The universal sign experienced by all women who go through menopause is the absence of periods. Only 10 percent of women experience an abrupt cessation of their menses at menopause. The majority of women will experience some type of cycle irregularity for two to four years prior to the loss of menses permanently. Periods may get lighter, shorter, occur at longer intervals and become unpredictable. A good rule of thumb is less is better. Bleeding that becomes heavy, prolonged or too frequent requires further evaluation. A reliable method of contraception should be used until there has been a complete absence of periods for 12 months.

When to call your health care provider for abnormal bleeding:

When bleeding episodes occur at intervals closer than 21 days.

When bleeding episodes are heavier than normal menses.

When bleeding lasts longer than seven days.

When bleeding, including staining and spotting, occurs between periods.

When any bleeding occurs after 12 months of no periods.

When one is uncertain about whether or not her experiences are normal.