Patient's question:
The appearance of white discharge with blood, menstrual period remains infrequent, main symptoms, onset time):Doctor's answer:
Analysis of the condition: Menopause varies from person to person. Generally, in rural areas of our country, it is around 46-47 years old, while in cities, it may be slightly later due to better nutrition, around 50 years old. This is the usual normal age for menopause. However, menopause is also related to genetics. For example, if a mother or sister experiences early menopause, she may also experience early menopause. If it starts later, she may also start later, and there is a certain relationship with genetic factors.As women enter menopause, ovarian function begins to decline. First, the corpus luteum function progressively declines, and follicles develop only to a certain extent before atrophying on their own and no longer ovulating. Without corpus luteum formation, fertility declines. However, in the early stages of ovarian decline, follicle-stimulating hormone (FSH) secretion increases, while luteinizing hormone (LH) remains at normal levels. Due to the body's natural adjustment of sexual function, FSH can return to normal levels, resulting in ovulatory menstrual cycles. Therefore, some women who have been infertile for many years may suddenly become pregnant during the premenopausal period.
As age increases, ovarian function becomes unstable and then declines, leading to imbalance. This often manifests as irregular menstruation before menopause, such as irregular cycles, prolonged periods, and continuous bleeding. Meanwhile, symptoms like premenstrual tension, cyclic breast pain, edema, and headaches may disappear. Generally, there are three types of changes in menstruation from ovarian decline to the cessation of menstruation:
Suggestions:
1) Infrequent menstruation: The menstrual cycle interval becomes longer, changing from a normal 20–30 days to 2–3 months or even longer. The amount of blood flow may remain normal or decrease slightly. The interval gradually extends to 4–5 months or half a year before menstruation occurs again. Eventually, menstruation stops completely.
2) Irregular menstrual cycles: The normal menstrual cycle changes to irregular vaginal bleeding. Sometimes the period extends, or it becomes persistent vaginal bleeding that lasts for 1–2 months without stopping. It may also involve heavy vaginal bleeding, leading to anemia, pale complexion, fatigue, palpitations, and shortness of breath. In severe cases, hemoglobin levels may significantly decrease. Some women experience repeated bleeding, and after 1–2 years, menstruation may completely stop. At this point, a doctor should conduct a detailed examination to rule out bleeding caused by tumors. For women over 40, a comprehensive examination or endometrial biopsy may be necessary. After ruling out tumors, treatment for menstrual irregularities during menopause can proceed.
Premenopausal menstrual cycle irregularity is the most common. It has been reported that among 282 premenopausal women observed, 181 (63.8%) exhibited menstrual cycle irregularity.
3) Sudden menopause: A few women who have always had regular menstrual cycles suddenly experience menopause. Others may have normal cycles with a few instances of gradually decreasing menstrual flow, followed by sudden cessation of menstruation. It has been reported that among 282 women who naturally experienced menopause, 40 (14.1%) experienced sudden menopause. Therefore, most cases fall into the first two categories. Another group of patients may experience uterine bleeding after a period of amenorrhea, lasting 2–4 weeks. The amount of blood and the duration of bleeding depend on the duration of estrogen effects and the rate of withdrawal.
The diagnosis of menopause requires retrospective evaluation and can only be confirmed if there is no menstruation for at least 6 months to 1 year.
Lifestyle care:
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