How do I know if changes in my periods are normal perimenopausal symptoms or something to be concerned about?

Irregular periods are common and normal during perimenopause (the menopause transition). But other conditions can cause abnormalities in menstrual bleeding. If any of the following situations apply to you, see a doctor to rule out other causes.

  • Your periods are changing to become very heavy, or accompanied by blood clots.
  • Your periods last several days longer than usual.
  • You spot or bleed after your period.
  • You experience spotting after sex.
  • Your periods occur closer together.

Potential causes of abnormal bleeding include hormonal imbalances, hormonal treatments, pregnancy, fibroids, blood-clotting problems or, rarely, cancer.

Can menopause affect sleep?

Some women may experience trouble sleeping through the night and insomnia during menopause. Insomnia is an inability to fall asleep or stay asleep at night. This can be a normal side effect of menopause itself, or it could be due to another symptom of menopause. Hot flashes are a common culprit of sleepless nights during menopause.

If hot flashes keep you awake at night, try:

  • Staying cool at night by wearing loose clothing.
  • Keeping your bedroom well-ventilated.

Avoiding certain foods and behaviors that trigger your hot flashes. If spicy food typically sets off a hot flash, avoid eating anything spicy before bed.

Can menopause affect my sex life?

After menopause, your body has less estrogen. This major change in your hormonal balance can affect your sex life. Many menopausal women may notice that they’re not as easily aroused as before. Sometimes, women also may be less sensitive to touch and other physical contact than before menopause.

These feelings, coupled with the other emotional changes you may be experiencing, can all lead to a decreased interest in sex. Keep in mind that your body is going through a lot of change during menopause. Some of the other factors that can play a role in a decreased sex drive can include:

  • Having bladder control problems.
  • Having trouble sleeping through the night.
  • Experiencing stress, anxiety or depression.
  • Coping with other medical conditions and medications.

All of these factors can disrupt your life and even cause tension in your relationship. In addition to these changes, the lower levels of estrogen in your body can actually cause a decrease in the blood supply to the vagina. This can cause dryness. When you don’t have the right amount of lubrication in the vagina, it can be thin, pale and dry. This can lead to painful intercourse.

Don’t be afraid to talk to your healthcare provider about any decreases you are experiencing in your sex drive. Your provider will discuss options to help you feel better. For example, vaginal dryness can be treated with over-the-counter, water-soluble or silicone lubricants. Your healthcare provider can also prescribe estrogen or nonestrogen hormones to treat the vaginal tissue. This may be prescribed in a low-dose cream, pill or vaginal ring.

Do all menopausal women experience a decrease in sexual desire?

Not all women experience a decreased sexual desire. In some cases, it’s just the opposite. This could be because there’s no longer any fear of getting pregnant. For many women, this allows them to enjoy sex without worrying about family planning.

However, it is still important to use protection (condoms) during sex if not in a monogamous relationship. Once your doctor makes the diagnosis of menopause, you can no longer become pregnant. However, when you are in the menopause transition (perimenopause), you can still become pregnant. You also need to protect yourself from sexually transmitted infections (STIs). You can get an STI at any time in your life.

Will I still enjoy sex after menopause?

You should still be able to enjoy sex after menopause. Sometimes, decreased sex drive is related to discomfort and painful intercourse. After treating the source of this pain (vaginal dryness), many women are able to enjoy intimacy again. Hormone therapy can also help many women. If you are having difficulties enjoying sex after menopause, talk to your healthcare provider.

Can menopause be a positive time of life?

Menopause can certainly be a positive time of life. Too often, myths foster misconceptions about this normal process of aging. Although menopause can cause some noticeable and uncomfortable changes, these can be effectively managed.

Last reviewed by a Cleveland Clinic medical professional on 12/24/2019.

References

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