Monthly 2 times a month


By the age of 40, the reproductive system of each woman is undergoing changes. The hormonal background is changing, a smaller number of eggs are produced, reproductive capabilities are gradually fading.

At this age, the appearance of menstruation 2 times a month is possible. The reasons for this after 40 years may be hidden in hormonal fluctuations, diseases of the reproductive system.

Polymenorrhea - menstruation, occurring more often 1 time per menstrual cycle - may occur in the life of a woman and up to 40 years. But it is age changes that are the most frequent cause of failure.

Menstruation after 40 years: what is it normal

Irregularity of the cycle, changes in the volume and duration of menstruation by the age of 40 can be the norm, but various pathologies that cause this condition cannot be ruled out. Having crossed the line at forty years old, a woman should be especially attentive to her state of health, including the nature of regulations.

Normally, menstruation at this age should not be:

  1. Durable. Prolongation of menstruation may indicate a violation of blood clotting, the development of inflammatory processes, side effects from taking contraceptives, diseases of the uterus and ovaries.
  2. Frequent. Violation of the cycle, consisting in a full menstruation twice a month or the presence of blood discharge during the intermenstrual period (polymenorrhea) is the result of a gradual decrease in the ovarian production of the hormone estrogen. In rare cases, this phenomenon can be triggered by the formation of cysts, endometriosis, other inflammatory diseases - up to cervical cancer.
  3. Scanty. After 40 years, a decrease in menstruation is the first signal of the onset of menopause. Typically, this phenomenon is combined with a violation of the duration of the cycle, which can be reduced to 20-21 days or lengthened to 40-45 days.
  4. Abundant. Bleeding also speaks about the onset of menopause, may act as a companion of fibroids, endometriosis and cancer of the uterus.

A delay after 40 years, as at any other age, may indicate a pregnancy or be a symptom of a beginning menopausal period.

Causes of menstrual failure after 40 years

The restructuring of the hormonal background of each woman starts at different ages. But on average, changes in reproductive function begin precisely by the age of 40–45. Therefore, frequent periods after 45 years, dizziness, migraines, first hot flashes, changes in the nature of bleeding during menstruation are typical signs of the onset of menopause.

Menstruation at this age twice a month means only that much less female hormones are produced, the reproductive function decreases, there comes a menopause. At this age, problems with conception can manifest themselves: due to a decrease in the concentration of hormones, a decrease in the number of mature eggs, it can be difficult for a woman to become pregnant and bear a child.

Hormonal changes

Hormonal balance is the main factor responsible for female reproductive health. Normal concentration and the ratio of sex hormones provide the possibility of conceiving and carrying a child, the regularity of menstruation.

Early menopause (about 40 years) is most often caused by hormonal imbalances. The production of estrogen and progesterone gradually decreases, the menstrual cycle is disturbed, the general state of health worsens, and bleeding may occur, including between normal periods.

The less significant causes of hormonal imbalance at this age are considered to be irregular or uncontrolled use of OK, stress, physical exertion, improper lifestyle.

Inflammatory diseases

The frequency of the cycle is also affected by the presence of female diseases, such as:

  • colpit,
  • vulvitis
  • Bartholinite
  • adnexitis,
  • bacterial vaginosis
  • candidiasis,
  • obstruction of pipes
  • inflammation of the ovary or uterus.

Diseases of the female genital sphere not only worsen state of health and manifest themselves with pronounced symptoms, but also cause long-term effects - anatomical changes in the female body. Most often we are talking about spikes or obstruction of the tubes, which impair the blood flow in the soft tissues, reduce the likelihood of fertilization of the egg, affect the process of ovulation.

Also, changes in the menstrual cycle are manifested - menstruation becomes very painful, irregular, appears in the middle of the cycle, increases or, on the contrary, decreases the amount of discharge.

Inflammatory processes in the pelvic organs, experts put on the first place in the list of possible causes of infertility. It is chronic or undetected low-intensity infections that also cause early menopause.

