What Is Menopause Flooding? Ob-Gyns Explain

There are a lot of potential symptoms women can experience during perimenopause and menopause. Unfortunately, many aren’t discussed, which can cause you to be alarmed if you happen to experience something like menopause flooding.

If you find yourself suddenly soaking through tampons or pads at a rate you haven’t experienced before and you’re in your 40s, there’s a chance you could be dealing with menopause flooding, says women’s health expert Jessica Shepherd, MD, an ob-gyn in Texas and author of the upcoming book on menopause, “Generation M.”

This doesn’t happen to everyone during perimenopause — which is the lead-up to menopause — and menopause, but ob-gyns say that menopause flooding happens often enough. So, what is this phenomenon and what should you do if you experience it? Doctors break it down.

Experts Featured in This Article:

Jessica Shepherd, MD, is an ob-gyn in Texas and author of the upcoming book on menopause, “Generation M.”

Mary Jane Minkin, MD, is a clinical professor of obstetrics and gynecology and reproductive sciences at Yale School of Medicine and founder of Madame Ovary.

Lauren Streicher, MD, is a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine.

What Is Menopause Flooding?

Menopause flooding is another term for perimenopausal dysfunctional bleeding. This is basically a change from your usual period that can happen during the perimenopausal phase, which usually starts in the mid-40s, according to the American College of Obstetricians and Gynecologists (ACOG).

During a normal menstrual cycle, the levels of the hormones estrogen and progesterone increase and decrease in a regular pattern, per ACOG. Ovulation, which is when an egg is released, usually happens in the middle of the cycle. If you don’t get pregnant, you’ll have a period about two weeks after ovulation.

But that process changes in perimenopause. Your ovaries start to make less estrogen and may not release an egg some months, explains Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine. Periods can become shorter or longer, and the days between them can be longer or shorter, too.

During this time, women can experience “abnormalities in bleeding,” Dr. Shepherd says. “That can impact the duration of a cycle, intensity of bleeding, and disruption of regular cycles,” she adds.

Why Does Menopause Flooding Happen?

It all comes down to hormonal fluctuations, explains Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale School of Medicine and founder of Madame Ovary. “As we head towards menopause, we don’t ovulate as well as we previously had,” she says. “We make progesterone when we ovulate — so, indeed, we end up making less progesterone.”

Dr. Minkin refers to progesterone as the “policeman” of the lining of the uterus. If you compare the lining of the uterus to a lawn, she says that estrogen is like a fertilizer and progesterone is like a lawn mower. “When you are growing the lining — i.e., you still have a good amount of estrogen — but you’re not making as much progesterone, you build up a pretty good lining and ‘you can flood,'” Dr. Minkin says.

Symptoms of Menopause Flooding

Symptoms of menopause flooding can vary. “For some people, it’s like constant spotting,” says Dr. Streicher. “For others, it’s this huge, heavy flood.”

Dr. Shepherd says you may also experience these symptoms with menopause flooding:

“This can go on for years,” Dr. Minkin says.

Menopause Flooding Treatment

Dr. Minkin says that progesterone can be helpful in controlling the bleeding. “Progesterone is often used to regulate the bleeding and stop the flooding,” she says.

That can be given in the form of birth control pills, Dr. Minkin says. “Not only do pills have progestin — synthetic progesterone — to help control the bleeding, they also have estrogen,” she says. “So, if someone is getting hot flashes and crazy bleeding, they can be very helpful.”

But Dr. Streicher recommends seeing a doctor if you’re bleeding a lot. “If it happens once, you can pretty much ignore it,” she says. “But if it’s persistent or it keeps getting heavier, you should get it checked out. You don’t want to write it off.” These symptoms can also be a sign of precancerous growths, fibroids, and a range of other health conditions, she points out. “You don’t want to fall into the trap of thinking, ‘I’m 40 or older and it must just be perimenopause,'” Dr. Streicher says.

Korin Miller is a writer specializing in general wellness, health, and lifestyle trends. Her work has appeared in Women’s Health, Self, Health, Forbes, and more.