BACKGROUND: To investigate natural menstrual bleeding patterns in pre- and perimenopausal women, a prospective observational population study was carried out. METHODS: A total of 1616 (80.8%) of a population-based sample of 2000 Danish women aged 45-54 years answered an initial questionnaire. Of 1059 women with natural gynecological functions, 951 (89.8%) completed 1 year of daily recording of bleeding. Of these women, 592 were pre- or perimenopausal and were included in this study. MAIN OUTCOME MEASURES: Length and heaviness of bleeding episodes, including frequency of spotting, flooding and prolonged bleeding, according to regularity of cycles. RESULTS: The proportion of women with irregular cycles increased from 58.3% at age 45-46 years to 100% at age 53-54 years (P < 0.001). Irregularity of cycles was accompanied by increased variation in both length and subjective assessment of heaviness of bleeding episodes in the individual woman and between women (P < 0.001). Episodes of spotting (P < 0.001) and prolonged bleeding (10 days or more) (P < 0.001) were more common in women with irregular cycles. Subjective assessment of heaviness of bleeding episodes, however, was higher in women with regular cycles (P < 0.001). One or more episodes of flooding were recorded by 24.0% of all women irrespective of regularity of cycles (P = 0.40) but more frequently in younger women (P < 0.001). CONCLUSIONS: Irregularity of cycle lengths at the end of the fertile period is common, and is accompanied by an increased inter- and intraindividual variation in the length and heaviness of bleeding episodes, including increased frequency of prolonged bleeding and spotting.
BACKGROUND: To investigate natural menstrual bleeding patterns in pre- and perimenopausal women, a prospective observational population study was carried out. METHODS: A total of 1616 (80.8%) of a population-based sample of 2000 Danish women aged 45-54 years answered an initial questionnaire. Of 1059 women with natural gynecological functions, 951 (89.8%) completed 1 year of daily recording of bleeding. Of these women, 592 were pre- or perimenopausal and were included in this study. MAIN OUTCOME MEASURES: Length and heaviness of bleeding episodes, including frequency of spotting, flooding and prolonged bleeding, according to regularity of cycles. RESULTS: The proportion of women with irregular cycles increased from 58.3% at age 45-46 years to 100% at age 53-54 years (P < 0.001). Irregularity of cycles was accompanied by increased variation in both length and subjective assessment of heaviness of bleeding episodes in the individual woman and between women (P < 0.001). Episodes of spotting (P < 0.001) and prolonged bleeding (10 days or more) (P < 0.001) were more common in women with irregular cycles. Subjective assessment of heaviness of bleeding episodes, however, was higher in women with regular cycles (P < 0.001). One or more episodes of flooding were recorded by 24.0% of all women irrespective of regularity of cycles (P = 0.40) but more frequently in younger women (P < 0.001). CONCLUSIONS: Irregularity of cycle lengths at the end of the fertile period is common, and is accompanied by an increased inter- and intraindividual variation in the length and heaviness of bleeding episodes, including increased frequency of prolonged bleeding and spotting.
Authors: G Lambert-Messerlian; M B Roberts; S S Urlacher; J Ah-Ching; S Viali; M Urbanek; S T McGarvey Journal: Hum Reprod Date: 2011-06-15 Impact factor: 6.918
Authors: P Paramsothy; S D Harlow; G A Greendale; E B Gold; S L Crawford; M R Elliott; L D Lisabeth; J F Randolph Journal: BJOG Date: 2014-04-16 Impact factor: 6.531