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18. Navigating Menopause:  Irregular Bleeding or Heavy Bleeding? with Dr. James H. Liu image

18. Navigating Menopause: Irregular Bleeding or Heavy Bleeding? with Dr. James H. Liu

S2 E18 · Our Womanity Q & A with Dr. Rachel Pope
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48 Plays9 months ago

September is Perimenopause Awareness Month! And we are diving into all things perimenopause and menopause.

In Part 2 of this episode, we dive deep into the complexities of perimenopause and menopause with expert guidance from Dr. James H. Liu, a renowned menopause expert and past president of the Menopause Society. As we celebrate Perimenopause Awareness Month, we aim to shed light on the common symptoms and treatments women experience during this transformative phase of life.

Here is some practical advice from one of the top voices in the menopause field, Dr. James H. Liu on why women experience irregular bleeding or heavy bleeding during menopause.

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Transcript

Introduction and Expert Guest

00:00:05
Speaker
just by social media claims.

Why Irregular Bleeding in Perimenopause?

00:00:08
Speaker
Endocrinologist and I would should say reproductive endocrinologist because your training is initially an OBGYN, but I wanted to ask you why do women bleed irregularly during perimenopause?

Understanding Menstrual Cycle Regularity

00:00:28
Speaker
it's usually between 24 to 36 days. And that's considered usual regular menstrual cycles, fertile window, and that is natural in the way that the system is set up.

Aging and Egg Responsiveness

00:00:39
Speaker
As the woman hits the 42 to 45 year age range, many of the eggs that are remaining in the ovary are less responsive. And so they can't be stimulated to release on a regular basis as it was during her 25, 30 year age

Cycle Irregularity Explained with Analogy

00:00:55
Speaker
range. And so what happens then is the ovulation is they either prolonged, in which case the cycles become long, or because the egg for some reason starts to develop and then it fails and and it doesn't respond anymore.
00:01:09
Speaker
the sudden drop in estrogen causes the bleeding to occur. So it's kind of like taking a birth control pill and then missing five days and then taking the birth control pill again, the birth control pill being your artificial ovary. And so if you think about it like that, that would explain why the cycles become irregular. I think that's a good analogy. That's a great analogy.

Heavy Bleeding: The 'Grand Finale'

00:01:28
Speaker
And then ah a lot of women talk about having this grand finale, really heavy bleed. Why does that happen?
00:01:35
Speaker
So that happens because the estrogen is being produced by the ovary, but it doesn't ovulate. And so the progesterone part of the cycle is not normal. And so another egg takes over and so more estrogen is produced. So the lining has been built up from not one cycle of estrogen exposure, but two or more cycles of estrogen exposure. And then the th lining is thicker. So when she does finally have a lenses, it's much heavier. There also may be other