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| Doctor, am I experiencing Perimenopause? | ||
| Question: What is the difference
between menopause and perimenopause? I am suffering from hot
flashes, night sweats, heart palpitations, dry eyes, irritability and
sensitivity, crying for no reason, dizziness, etc. Of course,
not all of these symptoms are constant, they come and go. Answer
blood test showed that I have the estrogen level of a
"post-menopausal" woman. What is going on?
Please check-out "Menopause, Perimenopause & Postmenopause: Definitions, Terms & Concepts" by Peter Kenemans, MD, PhD |
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| Question: I just turned 40 and for
about the last year I have had noticeable health changes. My
periods were coming anywhere from 3 to 5 weeks apart and lasting only
3-4 days. Now they are back to about 4 weeks apart, but last
only 2-3 days. Also, I was having significant abdominal bloating
a few days before my period and also extreme breast tenderness.
Those symptoms continue, but now start earlier in my cycle and last
longer. I have been taking Wellbutrin for about 3 1/2 years for
depression, but in the last year I also started having about 1 day of
severe moodiness and nearly uncontrollable rage a few days before my
period. My psychiatrist has started me on an extremely low
dosage of Zoloft (12.5 mg) (in addition to the Wellbutrin) to counter
the rage and it seems to be working. I frequently wake up at
night feeling either uncomfortably hot or cold and I have feelings of
abdominal pressure or nausea when I lie down at night. Do these
sound like symptoms of perimenopause? Answer: This symptoms are a part of the premenstrual tension syndrome, not perimenopause. The cause is probably a disturbance of serontonin. Serotonin reuptake inhibitors do help. |
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| Question:
Are there specialist who deal only with menopause and symptoms?
I have been to doctor after doctor and taken antidepressant and
different estrogen replacements. I had thyroid surgery last fall and
went on hormone replacement several months before. I have spent
the last year bouncing around from Ob-Gyn to endocrinologist to
psychiatrist and feel worse than I have ever felt with mood swings,
crying episodes. Any suggestions would greatly be appreciated. Answer: Every gynecologist has to be familiar with (peri)menopause, but some are more familiar than others. Please check-out "How to Find Doctor Right!" by Aniruddha Malpani, MD |
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| Question:
I am 42 years old. 7 years ago I was treated for Graves Disease.
I have been hypothyroid for almost 6 1/2 years and am currently taking
synthroid and cytomel. Having a normal level of thyroid has not
been easy for me over these years. Suddenly this month my
periods changed....and I started again today for the 3rd time this
month. I have noticed that I am overheated at times, but that
can occur with thyroid issues. Can this be perimenopause? Answer: There are lot of reasons for bleeding problems and bleeding three times a month needs further investigation. Consult your doctor. |
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| Question:
At age 38 my doctor said I was perimenopausal. I am now 42 and
have not had a period for 1 year, but fsh test show that I am still in
perimenopause. What could be making me not have a period for so
long? I still have mood swings and I am tired most of the time.
I feel like I have PMS all the time. Answer: Maybe high prolactin or other endocrinological disorders. What is the perimenopausal FSH level? What is the level of estradiol? |
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| Question:
I have had 2 miscarriages in the last 6 months and I am 38 yrs. old. I
had an endometrial biopsy done & it indicated I have a luteal
phase defect and then I had an FSH level of 35 on day 9 of my cycle.
Could I be entering menopause and if so what are my chances of having
another baby? Answer: FSH can vary enormously. A day 9 level is not the proper one for diagnosis. We prefer a day 3 level for pregnancy prognosis. The change for miscarriages increases with age. High FSH on day 3 makes the change for a new pregnancy low, but it happens from time to time. |
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| Question:
I am a 48 year old Caucasian female, married 8 years, no
children. My menstrual cycle has recently shortened from a
consistent 27 days to 25 days. I understand this could be the
beginning of the perimenopause phase of my life. I have been
experiencing periods of memory loss. Is this part of
perimenopause? I am also experiencing unevenness in my
disposition or mood. Is this part of perimenopause? After
an extraordinary 30 + year sex life I now have diminished (or no)
libido. Is this part of perimenopause? I am also
experiencing frequent insomnia. Is this part of perimenopause?
Could this be diminished testosterone? Do you have suggestions
regarding these perimenopause questions that I can present to my
health care provider? Answer: You have many questions at a time, but there is no reason to consider a decrease of testosterone as a cause of a changed sex life. Testosterone will remain at a constant level until far after menopause. Also memory loss is a questionable symptom. Your mood swings are compatible with perimenopause. |
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| Question:
I am a 30 year old experiencing changes in my monthly cycle that have
been worsening since age 28. I have extreme mood swings in a
matter of moments. My periods are heavy with clotting for two
days, stop completely for 1 to 2 days, then begin heavily again
(cramps and all). Sometimes this occurs more than once during my
period, extending the menstrual cycle up to 12 days. During
ovulation week, I am nauseated with unusually painful cramping.
I have virtually no sex drive, which is a major change for me. I
am on no medications except for Prevecid (for GERD). Am I going
into menopause or could something else be the cause of these symptoms.