Depending on the aggressiveness of the tumor of the female reproductive system is divided into benign and malignant:

  1. Benign tumors include uterine fibroids, cysts, ovarian tumors, serous cystoma, mucinous benign tumors, cystadenomas, Brenner tumors, stromal cell and germ cell tumors. Such neoplasms do not represent a great danger, but in most cases they are removed, since the risk of transformation into a malignant neoplasm increases. The diagnosis is made more often by biopsy, which additionally makes it possible to exclude cancer. The most common types of tumors developing in the female reproductive system are uterine fibroids and ovarian cystomas.
  2. Malignant tumors (cancer) require mandatory qualitative diagnostics and treatment, since such a condition is dangerous not only for the health, but also for the woman’s life. Cancer of the vagina, ovary, uterus and cervix, the labia often develops asymptomatically or has signs of another disease. The development of oncology can be detected with a sharp change in the nature of menstruation, the appearance of pain in the abdomen and lower back, severe bleeding, frequent unreasonable fever, external changes, constant fatigue, and weight loss of more than 10% in the last six months.

A reliable diagnosis of pathology can be made only by biopsy examination of the material - a piece of soft tissue (endometrium).

Treatment and diagnosis of failures in the cycle

The effectiveness of treatment and prevention depends not only on women's health in general, but also the timely onset of menopause, as well as the possibility of becoming pregnant during menopause, if a woman plans to conceive.

Prior to the definition of therapy, a compulsory diagnosis of diseases that may be the likely cause of a failure in the cycle is carried out. With abundant menstruation, the first drug prescribed to a woman will be a hemostatic agent. Other drugs are selected depending on the results of diagnosis.

Conservative methods

For appropriate treatment, you must consult a gynecologist. At the first stage, the disease will be diagnosed, which includes:

  • history taking with the definition of the time of the beginning of the change of the menstrual cycle,
  • gynecological examination, palpation of all available organs of the pelvis,
  • brush strokes
  • oncocytology (smear), especially when detecting pathological lesions on the cervix,
  • the exclusion of a probable pregnancy - a routine home test or a blood test for hCG,
  • study of endocrine status - determining the level of estrogen, progesterone, pituitary hormones, prolactin, if necessary, the study of thyroid function, adrenal glands,
  • Ultrasound - often used abdominal and transvaginal sensors,
  • histological examination of endometrial particles after prior curettage of the uterus - according to indications.

Treatment of abundant menstruation, when menstruation goes twice a month, is prescribed in accordance with the detected causes of violations of the hormonal cycle. It may include:

  • the use of hemostatic drugs with heavy bleeding,
  • elimination of hormonal disorders,
  • treatment of associated diseases - STDs, anemia,
  • revision of therapy used to combat major diseases (for example, hormonal drugs),
  • the use of drugs to stimulate the work of the ovaries, physiotherapeutic methods, phyto-and vitamin therapy,
  • the use of complex methods of infertility therapy (if you wish to conceive).

Operational methods

Surgical treatments for gynecological diseases of women are used for such purposes:

  • diagnostic and therapeutic curettage,
  • removal of polyps, cysts, myomas, fibroids,
  • resection of the ovary, removal of the fallopian tube,
  • extirpation of the uterus or other organs.

It is mandatory that all types of malignant neoplasms intervene. In this case, in addition to the removal of the tumor itself, chemotherapy and / or radiation therapy is prescribed.

Any failure of the menstrual cycle requires examination, and after 40 years the problem becomes especially urgent due to the increased risk of the formation of malignant and benign tumors.

Normal menstrual cycle

A woman's menstrual cycle depends on the lunar calendar, so normal bleeding should normally be once every four weeks, but no more. The normal duration of the period is from 28 to 32 days. This ensures the proper functioning of the reproductive system and indicates the body's ability to carry the child.

But there is a situation when the monthly go 2 times a month, and the reason - in a short cycle, for example, 21 days. This may be an individual feature of a particular organism and will not be a pathology. This can be observed in adolescent girls who have not yet established a stable production of hormones.

Regardless of the individual characteristics of each woman, there are generally accepted norms about what should be menstruation:

  • Duration 2-5 days (but not more than 7)
  • the interval between critical days is approximately 28 days,
  • heavy discharge characteristic of the first three days, then they go into scanty and even smearing,
  • menstruation should not be too heavy, normally a woman should change no more than 4 pads per day,
  • the absence of severe pain, forcing to take painkillers,
  • the absence of secretions of impurities in the form of pus, mucus or large clots.

