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| Doctor, am I experiencing Perimenopause? | ||
| Q: I sure hope you can answer some
questions for me. I will soon be 47 yr. old and in pretty good
health. I thought I was premenopausal about 3 yrs. ago and my M.D. put
me on prempro 0.625mg/2.5mg. After about 3 mo. I started
bleeding heavy, so I went back, he then gave me the cream and put me
on Testosterone. My periods stopped, after 30 days of this treatment he
took me off this and left me on the prempro. I still had spotting in
between periods every month without the testosterone. I have since
moved to another state and went to a FNP. She took me off the prempro
and didn't prescribe anything. I told her I thought I might be going
through the change, because of my abnormal bleeding, night sweats, and
mood swings, I don't have hot-flushes at all. About the last 3 months
I have been spotting in between periods, about 5 days before my period
and during my ovulation. I also feel like I am extremely bloated. Is
my spotting normal? My regular periods last about 7 days counting my
spotting, I bleed heavy for 2-3 days. I get one week a month of
freedom. When I do have periods I have a lot of strings and
clots. Is this normal? Sometimes I will have 2 periods a month lasting
about the same. I go 21-28 days pretty regular, not counting the ones
in between. I don't have high blood pressure and only a few heart
palps. The heart disease on my father side is extremely high. Should
I ask to be put back on a prescription? I also have an 8 year IUD.
This will have to be removed in 2 years. I hope you can shed some
light on this for me. Oh, I do smoke. A: This is a lot of information and indeed confusing. Using Prempro by a menstruating woman is asking for bleeding troubles. This kind of continuous combined HRT has to be reserved for women after menopause (no menstruations during 12 months). Even then, a lot of women (40-50% experience spotting or break through bleeding). Continuous combined HRT has not been studied in premenopausal or early perimenopausal women. The bleeding pattern can be caused by the IUCD, but also by a submucous myoma or by a systemic bleeding disorder. A gynecologic investigation with transvaginal ultrasound will give the information needed. |
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| Q: I
am 38 years old, and without question, am experiencing
symptoms of perimenopause. I have irregular bleeding, night
sweats, no interest in sex, and vaginal dryness. Most are tolerable
at present, except for the loss of sexual desire. I had
noticed a gradual decline over the past 6 months or so, but now it
has gotten to the point where it is totally non-existent. This
really bothers me more than anything. Is there a treatment for
this? I am in excellent health. I exercise
every day and have no other health issues. Thanks for any help. A: Loss of sexual desire is not a perimenopausal symptom. It can be caused by other reasons, like some medication or by a changing attitude toward your husband. It is a sexuological problem and that has nearly always a psychological cause. Consult a sexuologist when it is a problem to you. |
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| Q: My wife is 46 years old
and now says that she has no sexual desire for me or any man. She was
on estratest for two years, which helped some but now is concerned
that it is affecting her health so she has stopped. Do you think she is
undergoing menopause? She is normal in every way, very busy as she
owns her own business. She works 7 days a week unless we are on
vacation. She says the problem is not me, it is her? A: I think that you have already given the answer in the question. Working for 7 days a week is not healthy, certainly not when doing it continuously. Every person needs time for rest. Time for recovery of body and mind. This has nothing to do with menopause. Usually menopause does not affect libido. |
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| Q: Should
I be taking black cohosh for menopause, and can it cause muscle pain
in my legs? A: Why should you take any medicine, regular, herbal or homeopathic without need, without a proper indication? First of all, you need complaints. With complaints a proper diagnosis has to be made. When diagnosis is perimenopause, there are several possibilities for treatment. Black cohosh is one of them, especially for light or moderate vasomotor symptoms. Herbal medicines like this have not been investigated as regular medicines. So there exists no list of side-effects. |
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| Q: For over a year now, I
have been suffering from depression, insomnia and night sweats.
I went to my OBGYN. He said he saw physical signs that my
estrogen may be dropping (something about the way the inside of my
uterus looked). At any rate, we agreed upon a HRT. He put
me on Prefest. In less than one weeks time, I felt great, was
sleeping at night. Then, after the third month, I started getting my
period earlier and it lasted longer. The Dr. said that this is a
side affect with HRT. He said to stop the pills. I did and
the feelings I had earlier came back. I asked him about BCP's.
