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| Doctor, am I experiencing Perimenopause? | ||
| Q:
I have written before and your reply was very helpful. As I keep
reading I have noticed there are many woman in their early forties
like myself with changes regarding their menses. I would like to
know what hormone triggers the skipping of periods or like myself at
thirty eight had 2 periods a month for a while (the irregularity)? Is
it the progesterone that declines first to begin these changes? Was
there any thing I could have done then beside birth control to adjust
my hormones. Now at 42 I believe I am very perimenopausal and I
am too moody. w hen on the pill I am fine. Its just that I want
to know the process of this. I smoke and have for 20 years.
Do you think that has caused my perimenopause. My sister
started young also ,but she had a tubal ligation. My dads sister
at 40, and my mom was 51. So those are my questions. Is it
progesterone to go first and could my dads sister have anything to do
with my sister and I going through this early? Lastly the
smoking, my sister and I both smoke. Thank you.
A: Smoking is a very bad custom and it is also toxic for the ovaries. Furthermore, it lowers estrogen levels. Smoking is certainly involved in early menopause. Usually the first symptom of perimenopause is a shortening of the menstrual cycle and that is caused by rising FSH. FSH increases when the number of ovarian follicles decreases and less inhibin is formed in the follicles. With higher FSH the follicular phase is shortened because of a faster speed of developing follicles. In a later phase of perimenopause ovulatory problems arise with progesterone shortage. In that situation usually the menstrual cycle becomes longer again. |
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| Q:
I am a 40 year old woman and have
been having my periods at longer intervals, but with shorter
duration. My PMS seems to have increased since my last child was born
two years ago and my periods returned a year ago. My cycles were
never regular. My bleeding seems less heavy than in the past. In the
past few months I have been having what appears to be hot flashes,
mostly in the evening. I assume I am entering perimenopause.
I am also breastfeeding my 2 year old. She nurses about 5-10 times a day and sometimes once during the night. I know that lactation decreases estrogen production but, even though I work as a lactation consultant, have seen nothing about perimenopause during lactation. Could the breastfeeding have hastened my menopause? I do not feel that my symptoms are severe enough to require treatment, but I do want to know if I am entering menopause. I have been advised by my mother (who is not a health care provider) that this is impossible as all the women in our family enter menopause "late in life." I believe there is more to the timing than just heredity. Could I be perimenopausal and has the
breastfeeding contributed to it? I have no plans to wean my child
before she is ready for it and may be breastfeeding an other year or
more if she likes.
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| Q: I'm a 32 years old for 4 months I have been having hot flashes,
mood swings, loss of sex drive, breast tenderness, sleeping problems,
irregular periods (sometimes two in one month) aches and pains of the
joints. I always have to go to the bathroom and very
tired all the time. My Doctor suggested that I was depressed, which I
feel is wrong or that I was in postpartum depression I also feel this
is wrong. My hormone levels are all normal as well. She gave me some
estrogen pills but she said if I can't use them because of headaches,
she won't be able to gave me anything else. Can I be in perimenopause
and still have normal hormone levels?
A: Normal hormone levels exclude perimenopause as a cause. Depression or anxiety disorders are much more likely to be the cause of your problems. |
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| Q:
Most of your advice is to women who have changing menstrual times. My
periods are very regular. Always right on day 28. I am on no
medication. But I have debilitating fatigue. The fatigue is most of
the time but occasionally gets so bad I cannot walk for a day or two,
then I will get better for awhile. It sometimes is connected
with times for hormonal changes (ovulation, and estrogen ups and
downs) but not always. But my periods are always normal. At age 52 I
expect it to be perimenopause as tests have ruled out thyroid, adrenal
problems, CFS, MG etc. But is there ANYTHING I can do about the
fatigue? I've had to quit work etc. A: Chronic condition of fatigueness is a very difficult problem. It is not in the field of gynecology and has nothing to do with hormones or with perimenopause. I cannot help you. Please consult with your doctor. |
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| Q:
I have been suffering from "formication" of
the legs and arms for a few years now. I am 50 and in the middle
of menopause (e.g. periods coming and stopping - hot flushes etc.)
