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What to Know About Heavy Bleeding After 50

Reviewed by Dan Brennan, MD on March 16, 2021

Heavy bleeding — also known as menorrhagia — is excessive or prolonged menstrual bleeding. One in 3 women describes their period as heavy, with 1 in 20 women consulting their doctor about this change to their cycle each year. 

Heavy bleeding is blood loss during a period greater than 80 milliliters or periods lasting longer than a week. While this varies from woman to woman, you may be experiencing heavy bleeding if you:

  • Need to change sanitary products more frequently than usual
  • Require double protection, like with both tampons and pads
  • Pass blood clots larger than 2.5 centimeters
  • Have your sleep interrupted by your period or bleed through your clothes and bedding

The best way to determine if your bleeding is heavy is to consider how your cycle affects your daily life. Heavy bleeding can cause you to be tired and put you at a higher risk of anemia, which can lead to dizziness, irregular heartbeat, and shortness of breath. An unusual flow may also interrupt your day-to-day activities due to cramping, tiredness, and having to change your tampons or pads more often. 

Is Heavy Bleeding After 50 Normal?

Heavy bleeding is common among women transitioning into menopause, the point when your body’s reproductive system stops releasing eggs. One study found that among women ages 42 to 52, more than 90% experienced periods that lasted 10 days or more — with 78% reporting their blood flow as heavy.

This is because when women approach menopause, there are fewer eggs to mature in the ovaries. The body releases higher levels of follicle-stimulating hormone (FSH) in an attempt to maintain normal ovulation, which produces more estrogen.

These greater levels of estrogen thicken the lining of the uterus, often resulting in heavier, longer periods. The time it takes for a woman’s body to complete this cycle can extend as well, leading to longer gaps between periods and more blood flow. 

This change in reproductive hormone levels called perimenopause generally begins about four years before a woman has her last period. But the transition can start as early as 10 years before menopause.

What Changes to Expect During Perimenopause

Over time, a woman’s estrogen levels decrease, thinning the lining of the uterus. Periods happen less often until they stop altogether.

But when hormones are still in flux during perimenopause, it’s common for women to experience significant changes to their menstrual cycle. This can include:

Shorter, longer, or missed cycles

The hormone changes during perimenopause are because of a decreased number of eggs in the ovaries. This can result in a longer time between cycles — at least 38 days apart — or missing your period entirely. Women with lower estrogen levels may experience shorter cycles than normal.

Spotting between periods

Changes in the time between periods can also cause spotting between periods. It's common for thicker walls of the uterus to cause spotting that’s red, brown, or dark-colored.

Abnormally heavy flow

As higher estrogen levels thicken the lining of the uterus, there can be more bleeding as it sheds. Unusual changes in your period cycle like missed or infrequent periods can also trigger heavier blood flows.

Other physical and mental symptoms can accompany perimenopause as well, including: 

How to Manage Heavy Bleeding after 50

While normal, heavy bleeding can disrupt everyday life for many women. 

Research shows that ibuprofen can help decrease bleeding during periods by 20 to 40% and alleviate symptoms like cramps. Attention to your diet and lifestyle can help manage perimenopausal symptoms as well, including:

  • Manage healthy stress and sleep levels to avoid greater hormone imbalance
  • Replenish your body with iron to prevent anemia — which causes symptoms like tiredness and may contribute to heavier bleeding
  • Track your period cycles to gain better control over a heavier bleeding pattern
  • Using pads or tampons that give heavy-flow comfort and avoid leakage

When to See Your Doctor

Heavy bleeding and unusual period cycles are common in women over 50. But if your symptoms interfere with your life and well-being, you should contact your doctor. You may be a good candidate for hormone therapy that helps balance your estrogen and progesterone levels, easing heavy bleeding and other perimenopausal symptoms. 

Bleeding can occur in women over 50 after they experience menopause as well. Studies show that this postmenopausal bleeding is usually caused by conditions like uterine fibroids or polyps. It can also be a sign of endometrial cancer, which affects 2 to 3% of women and is most common among postmenopausal women. 

Heavy bleeding could also be a symptom of another underlying health condition. Make sure to monitor your flow and see your doctor if you experience:

  • Extremely heavy bleeding — like soaking through a sanitary product hourly
  • Consistent spotting between cycles
  • Several cycles in a row that are shorter than 21 days or several days longer than usual
  • More than three months between periods
  • Bleeding after sexual intercourse

Show Sources

SOURCES:

Cleveland Clinic: “Menopause, Perimenopause and Postmenopause.”

Harvard Health Publishing: “Abnormal uterine bleeding in peri- and postmenopausal women.”

Harvard Health Publishing: “Bleeding after menopause: Get it checked out.”

International Menopause Society: “Changes before the Change.”

JAMA Internal Medicine: “Association of Endometrial Cancer Risk With Postmenopausal Bleeding in Women.”

The Journal of Reproductive Medicine: “Abnormal uterine bleeding associated with iron-deficiency anemia. Etiology and role of hysteroscopy.”

Mayo Clinic: “Anemia.”

Mayo Clinic: “Hormone therapy: Is it right for you?”

Mayo Clinic: “Perimenopause.”

National Health Service: “Heavy periods.”

Office on Women's Health: “Your menstrual cycle.”

Science Daily: “Prolonged, heavy bleeding during menopause is common.”

USC Fertility: “4 Ways to Decrease Menstrual Flow.”

Women's Health Concern: “Heavy periods.”

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