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Monthly bleeding is a fundamental part of the menstrual cycle. The lining of the uterus thickens during your monthly cycle as it prepares to receive and nourish a fertilized egg. If no egg implants into the uterus, then the whole lining inside the uterus is shed through the vagina and out the vulva, resulting in a monthly flow of menstrual blood. This process is completely driven by hormones, so it is not surprising that the variability in hormone levels during the menopausal transition impacts this monthly cycle and affects the regularity, heaviness, quality, and length of menstrual bleeding. Any of these issues, alone or in combination, can have a significant impact on a woman’s quality of life.
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