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Perimenopause and continuous staining

13 November, 2008

Question:

I am 54 years old. I have been married for 30 years and began using the mikvah about 10 years ago when my husband and I started living an observant life. My periods came very regularly and I have never had any major questions or concerns regarding the observance of this mitzvah until now.

I had a normal period a few weeks ago. On the day before I was to go to the mikveh, I started having some light bleeding/discharge. It was not enough to require a tampon but I did need something to protect my underwear such as a light pad or "pantyliner." This seemed to be diminishing over a few days but it keeps coming back and I have not had anywhere near a "clean" day since this began 12 days ago. The discharge is now lighter and purely brown.

My question is this: does this now count as bleeding? what happens to a couple's sex life during the onset of menopause?

I saw my doctor today. She did some blood work to determine exactly where I am hormonally. She said that what I describe is a very normal, common way to go through menopause. Since she isn't Jewish, I did not discuss the implications of this from a Jewish standpoint. After an exam, the doctor said it looks like this is a totally normal process but wants to rule out other more serious conditions which mimic menopause — ie uterine or ovarian cancer. If it is part of menopause (the blood work will confirm this), then the bleeding could go on like this for a long time and is not at all predictable.

My husband called a rabbi he knows who does not live in our community. He said that it needs to be checked by a rabbi. For many reasons, this is a mortifying idea to me. We live in a very small religious community. The rabbi is not someone who I feel comfortable with at this level. I'm not sure that I would ever want to take a sample to any rabbi unless it could be done anonymously. Please advise. Thanks so much for your help.


Answer:

Kol hakavod on your increased observance!

Unfortunately, mid-cycle bleeding or staining is common during perimenopause. Please start by reviewing our article on Stains to make sure you are not considering yourself niddah at any time in your cycle when you are not halachically required to do so.

At this point, if the staining is light brown you should try to perform a new hefsek taharah and begin counting seven clean days again. If there are stains on the cloth that are yellow or light brown (the color of coffee with milk) without a reddish hue, they can be disregarded. Any other colors (pink, reddish, orange, darker brown) must be evaluated by a rabbi.

Many rabbis have an anonymous system in which questions or bedikah cloths are dropped off in a mailbox with any relevant details of the situation and a number/email to reach you with an answer. You or your husband should inquire with the rabbi (or his wife, if that makes you more comfortable) about how to go about dropping off cloths anonymously. It is important that you are able to bring questionable stains so that you need not be unnecessarily strict on yourself and delay immersion.

You could also look into the possibility of mailing bedikot or stains to a rabbi in a different community, with whom you feel more comfortable.

If you are having trouble getting through the seven clean days, we recommend that you perform only one bedikah per day throughout the seven clean days. If you notice that you are staining one day, you should skip the bedikah that day. It is important that you make sure to perform a bedikah on days 1, 7 and at least one more intermediate day. You also may find it helpful to change your underwear frequently so that stains do not accumulate to the size of a gris (the size of a US dime). 

Once you are able to immerse, you should take care to avoid becoming niddah from any further staining by wearing colored underwear and avoiding to look at toilet paper within 15 seconds after urination. If you are spotting, we do recommend that you abstain from intercourse until the spotting subsides.

You may want to refer your physician to www.jewishwomenshealth.org, our website for medical professionals, now also available as an app. The site is designed to assist health care professionals in providing optimal care to patients who observe hilchot niddah. While this staining is common at this stage in life, it may be helpful for your physician to understand the implications it has on your marital life.

Please feel free to get back to us with any further questions. If you would like to speak directly with a yoetzet halacha, you can call our telephone hotline, or click here for a list of community yoatzot in North America and England.


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