Patient's question:
Female, 46 years old. Before the 14th of last month, her menstruation was always very normal. However, in early this month, she was diagnosed with pelvic inflammation and took two boxes of Prunella vulgaris tablets prescribed by the doctor, as well as applying metronidazole chlorhexidine lotion externally. It has been more than half a month since then, and her menstruation has not yet appeared. She asked the doctor if she has reached the point of menopause, which is why it is like this?Doctor's answer:
Hello, please don't worry about the past. Menopause is something that every woman will experience. Menopause varies from person to person. Generally, in our country, rural women are around 46-47 years old, while urban women might be slightly later, as they tend to have better nutrition, around 50 years old. The transition from ovarian function decline to the cessation of menstruation can manifest in three ways:(1) Oligomenorrhea: 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 can remain normal or decrease compared to before. The interval gradually extends to 4-5 months or half a year before menstruation occurs again, after which it completely stops.
(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, general fatigue, palpitations, and shortness of breath. In severe cases, hemoglobin levels can significantly drop. Some women experience repeated bleeding, and after 1-2 years, menstruation usually completely stops. At this point, a doctor should conduct a thorough examination, first ruling out bleeding caused by tumors. For women over 40, a comprehensive check-up or an endometrial biopsy should be performed. After ruling out tumors, treatment for menstrual irregularities during menopause can proceed. The most common symptom before menopause is irregular menstrual cycles. It has been reported that in an observation of 282 pre-menopausal women, 181 (63.8%) exhibited irregular menstrual cycles.
(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 in an observation of 282 naturally menopausal women, 40 (14.1%) experienced sudden menopause. Therefore, the majority exhibit the first two types of symptoms. 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 to confirm it. Amenorrhea must persist for at least 6 months to 1 year to establish the diagnosis. I hope my response helps you. Wishing you good health!