Monthly 2 times a month: the main reasons

Consider the main reasons why the monthly 2 times a month:

  • Malfunction of the hormonal system. If hormones are produced in the body in insufficient quantities, this contributes to the appearance of menstruation a second time. Lack of progesterone will lead to premature exfoliation of the endometrium in the uterus. Inflammatory processes and infectious diseases can provoke improper production of the hormone.
  • Hormonal contraception. Acceptance of such drugs by a woman can cause premature bleeding in a woman. The situation can be repeated for several months, until the moment when the body's hormones stabilize and the menstrual cycle normalizes.
  • Ovulation. The maturation of the egg occurs approximately a couple of weeks after menstruation. If conception occurs, the fertilized cell moves into the uterine cavity and begins to attach to the endometrium. As a result of this process, damage to the capillaries may occur, resulting in a poor bleeding. This is the so-called implant bleeding.
  • Age. If there are monthly 2 times a month in adolescents, the reason for the formation of the menstrual cycle. The reproductive system is under development, so critical days twice a month are not excluded. To install the cycle will take about two years. If there are monthly 2 times a month after 40 years, the reason - in the coming menopause. The processes of aging of the body are launched, which has a direct effect on the hormonal background of the female body. There may be a situation such as monthly 1 time in 2 months, the reason is still in the same coming menopause.
  • Navy. This contraceptive can cause a discharge that can be taken for menstruation. If a similar situation arose more than once, and the allocation is abundant, it is necessary to consult a doctor and choose other methods against conception.

Menstruation Diseases Twice a Month

In addition to the above situations, there are various diseases that can cause menstruation 2 times a month.

  • Endometrial polyps and endometriosis. Diseases associated with the mucous membrane of the uterus. Inflammatory processes and neoplasms have a direct effect on the frequency of menstruation, because these are parts of a flaking endometrium.
  • Adenomyosis. Inflammatory disease that affects the endocrine system. From here and monthly twice a month.
  • Uterine fibroids. A benign tumor that has the ability to grow to very large sizes. The neoplasm leads to a violation of the synthesis of sex hormones, resulting in bleeding in the middle of the cycle. Treatment - drug or surgical.
  • Ectopic pregnancy. Attaching the embryo in the fallopian tube can lead to bleeding. This condition is dangerous to the health of the woman and requires immediate treatment to the clinic.
  • Abortion. If conception occurred, but the fertilized egg did not adhere to the uterus, it is rejected from the body. In other words - miscarriage in the early stages. In this case, there is bloody discharge, which does not depend on the regularity of the cycle.
  • Uterine cancer. Malignant neoplasms can lead to various symptoms, including menstruation 2 times a month. The spotting in this case may be watery. The diagnosis in this case is determined only by the doctor after the examination.
  • Problems with blood clotting. This is another problem that causes menstruation twice a month.

Influence of other factors

Often the appearance of bleeding in the middle of the cycle is not menstrual, but bleeding, which only resembles menstruation.

In addition to diseases and physiological characteristics of the organism, the following factors can lead to a similar symptom:

  • stressful situations
  • heavy physical exertion
  • climate change,
  • sudden changes in body weight.

How to accelerate the arrival of menstruation? Read in the article about the causes of delayed menstruation, medicines and traditional medicine to speed up the onset of menstruation, as well as situations where you can not interfere with the menstrual cycle.

After how many after childbirth begin monthly? Details on the link.

What to do?

If a woman noticed a failure of the menstrual cycle, it is better to get tested right away. The doctor will check up, appoint an ultrasound scan and take tests to determine the reasons.

Timely access to a doctor will prevent the development of conditions that are dangerous to a woman’s life and preserve the possibility of a normal pregnancy in the future.

Menstruation after 45 years: what is it normal?

When a woman steps over the line at 45 years, the nature of her menstruation should change: after 45 years her period should gradually disappear, the irregularity of the cycle at that age is a normal phenomenon, which indicates a decrease in ovarian activity. If earlier monthly went for 5 days, then at this age a three-day menstruation is the norm. The lengthening of the cycle is also considered normal. If earlier the cycle was 28 days a day, now pauses at 35 or even 45 days should not be embarrassing. The amount of discharge can range from heavy to scanty, and this is also considered the norm (if the duration does not exceed 7 days).

