Abnormal vaginal bleeding

Q What is considered to be abnormal bleeding for women in their 40s? How can they determine if they are premenopausal?

C. W., Detroit

A Doctors say bleeding from the vagina--for women who are still in their reproductive years (many who are in their 40s)--is considered abnormal when menstrual periods are too heavy, too light, continue too long, occur too frequently, or are irregular. Additionally, any vaginal bleeding that is not normal menstrual or mid-cycle spotting may be abnormal and must be investigated by a medical professional.

Harmonal imbalances, doctors say, are the most common cause of abnormal bleeding, but it could also develop as the result of infection in the uterus, polyps and fibroids in the uterus, ectopic pregnancy, and cancers of the cervix, uterus or ovaries.

According to doctors, most premenopausal women experience changes in their menstrual cycles. When estrogen levels drop, the total cycle can be shortened from 28-30 days to 24-26 days, causing more frequent periods. Some women have longer cycles because they aren't ovulating as frequently.

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