Are these symptoms of Menopause? Are these symptoms of Menopause? page 2 What about life after "the change?

Doctor, Are these symptoms of Menopause?

Q: Irregular Periods I am 50 years old and experienced irregular periods right up to my 40s. Then they came like clockwork. Almost exactly the time I turned 50, they became irregular again. One cycle lasting up to 37 days and next 26-28 days. Is this a sign of the onset of menopause? I have no other symptoms associated with menopause. Thank you for your response. A: Maybe your problem in the past was PCOS: Polycystic Ovary Syndrome. That syndrome with irregular periods is usually cured by time with diminishing cohorts of follicles in the ovaries. So periods become regular. And now it is the time for the change. However, you cannot diagnose that with only one prolonged cycle. Wait and you will see what is happening. (Please visit the OBGYN.net PCOS Pavilion for more information on PCOS)

Q: Does early menarche mean early menopause? I am 47 years of age and started my monthly at the age of 8. Does this give me reason to start menopause early? I was given provera to see if I had anything left for bleeding but to no avail. I have the night sweats really bad and the attitude change is scary. Or is this all in the mind? A: An early menarche is not related to early menopause. The remainder of your question cannot be answered due to a lack of data.

Q: Should I have my estrogen levels checked? I have been having intermittent hot flashes for several months now yet I have not missed a period. My OB/GYN told me a year ago that unless I start missing periods or experience an irregular cycle I could not be in menopause. I am 45 years old and due to see my doctor soon. Should I request a blood test to measure estrogen levels? I also have frequent headaches, lower mid and right side abdominal pain, fatigue, and irritability at times other than the onset of my period. A: Blood tests are usually not helpful. Be aware for psychological problems. Anxiety, and panic, can mimic perimenopausal symptoms.

Q: Am I too young for Perimenopause? I am a 42 year old woman with symptoms of Missing periods, seldom night sweats, moodiness (which I was on Celexa for a short time) felt better though and sleeplessness. My periods may come every two months, every three months, sometimes they actually fall month after month. A great deal of cramping that I have never had even as a teenager and Adult. I was told by a gyn that I am too young for all of these symptoms. Could you tell me if I really am too young, or maybe I have to look at another answer. My last Pap test done just a few months ago came out negative. My FSH levels are at 28. A: No one is too young for perimenopause. And your symptoms with the FSH levels and your age make the diagnosis perimenopause rather likely.

Q: Change in sleep patterns, irregular periods, are these symptoms of perimenopause?I am a 43 year old. Last spring, I skipped 3 periods. There were no other symptoms. This year, I started skipping periods again, one month it would be very light, the next month, very heavy. I now do not know what to expect. The last couple of weeks, it has taken me longer to fall asleep and I'm up a little earlier now. Are these symptoms of perimenopause? I thought I was a little too young to be starting menopause. I don't have any hot flashes or dizziness, but I can walk into another room and forget what I was going to do. Although this only happened to me once or twice. Please let me know if there are any natural remedies for perimenopausal symptoms and if I am truly experiencing them, what can I expect from now on? A: Only time can tell you what will happen in the forthcoming years. But without any complaint, why worry about remedies? 43 is not too young to start with perimenopause. This period will stay for 4 years (mean) and sometimes much longer.

Q: Missed period I am 43, apparently in good health, and am usually very regular with my periods. This month, however, I felt all the build-up to a normal period, then 4 days before it was due I had some very slight blood spotting. Then nothing! Should I be worried? Could this be a symptom of perimenopause? A: There is no reason to be worried by 1 unusual period. Wait to see what happens next month.

Q: What happens to fat women during menopause? A: Basically the same as with thin women. However, women who are overweight have an large amount of adipose tissue, or fat tissue, on their bodies. This tissue can produces estrogens all by itself, so women who have a lot of adipose tissue will have extra estrogens in their bodies because of the extra estrogens made in this tissue. They consequently do not have as fast or as large a decline in the estrogen at menopause because of this extra production, and rarely become as hypo-estrogenic as someone who has less adipose tissue. After menopause the basal metabolic rate slows down so women need less intake than before just to stay at he same weight. So many women will grow somewhat if they continue with the same diet and intake. Be careful. It is important to diminish your nutritional intake after menopause if you are overweight.

Q: No periods for two months and I'm not pregnant I am a 36 year old women with normal cycles till about two months ago. I still get the symptoms of a monthly coming on the lower back ache, the bloating, break out on my face, the high energy and the low energy but no menstrual flow. Sometimes when I make love to my husband during the time I will have some blood flow. but nothing like a normal flow. Is there a reason for why I do not have the monthly flow and only the symptoms of the cycle. I am not pregnant. A: There is a need for proper evaluation of spontaneous amenorroea at your age. Go to see a gynecologic endocrinologist

Q: Spotting between periods I'm 42, for the last 3 months I have bleeding between periods. Sometimes it is a pink discharge, other times it is actual blood. For about two days during my period I bleed heavily, this has been going on for over a year. My primary care physician did a pap smear and an endometrial biopsy, both were negative. She says its hormonal fluctuations. Is there a need for me to follow this up with a gynecologist? A: Intermenstrual bleeding needs further investigation. Maybe it is a submucosal myoma, but other causes are also possible. Bleeding between regular periods are usually not caused by hormonal dysbalance.