If the breaks do not increase and the amount of blood released remains the same, then this is a reason to visit the gynecologist. If menstruation is absent in 40-45 years old, then this indicates the onset of an early menopause, since on average, menopause in women in our country occurs in 51-52 years.

Abundant periods after 45 years

Many women after 40-45 years are faced with such a phenomenon - before this age menstruation was regular for 3-5 days and average in blood volume, and as soon as they crossed this age line, they immediately began to “pour like buckets”.

This phenomenon is a precursor of incipient menopause, so it is advisable to visit the gynecologist as soon as it happens. In addition, it can be a symptom of not only menopause, but also diseases such as:

The doctor should examine you for the above pathologies. If none of the diagnoses is confirmed, he will prescribe hormone therapy to alleviate the symptoms of menopause.

Long periods after 45 years

Lengthening menstruation is a bad sign, the appearance of which can speak of the following pathologies:

  • diseases of the genital organs (ovaries, uterus, vagina),
  • inflammatory process,
  • coagulability,
  • side effects of OK or other drugs

Frequent periods after 45 years

Some women experience the phenomenon of “menstruation twice a month” or bleeding between periods.

Menstruation more often than once a month is called polymenorrhea. At this age, it occurs as a result of the gradual extinction of ovarian function, producing estrogen (which regulates the duration and frequency of cycles).

If the "monthly" is not in time is not associated with the activity of the ovaries and are not polymenorrhea, then this may be one of the following phenomena:

  • endometriosis,
  • inflammatory diseases,
  • fibroids, cyst, polyps,
  • pill response,
  • bleeding from the uterus vessels, which, due to insufficient estrogen levels, become brittle, thin, and burst easily,
  • cervical or endometrial cancer
  • symptom vaginal prolapse.

What does delay menstruation after 45 years?

  1. unlikely, but pregnancy. Yes, a woman with good reproductive health can become pregnant even at age 45. If you decide to leave the child, you need careful medical supervision,
  2. endocrine disruption (special attention should be paid to the thyroid gland),
  3. side effects of antipsychotic or hormonal drugs,
  4. fibroids, polyps, endometritis, inflammation of the appendages and / or ovaries,
  5. diabetes mellitus, urolithiasis, cirrhosis, coagulability,
  6. consequences of a recent severe infectious disease.

Treatment of menstrual disorders after 45 years

Most often, the basis for the treatment of menstrual disorders in the age over 45 years is hormone replacement therapy. It helps to significantly improve the woman’s well-being and alleviate the manifestations of menopause symptoms - the hair and skin condition improves, the cycle is normalized, the emotional background stabilizes, etc.

If a woman has cancer, then hormonal chemicals are contraindicated in her. However, there are lots of homeopathic remedies that have the same effects. The only thing you need to start to apply them when the first symptoms of a violation of the cycle.

Alice Edelberg, obstetrician-gynecologist, especially for

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Causes and mechanism of development

Frequent periods in most cases arise as a result of disruption of complex relationships between the regulators of the menstrual cycle. They are based on hormonal imbalances that can occur at any level - the hypothalamus, pituitary, ovaries - and manifest structural changes in the mucous membrane of the uterus (endometrium). In varying degrees, this is characteristic of both young girls and women after 40 years.

The menstrual cycle consists of two phases: follicular and luteal. It begins with the release of blood, which is a detached endometrium. At the same time, under the influence of pituitary hormones in the ovary, the follicle with the egg cell matures. This process continues exactly half a cycle, and the monthly period ends normally in 7–10 days. At the end of the first phase, ovulation occurs - the follicle ruptures and the egg is released. From this point on, the corpus luteum, which secretes progesterone, necessary for the development of pregnancy, ripens in the ovary. If fertilization has not occurred, then the luteal phase ends with the next menstruation.

The cause of polymenorrhea can be hidden behind violations in any part of the cycle. Most often this occurs in such conditions:

  • Hormonal changes.
  • Inflammatory diseases (salpingoophoritis, endometritis).
  • Tumors (fibroids, cysts, polyps).
  • Endometriosis.
  • Common diseases (diabetes mellitus, thyroid pathology, liver cirrhosis).
  • Acceptance of oral contraceptives.