He said I was still young enough and let's give it a try (I am 46). At
any rate, I had to stop them after 1 week (was getting severe
migraines every day, getting worse). I want to go back on the HRT but
do not want to have my period every day! Will this eventually work
itself out? I now have my depression back and insomnia. A: Prefest is a regimen of 3 days of estrogens and 3 days of a combination of estrogens and norgestimate. Starting with a regimen like this before menopause (when periods are not stopped already for a year) is famous for bleeding problems. The best method of HRT in perimenopause is a sequential combined regimen: continuous estrogens and 10-12-14 days a month progestogens added to it. This will induce most times a regular cycle. Try premphase or another sequential combination. |
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| Q: I am a 47 year old woman
with a 6 year old child. I have been suffering from an early-morning
"fog" for about 3 years now. This has coincided with a house
move, a work move (starting a new company), an on-going lawsuit and
the typical stresses of a 47 year old and a 58 year old parenting a 6
year old. Upon waking I am in an extremely good mood - almost euphoric - but I
begin to experience extreme anxiety and a complete mental fog. The fog
can last all day sometimes or on a weekday it seems to calm down when
I sit at my desk and begin concentrating on work. Some mornings I am
cross-eyed and have trouble reading until all this settles down. My
doctor told me that the "eye thing" was due to being
prescribed glasses for the first time three years ago and the change
in wearing them and taking them off. I am usually a very
outgoing person enjoying being the hostess but now I find I don't even
want to invite someone over for a meal. This year I managed to cook
the Christmas lunch but went into a rage and couldn't eat it. Needed a
nap for two hours! Not much fun for a 6 year old! The normal demands
of a little boy make me fly into a rage at times. My periods are
VERY regular. Every three weeks for three days only. The doctors
say they can't test for perimenopausal symptoms because my hormones
haven't "packed" up completely. I am also very
forgetful and just kind of "spacey" at all times. If I take early morning exercise by
walking the dog I come back feeling worse. But at no time anymore do
feel euphoric or excited about anything. Just little things like
enjoying getting up early to pack for a holiday throw me and I can't
seem to cope. Any suggestions? A: These symptoms are not perimenopausal. It sounds like a depression. Ask help for it. |
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| Q: I will be 34 years old next
week. I was just informed yesterday my doctors office that I am
premenopausal. I have been experiencing classic menopause symptoms
for about 6 months. What can I expect in the future and how long
will this last. I am concerned about possible strange behaviors as
I am taking Zoloft for depression and zanax for anxiety. A: Depression and anxiety can mimic all perimenopausal symptoms. On which criteria your doctor has diagnosed perimenopause (you wrote premenopause)? Are there changes in the menstrual cycle? Is FSH already high? Or is it because of atypical climacteric symptoms? It is quite unusual to diagnose perimenopause at your age. |
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| Q: I am 43 years old.
For several weeks now, I've had the strangest sensation throughout my
upper body (chest and shoulders) that someone "plugged me
in" and there's an electrical current surging through me. It
bothers me mostly at night in bed, and sometimes when I first wake up.
Is it possible that this is hormonal, and due to perimenopause? Thank
you so much! A: These sensations are not known as typical climacteric complaints. A hormonal cause is very unlikely. |
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| Q: My doctor ordered blood
tests that say I'm not perimenopausal. I started a period 16
days after my last one and then again in 20 or so days. During
this time I am experiencing headaches, breast tenderness and cramping.
I've taken OC before but find that I have headaches, breast tenderness
and feel very moody. Is there something else I can do to stop
the headaches and breast tenderness? A: It is not clear why your menstrual cycle is disturbed. A cycle of 16 to 20 days (day 1 to day1 of the next period) is not normal. The complaints that you describe are usual seen before the bleeding and not during the period. Before the bleeding it is seen in the so called Premenstrual Syndrome. But with your breast tenderness with cycle disturbances also hyperprolactinemia has to be considered. It will be helpful to you and your doctor when you write down your symptoms and the days of bleeding in a diary. With daily a short note your doctor can easily have a good impression of the relationship of complaints with the menstrual cycle. |
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| Q: I am 31and for at least the past four
years I've noticed that my menstrual cycle is very unpredictable. I
always could predict when it would show up. But now they show up
whenever sometimes two a month. The flow can be different but its not
always that way. Sometimes I will stop for a day or two during
it only to start up for another day or two. My cycle can range
anywhere from 20 to 36 days apart. Is this premenopause?
I've always heard that this age is too young to begin that. I have had
four children, all healthy and normal pregnancies. I do
experience hot flashes occasionally, usually mid cycle. Mood
swings usually occur 1 to 2 weeks before I start. But these also
do not happen consistently. Migraines are also something that
seems to come and go. I've begun to experience acne, which is
something that has just happened within the last few months. If
you could give me some idea of what I am experiencing? A: A menstrual cycle with a range 20-36 days is not abnormal and completely compatible with a normal ovulatory cycle and with premenopause. Premenopause is the phase of life with normal ovarian function and normal fertility: the lifetime before perimenopause starts. During the days before a period many women experience mood swings and sometimes other symptoms. When this becomes a problem, premenstrual syndrome (PMS) is there. PMS has something to do with cerebral serotonin levels. Serotonin reuptake inhibitors can be helpful. |
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| Q: I am 48 years old and
have always had regular periods, usually lasting 3-5 days. For
several months they have become a little lighter and shorter,
and then maybe the last 4 weeks I have a very light period every week,
lasting 1-2 days then it stops. I have no symptoms like hot
flashes or headaches, maybe some mild anxiety at times, but not much
different than I always had. I had assumed that this change in
my cycle was the beginning of perimenopause, do I need to see my
doctor? A: This bleeding pattern is not normal. Shorter or lighter periods is not a problem, but bleeding every week is. This can be so called dysfunctional bleeding as often seen during perimenopause, but other problems must ruled out first. Consult your doctor for this pattern. |
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| Q: I am a 35 year old female that has had a tubaligation 6 years
ago. Since the procedure, there have been many things that have
changed. I have been to the OBGYN and discussed the pain in my stomach
before my period. I actually feel at times that I have been hit in the
stomach with a baseball bat. I am now experiencing night sweats and
frequent headaches, usually several times weekly. I am also these
symptoms experiencing some during the day. I have frequent hot spots
on my legs and cold spots in both of my hands. The advice I have
gotten is to take birth control pills or comments such as "you
know a women of your age". I can not take birth control pills
because of terrible mood swings. I am also experiencing severe mood
swings before my periods. My periods are also extremely heavy and last
5-7 days. Do you feel that these are signs of perimenopause or are
they signs from the tubaligation? A: These are not signs of perimenopause nor signs of tubaligation. I cannot help you with this symptoms. Please consult your doctor again. |
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