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Experiencing Changes in Menstrual Bleeding During the Menopausal Transition

This qualitative study of 61 women's perceptions of their experiences of changes in bleeding during the menopausal transition revealed great variation in the pattern of changes each woman experienced. Using grounded theory methods, four dominant processes experienced by women during the transition of going from a menstruating woman to a nonmenstruating woman were uncovered. These were: noticing menstrual cycle changes, relinquishing familiar patterns, taking precautions, and wanting it to end. The process of relinquishing familiar patterns was comprised of two phases: losing one's baseline and searching for validation. As menstrual cycle changes obscured a woman's familiar menstrual pattern, her focus shifted from what was normal for her to what was normal for women going through menopause. Variability and uncertainty replaced predictability and familiarity, traits that gave women an illusion of control over menstruation, the loss of which created more discord for some women than for others. These findings underscore how important it is for clinicians to understand the ways in which women perceive the changes in bleeding they experience during the menopausal transition. The findings also demonstrate the need for continued investigation and documentation of variations in bleeding patterns during perimenopause.