Frequent periods can occur not only in functional disorders - structural changes in the female reproductive system are also important.

In order to eliminate the cause of polymenorrhea in time, you should not rely on the possibility of self-recovery of the cycle, but you should be examined by a doctor.

Normally, menstruation is observed with the same frequency with an error of 10 days. If the discharge appears in less than 21 days, then we can talk about polymenorrhea. But such a violation is characterized not only by shortening the gap between periods. There may be other disorders of the menstrual cycle:

  • Abundant and prolonged periods - hypermenorrhea or menorrhagia.
  • Short menstrual cycle - pseudopolymenorrhea.
  • Scanty periods - oligomenorrhea.
  • Uterine bleeding - metrorrhagia.
  • Lack of ovulation (anovulation).

Such features of the cycle are observed in various pathologies, and therefore, to accurately determine their causes, it is necessary to conduct a competent differential diagnosis. This will help the clinical examination of women by a gynecologist with the necessary additional funds.

The reasons for which can go monthly 2 times a month

In order to determine whether a two-time monthly norm or deviation, it is necessary to objectively assess the duration of the normal menstrual cycle. After a simple mathematical operations, you can calculate the number of days from the end of one menstruation to the beginning of the next. If the figure is less than 30 days, the answer to the question is obvious.

Experts point out a number of factors:

  • adolescence,
  • preparing the body for menopause,
  • hormonal failure (hormone imbalance),
  • incorrect reception of contraceptives and the installation of the IUD (intrauterine device),
  • regular stressful situations and depression
  • the presence of diseases and pathologies of the uterus.

The menstrual cycle is disturbed after an abortion, after a miscarriage or childbirth. Under such circumstances, the discharge reappears per cycle, which is not considered a serious abnormality or symptom of disease. However, this is not the norm. A consultation with a specialist, carried out on time, will eliminate suspicion and prevent the possible development of serious diseases. The exception is women with pathology in the form of a bleeding disorder.

The cause of recurrent menstruation in women after 40 years

Menopause is a natural process that occurs as a result of age-related aging. The onset of menopause is indicated by the absence of menstrual flow for one year. After 40 years, the ovaries reduce their activity, resulting in significant disruptions of the menstrual cycle. Monthly come with delays or, on the contrary, arise again through a short period of time in the form of copious bleeding.

Climax develops gradually. Menopause occurs a few years after the onset of the first symptoms. If monthly periods began to come again in one cycle and your age is more than 40 years, then to compile an objective picture of what is happening, it is necessary to identify additional signs of the approaching cessation of ovarian function. The symptoms of menopause are individual, but some of them occur in most women.

  • the increase in the duration and profusion of menstruation,
  • the occurrence of re-discharge in one cycle,
  • fever, sweating,
  • drowsiness and fatigue,
  • sudden pressure drops.

After childbirth?

After giving birth, the woman’s body undergoes a recovery phase. This period passes in different ways and depends on the individual characteristics of the organism. Menstruation does not appear within a few months, and their renewal is directly related to the lactation period. The cycle in such a period is not distinguished by regularity, so monthly come with delays or twice a month.

What do repeated periods in adolescents 13-14 years mean?

In adolescents, repeated periods during one cycle are not a symptom of abnormalities or diseases of the internal organs. For the first time monthly appear in girls at 9-14 years. The first two years, the body is actively rebuilt and changed. The ovaries begin to perform new functions and are preparing for the realization of a potential conception.

For adolescents, irregular menstruation is a common and well-founded manifestation. However, at the slightest suspicion about the presence of diseases of the genital organs, you must constantly be observed by a specialist. If the discharge is too abundant, accompanied by sharp pain, clots appear, then the consultation of a gynecologist will prevent possible complications.

Are frequent periods and what to do?

With the regular appearance of monthly prematurely, it is necessary to undergo a course of examination. Frequent menstrual flow leads to anemia. After analyzing the causes of such changes, the specialist prescribes a specific treatment. Folk remedies or own initiative will cause significant harm to your health.

Traditionally, menstruation is stopped using drugs with a high iron content, hormonal agents, and special procedures. Ignoring the problem will not only lead to the development of possible diseases, but also cause infertility.