Menopause: Is It Normal to Experience Periods Again?

Menopausal issues

Hello Doctor: I am 54 years old and have been menopausal for about a year.
A few days ago, I experienced breast tenderness, abdominal bloating, and calf edema, which are premenstrual symptoms.
Yesterday morning, I discovered that my menstruation had returned! I visited a gynecologist, who inquired about my recent diet and whether I had taken any medications (aside from consuming a bit more edamame, I haven't taken any supplements).
The doctor suggested that it might be hormone-related, as my uterus has not completely atrophied, and prescribed medication to stop the bleeding, but did not ask me to return for follow-up or further tests.
I would like to ask: Is it okay not to allow the menstrual blood to be expelled? Is it normal for someone like me, who has been menopausal, to have menstruation again? Will menstruation continue? Thank you 🙏

Ri Qing, 50~59 year old female. Ask Date: 2022/04/29

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the causes of bleeding can be numerous.
It is crucial to rule out conditions such as uterine tumors, endometrial hyperplasia, cervical lesions, and vaginal lesions, among others.
If the bleeding persists, it is advisable to consult a physician for further evaluation.
Thank you! Wishing you safety and health.
Dr.
Chang

Reply Date: 2022/04/29

More Info

Experiencing menstrual bleeding after a year of menopause can be concerning and raises several questions about hormonal changes and overall health. Menopause is defined as the cessation of menstrual periods for 12 consecutive months, marking the end of a woman's reproductive years. However, some women may experience what is known as "postmenopausal bleeding," which can occur due to various reasons.

Firstly, it is important to understand that while some women may experience irregular bleeding or spotting during the perimenopausal phase (the transitional period leading up to menopause), experiencing a full menstrual period after a year of no bleeding is less common and should be evaluated. The symptoms you described, such as breast tenderness, abdominal bloating, and leg swelling, are often associated with premenstrual syndrome (PMS) and can be influenced by hormonal fluctuations.

The doctor you consulted mentioned that your uterus has not completely atrophied, which means that it may still respond to hormonal signals. This can lead to unexpected bleeding. Hormonal imbalances can occur due to various factors, including stress, changes in diet, weight fluctuations, or even certain medications. In your case, the increased consumption of soybeans (edamame) may have contributed to hormonal changes, as soy contains phytoestrogens that can mimic estrogen in the body.

Regarding the treatment prescribed to stop the bleeding, it is common for healthcare providers to use medications such as progestins to help regulate the endometrial lining and prevent further bleeding. While stopping the bleeding can provide immediate relief, it is essential to monitor your overall health and any further episodes of bleeding. Not allowing the menstrual blood to exit the body is generally not harmful in the short term, but it is crucial to understand the underlying cause of the bleeding.

As for whether this is normal and if you will continue to experience menstrual periods, it is difficult to predict. Some women may have a single episode of bleeding and not experience it again, while others may have recurrent bleeding due to hormonal fluctuations. It is essential to keep track of any further bleeding episodes and report them to your healthcare provider.

In summary, while experiencing menstrual bleeding after a year of menopause is not typical, it can occur due to hormonal changes. It is advisable to follow up with your healthcare provider if you experience any further bleeding, significant changes in your symptoms, or if you have concerns about your health. Regular check-ups and open communication with your doctor are vital for managing your health during this transitional phase. Additionally, if you have any risk factors for uterine cancer or other health issues, further evaluation may be warranted to rule out any serious conditions.

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