As women and those with the potential to menstruate age, their bodies begin to go through a normal transition called menopause. Menopause and perimenopause are the stages of life when your body stops having periods and producing hormones. Menopause is completely normal, and this section provides information on the basics of menopause and perimenopause as well as what to expect and treatment options.
This section will cover the following information about menopause:
Basics of Menopause and Perimenopause
Menopause and Bleeding Disorders
Basics of Menopause and Perimenopause
As women and those with the potential to menstruate age, their periods happen less and less often until they fully stop. Menopause begins when you have not had a period for 12 months. During menopause you may experience hormonal changes and other physical and emotional symptoms. In the United States, the average age of menopause is 51 years. Usually, the age that you experience menopause is similar to when others in your family went through menopause.
The time leading up to menopause is called perimenopause. The perimenopause stage may last several months or years and ends when you period stops for 12 months. During perimenopause you may have symptoms similar to menopause, including changes in mood, periods that are irregular, and hot flashes. If your menopause or perimenopause symptoms are affecting your quality of life, talk with a health care provider or your Hemophilia Treatment Center (HTC) team.
What to Expect
The symptoms you might experience during menopause and perimenopause may vary, and could include the symptoms listed below.
Most Common Symptoms:
- Hot flashes
- Sudden feeling of extreme heat on face, neck, and chest
- Last 1-5 minutes
- 33% of people who get hot flashes get them about 10 times per day
- Vaginal dryness
- Decrease in sexual desire
- Mood changes, anxiety, and depression
- Sleep disruptions
Menopause and Bleeding Disorders
Women and those with the potential to menstruate with a bleeding disorder may experience some changes as they enter menopause and perimenopause. While vaginal bleeding symptoms might improve, there will be no changes to how often nosebleeds and bruising occur. As people age, factor levels may increase, especially von Willebrand factor (VWF) levels for people with some subtypes of von Willebrand disease (VWD). Research is still ongoing to conclude if increased VWF levels reduces bleeding symptoms or how treatment should change if you have a procedure. If you have any questions or concerns about how your factor levels have changed as you have aged, talk with your health care provider.
Vasomotor symptoms, often felt as hot flashes and night sweats, are symptoms that happen with the narrowing or widening of blood vessels. There are some lifestyle changes that could help address vasomotor issues.
Vasomotor Symptoms: What to Expect
- Can affect everyone going through menopause
- These symptoms can last from 6 months to 10 years
- If symptoms are not addressed by lifestyle changes, then non hormonal or hormonal replacement therapy can be an option
- People with bleeding disorders have the same rates of vasomotor symptoms as those without bleeding disorders
Lifestyle Changes for Vasomotor Symptoms
- Dress in layers, so you can take off a layer when you have a hot flash
- Maintain a lower temperature at home or work, or carry a small fan
- Avoid hot drinks
- Avoid alcohol and caffeine
- Consume cool drinks
When entering perimenopause or menopause, women and those with the potential to menstruate may also have a greater likelihood to develop additional conditions, such as fibroids, endometriosis, uterine polyps, uterine cancer, and endometrial hyperplasia. All of these conditions can cause heavy bleeding. If you have changes in symptoms, such as new or worsening bleeding or pain, talk with your health care provider or your HTC team.
Treatment Options
There are many options for treatment for perimenopause or menopause symptoms, including both topical treatment and hormone replacement therapy. If you have symptoms affecting your daily life talk with your health care provider or Hemophilia Treatment Center (HTC) team about what treatment might be right for you.
Topical Treatment
- Comes in many forms, including creams and medicines designed to be put directly into the body
- Has a lower risk than hormone replacement therapy
- Used as the preferred treatment option for those with:
- Vaginal dryness
- Pain with sexual intercourse
- Bladder problems including frequent urinary tract infections
Hormone Replacement Therapy
- Used to treat menopause symptoms
- Comes in many forms, including pills, patches, injections, sprays, and creams
- Three main types:
- Estrogen
- Progesterone
- Estrogen and progesterone combined
- Considered safe for women within 10 years of menopause and less than 60 years of age
- Use for the shortest time needed, and assess yearly for the need to continue
Estrogen, sometimes in combination with progesterone or a progestin, has been shown to increase the risk of heart attack, stroke, blood clots, and breast cancer. You should talk about the benefits and risks of this type of therapy with your health care provider or Hemophilia Treatment Center (HTC) team.