Bleeding problems in late reproductive and perimenopausal years

Menstruation is the genital sign of systemic endocrine and immunitary events. Data indicate that the heterogeneity of perimenstrual symptoms is associated with levels of inflammation, triggered by the fluctuation and fall of estrogens and progesterone, at genital, systemic and brain level.
Abnormal uterine bleeding refers to any change in the regularity, frequency, heaviness or length of menstruation.
There are several potential causes for bleeding disturbances, the two most common being primary endometrial dysfunction and fibroids. Management of abnormal uterine bleeding involves both medical and surgical options and will largely depend on a patient's fertility plans and “meaning” of the uterus for her sexuality and inner self-perception.