Q: Does irregular bleeding signal menopause? Over the last few months I have been passing a lot of blood clots with my menses. It usually happens on the 2nd & 3rd day, the worst being on the 2nd day. It is uncomfortable and I spend a lot of the day in the restroom changing pads. My menses still occur on a regular monthly cycle, and I bleed approximately six days. I am 41 yrs. old. I have been told that my uterus is enlarged, although I am not sure how much, and no further testing was discussed. Do I assume this is normal for my age? A: Your problem is hypermenorroe. With regular menstruations it is usually a problem with your uterus. When bleeding is causing anemia, further investigations are necessary. With age the mean amount of blood loss with a period increase from 30 ml to 60 ml. So you can decide for yourself if further testing is necessary.

Q: Do long cycles mean menopause? I am a thirty year old female with 2 children aged 6 and 12. I've had abnormal paps twice, had LEEP about a 18 months ago, and cryotherapy about 2 years before that. Paps since my LEEP have been normal. Since discontinuing the Depo-Provera shot about a year ago, my cycles for the last several months have been every 38 days whereas they were always 28 days before. Could set your clock by them. I called my family practitioner's office and they asked when my last pap was. I scheduled an appt to go in a few weeks. Should I be concerned about this? There is no history of ovarian, cervical or breast cancer in my family..... but since they asked about my last Pap...... I'm worried. Should I be? What are they thinking? Seems rather early for Menopause.... or is it? A: A cycle of 38 days is not abnormal. It fits in a completely normal hormonal milieu. And it has nothing to do with cancer. Early menopause is extremely unlikely.

Q: Heart Palpitations and Perimenopause I am 44 years old and am in the perimenopause stage. Every so often, I'll experience a month where I have a lot of heart palpitations, sometimes lasting several days straight where my heart is not beating regularly. Years ago this happened and I had an echocardiogram, stress test, halter monitor for a day, and an EKG, and everything seemed to be normal except for a slight MVP and a heart murmur, which I've had all my life. Then the symptoms disappeared for a while, or would only happen occasionally. Now, at the age of 44, I find the palpitations are happening more often. There is no chest pain or shortness of breath involved, although occasionally I do feel a "fullness" in my nose, if that makes any sense! Is this a normal or common occurrence in women of perimenopausal age? Naturally, when I go to the doctor, the palpitations disappear. Just like when you bring your car in for repairs and it doesn't make that strange noise anymore! A: Palpations is a matter of unrest. You can get them as you work too hard, and in many other circumstances. Especially when you take a rest after a busy day. Seldom there is a relation with heart disease. Perimenopausal palpitations have to do with flushes and vascular instability. Without flushes, no relation with perimenopause is to be expected.

Q: Perpetual PMS or Perimenopause? For about the last 2 years My periods have been very hard with gushing upon standing for the first 3 days then it slows down but continues for about 10 days. There is a bloody discharge for a few more days after that. Lately it has been coming every 22 days. It feels like I am always in the PMS state with my stomach bloated and my breasts tender. What is going on? Is this how menopause starts or does it sound like a problem? I had my last check-up in October of 99. Should I call for an appointment. I was told unless you soak a pad an hour not to worry about it. I sure would like to know if this is common. A:  This pattern of bleeding is called menorrhagia. Menorrhagia can exist with regular periods or with cycle problems. With regular periods one has to search for uterine problems like myomas. With irregular cycle ovarian function is likely to be involved. And with your PMS like complaints this is likely your problem now. And with a treatment of the cycle problem (with oral contraceptives?) usually the bleeding problem will stop also. Consult your gynecologist for an advice.

Q: Enlarged Uterus My uterine lining measured 8mm on a transvaginal sonogram. I am 54 years old and have been without a period for 4 months. Is this a concern for hyperplasia that should be treated immediately with a progestin? (I have never had heavy bleeding. My doctor ordered the sonogram because my periods were light but long and he suspected that I am not ovulating.) I am not pregnant, as was confirmed by the sonogram, but feel that I am. If this feeling suggests that I am producing unopposed estrogen, what are the chances that this condition would correct itself and that I would eventually shed my uterine lining without taking a progestin? What risks are associated with a 14 day course of Prometrium, 200mg/day? What are the risks of doing nothing? A: A uterine lining of 8 mm after 4 months of amenorrea is suggestive for some proliferation of the endometrium due to estrogenic stimulation. It is completely normal in this period of life. The thickness of the endometrial lining has only meaning in detection of hyperplasia and carcinoma at least 1 year after menopause. Before that time no one has done adequate research and the sign of endometrial thickness is atypical. With a course of Prometrium 200 mg for 14 days, most probably a withdrawal will occur. Normally one has not this information and waits if a next bleeding will occur. perhaps yes, perhaps no. Again, this is completely normal in perimenopause

Read Past Ask The Expert Topics Note: Opinions expressed here are for educational purposes only and, as such, do not constitute and should not be interpreted as initiation of a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.