I cannot tolerate birth control pills. Answer: There is no reason to consider perimenopause as a cause of your problems. You have to decide yourself to take birth control pills or not. But they are excellent for cycle regulation and for ovulatory problems. Periods of 12 days are not normal. Do you have consulted a gynecologist for that reason? Please check-out the OBGYN.net PCOS Pavilion for more information about your question. |
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| Question:
I'm 44 years old had my tubes tied 19 years ago. I've missed 3 months
of periods is it possible that I'm pregnant or is it more likely to be
menopause? Answer: The possibility of pregnancy still exists after tubal sterilization. The change becomes lower with age, but you have to check it. |
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| Question:
I am 43 years old and had a partial hysterectomy at the age of 25 (the
doctor left one ovary). For the past year I have been having
occasional night sweats. My sleep has really been disturbed by this.
I also get a little nauseated with this. Since I do not menstruate how
would I know if these were perimenopausal symptoms? I talked
with my Gyn doc last year and asked him to do a hormone level but he
said that it wouldn't indicate perimenopause. Should I ask for
hormone replacement? Answer: Perimenopause can be diagnosed by a FSH test. With one ovary it is not unlikely to experience menopause earlier than the mean. You have typical perimenopausal complaints and I suppose that your ovary is not working as good as in the past. With estrogen replacement your nightly flushes will disappear and sleep will be better again. |
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| Question:
I am 50 years old and I am in excellent health and physical shape. I
have been on HRT for 6 years. I have a great deal of
breakthrough bleeding every day. Is there a better regime that I
can try? My gyn history includes endometriosis and infertility (I took
Danazol 20 years ago), left oophorectomy, resection of right ovary for
endometrial tumors at age 30 and at age 32. At what point is
hysterectomy recommended? Answer: I can never recommend on hysterectomy only with a history. There are a lot of other relevant considerations before such a decision. You are using a continuous combination of estrogens (premarin) and progesterone (prometrium) and with such combinations erratic bleeding is often seen. Alternatives are birth control pills, or sequential combined HRT such as Premphase. |
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| Question:
I am 46 year old still getting my periods, but notice that I get migraine
headaches with my period. What Should I do ? Do you have any
natural treatments? Also what labs should I have to find out if I'm
perimenopause and when should I have the labs drawn in my cycle? Answer: Menstrual migraine is a rather common problem. During that time estrogen levels are low. Sometimes the use of estrogens during that week will be helpful e.g. a one-week patch during the menstrual phase of your cycle. Perimenopause can be diagnosed by elevated FSH, but such a determination is not really useful. FSH can fluctuate enormously during perimenopause and it will tell you nothing about what to expect with the menstruations. |
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| Question:
At what stage of menopause will I be unable to get pregnant? Answer: You can never say never, but after 12 months of amenorrhea there is almost no chance to become pregnant again. |
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| Question:
I am 36 years old and I am in good health. I have been spotting up to
2 weeks before my period starts and my periods are coming sooner. I
also have been experiencing a lot of gas pain in the 2 weeks prior to
my period. Approx. 1 week before my period, I also suffer from
indigestion, which worsens 1 to 2 days before my period starts. Am I
experiencing Perimenopause symptoms? Answer: It looks like Premenstrual Tension Syndrome. |
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| Question:
I am 53, had a hysterectomy 5 years ago for heavy and extended periods. Right ovary
removed also, hot flushes commenced and increased by stress,
especially severe emotional stress, but also physical stress,
like late night or illness, but can be absent for months on end.
Only other symptoms weight gain, especially on stomach, irritable
bladder, and loss of libido. My skin is still oily, and I have
very few lines. I am on thyroxin for longstanding Hashimoto's disease.
Am I perimenopausal as I think I must be, and without periods as
indicators, how can I tell when the process is complete? Many thanks. Answer: Yes, you are perimenopausal. The process is complete when symptoms are over. There is no other way than waiting for that. No diagnostic test available. |
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| Question:
I am a 51 year old woman that has been diagnosed as perimenopausal,
but I was given no hormonal tests or any other exam. I went to
the doctor because I had two irregular periods, and fibrocystic
breast problems. However, I have none of the typical
perimenopausal problems. I am thin and in good shape (due to
regular exercise) and have no other health problems. What I want
to know is how can one be diagnosed as perimenopausal when one does
not have the typical symptoms.
Does age 51 always mean perimenopause? Answer: Perimenopause is defined as the period before menopause with irregular menstruations. No complaints are necessary. Sometimes women have no complaints at all during the total perimenopause. At the age of 51, irregular periods are nearly always a sign of perimenopause. No tests are necessary, no tests are conclusive. |
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| Question:
I am 44 years old a mother of 4. Have had one ovary removed, one tied
11 years ago. And in the last month I have had 2 periods first one in
the beginning of the month flow was heavy, the second one, the second
week of the month flow was heavy 11 days later still light bleeding.
My breasts were not tender with the first period but with this second
one am in pain all the time especially if they are bumped & they
hurt when I take off my bra. Is there a medical reason for this such
as menopause? Or is there an under-lying problem? Answer: You have had now one strange bleeding period. Maybe this is the start of a period of irregular and heavy bleeding, that needs thorough investigation. Maybe it was just once an anovulatory bleeding: a breakthrough first and two weeks later the anovulatory menstruation. Wait and see what happens next time. And if it is again an abnormal bleeding, consult your physician. |
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| Question:
I am a 43 yr old woman. This month I had a positive home
pregnancy test on day 20 of my cycle then negative the next day.
I was told that perimenopause could cause false positives. What
happens during perimenopause to cause this? Answer: High levels of LH (Luteinising Hormone) can cross-react with the pregnancy hormone hCG, hCG is tested in pregnancy tests. |
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