate the build up of lining of the uterus (even if she is menopausal). So occasionally we will have our heavy patients take some progesterone periodically, to sort of clean out the lining of the uterus, even if they are menopausal)
    Hope that's helpful,
    Mary Jane


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