Menorrhagia and the Menopausal Transition

The menopausal transition in defined by the presence of clinically evident irregularities in the cycle. Prevalence and type of bleeding disturbances varies among studies. The Study of Women’s Health Across the Nation (SWAN) reveals that bleeding is usually associated with acceptable estrogen levels while amenorrhea is associated with low or undetectable estrogens. Bleeding episodes require an appropriate diagnosis, where histological investigation is mandatory. Treatment should address the organic pathologies, when present. Bleeding with anovulatory background may be managed with hormonal treatment. Surgery represents a desired option for some women.