Menopause: From mild hot flashes to' gushing blood', here's what every woman needs to know

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.

When Giovanna Gerencser turned 50, she knew she was entering menopause. What she didn't expect was waking up in a pool of blood years later — landing her at the doctor's.

At the start of her menopause, Gerencser's symptoms were mild. "When I got my first little hot flash, I thought, 'I've heard about menopause for so many years, if this is what this is about, I got this'," she recalled thinking naively.

Gerencser, owner of skincare company Halo & Horns, said she was still having regular periods until about six months after she turned 50. One year later, she had a spontaneous period, followed by another year of nothing. "Exactly a year later, at 52 and a half, I got another period. And I thought, 'Oh, this is kind of weird. I hadn't heard of this before.'"

She went another fully year without any bleeding. "I was about 53 and a half, I think it was around November, December. I woke up one morning, and my sheets were full of blood," Gerencser said. "I ran to the bathroom and it scared the living daylights out of me. I was just gushing blood, and I felt extremely weak."

She then got up — and collapsed — before her husband took her to the doctor. The fear didn't end there, as she was told the extreme bleeding was "not normal" and she needed a biopsy to test for cervical cancer.

"I want to start crying thinking about it... He said, 'It came back negative.' And he said, 'I think this is just your one last hurrah'," Gerencser remembered. "He said I must have just had one last egg."

Now at age 58, Gerencser said she hasn't had a period since then, calling it "definitely" her "last period." Reflecting back on the "extreme" bleeding, she said she never saw that coming. "I've always had regular periods — regular blood flow, mild cramps — I was sort of one of the lucky ones, I thought."

As we mark Women's Health Week from May 12-18, here's what you should know menopause symptoms.

Is bleeding in menopause normal? What to know

A top Canadian gynecologist tells Yahoo Canada though heavy bleeding in menopause is scary, it's not uncommon. "Menopause is like puberty. So it starts slow, and it ends slow. So most of the time, it's not like an "on-off switch," said Dr. Diane Francoeur, CEO of the Society of Obstetricians and Gynaecologists of Canada.

"You can go a long time without having any bleeding, and all of a sudden, after a few months, it can bleed quite a lot." What women need to know in this stage is it's important to be seen by a physician.

"Sometimes they can bleed enough to need blood transfusion," she claimed. But also, "the first thing to do is to make sure the women are not pregnant."

Francoeur explained fertile women can get pregnant for at least a year after their last period in menopause. "We see that really commonly in women, menopause was there and they just had a miscarriage."

With abnormal bleeding, it's also important to get an endometrial biopsy and test for any cancer cells. "Those can be treated very easily, so it's important not to wait for too long."

What causes bleeding in menopause?

Francoeur said about 15 to 20 per cent of women will experience bleeding in menopause after not having a period for a while.

For women who have had "easy" periods in their pre-menopause days, their last few could feel intense even if they are normal, she said. But, you should always check with your doctor, because there's always a chance, Francoeur advised.

Here are some factors the expert named that can cause bleeding in menopause:

• hormone imbalances

• problems with the thyroid gland

• infections or STDs

• a miscarriage

• (pre)cancerous cells

"We always want to focus on the worst case scenario, which is precancerous or cancerous cells in the endometrium," Francoeur claimed, assuring that is usually not the case.

How to tell if your bleeding is normal or abnormal?

According to the expert, menopausal women need to track their blood flow. More than a cup of blood an hour, for several hours, is "way too much," for example.

"If you have big clots all the time, it means that you're bleeding more than usual, or if you soak your bed at night, or go around having to always change clothes — it means you're bleeding more than average."

Francoeur's advice is: don't hesitate to see someone. "I know it's really complicated to see a primary doctor but try to call in... Don't just ask your friends."

Let us know what you think by commenting below and tweeting @YahooStyleCA! Follow us on Twitter and Instagram.