The formication started about 5 yrs. ago. It is much worse if I
eat sugar, so I try to cut it from my diet. I also have another
sensation on the inner thighs of the legs if I fail to wear trousers
or pajamas at night and that is a stinging sensation. It
awakes me in the mornings. There is absolutely no skin rash at
all. Also after contact with water (a shower especially) I have
itching of the legs and arms (nothing to do with dry skin as my skin
is not dry). Sometimes my legs redden slightly in this case but
not always. Do you think this is food intolerance (when I was
sick a week or two ago and I had nothing but water for 2 days my skin
felt perfect, with no formication and no itching), or do you think it
is the hormones or a mixture of both? I am trying to be my own
doctor as I have seen countless doctors for this problem and nobody
has been able to help me. The problem is dominating my life and
I feel very desperate. Can you give me any advice? Thanks
for your help. A: Formication is a symptom frequently cited as a climacteric symptom, but in daily practice it is not seen very often. The mechanisms involved are obscure. There has to be a changed sensitivity of the small nerve ends in the skin. In your situation, the symptom started already before perimenopause and a hormonal relation is for that reason very unlikely. Your observation of no complaints during a period without food points to a dietary cause of the problem. It is very troublesome to find out what dietary substances has to be omitted. Orthomolecular medicine claims to be helpful, but I have no experience with that kind of medicine. |
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| Q:
I'm 48 and I have not had anything removed No operations. Can
menopause or HRT therapy cause facial numbness? Tingling around the
mouth area and tongue? I have had a MRI a CT scan a brain stem test. I
have seen my dentist and a ENT and a neurologist. and of course my
regular doctor. All the test have come back fine. I was completely
fine before I started menopause. I am sure I'm menopausal because of the
blood work also I haven't had a period in over 6 months. I have been
on Prempro (the peach one) and Prempro (the blue one) Phempase,
Estratest, Progestrone and Activella and now I'm on Evista. And I
still have the numbness and tingling. Also when it feels like my
period is going to come, my teeth ache too. This has been going on for 2
years now with no relief. As soon as I open my eyes in the morning I
feel it until I fall asleep at night. Every single day. Some days it
is worse then others. Also I have a very big problem with my libido I
have none at all. I went from being very sexual to nothing. I have no
nipple sensation and I don't have any clitoris sensation either never
reach orgasm. I never had a problem before I started menopause. My
neurologist put me on Elavil I was on it for a little over a year. Now
he took me off it. thought that could be a side effect (sexual). My
question is. Do you have any knowledge of what I'm experiencing? Or
could you give me some suggestions as to tell me Doctor what kinds of
tests to do to see what is wrong with me? I have no problems in my
marriage. It is not all in my head. I feel this everyday of my life.
Like I said I have had many tests done and I still don't get any
answers. I hope you can suggest something...I really need help
with this. And all my doctor's don't know what it is. Could this
be some kind of Hormonal problem?
A: I have no suggestion for you. Your symptoms are strange to me and I see no association with hormonal treatments. |
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| Q:
Hello, I'm
a 24 year-old woman. I am wondering if I'm having symptoms of
menopause. Although menopause usually comes with older women, I
am afraid that I am experiencing that signs of menopause. Well, let me
tell you what I am going through. I get hot flashes from my chest
once in a while. Currently, I am having period right now and seems
like the flash is coming more frequently. I am having period regularly each month but the amount and duration of flow have been decreased as I get older. From second day of period, the flow gets to decrease a lot and I get only little period from third day to around fifth day (usually the last day of period). I am worried because I am still young and I have to get pregnant when I get married. Currently I am not sexually active. Does menopause have to do with past sex activities? And I have never had surgery in my life. I don't take contraceptive pills either. Please tell me whether I should get examined at the clinic. I am so afraid and afraid to tell my mother about this. A: Don't worry. No sign of menopause at all. Some women experience hot flashes also in other conditions, by eating hot pepper for instance. Also during the premenstrual days hot flashes are sometimes observed. Also no relation exists between sex activities and menopause. No visit to any clinic necessary for a completely healthy women. Please check-out the OBGYN.net Young Woman Section for more articles and information. |
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| Q:
I
am a 52 year old woman who has a history of heavy periods (was anemic in
high school!). I have been
having heavy bleeding with clotting lasting 3 - 4 weeks
over the last 4 months (with 2 - 4 weeks off in between). I
have had the
lab work (drink water/ take picture, bone
density screening, blood tests, and
physical exam/pap) and the only things found were osteopenia, anemia,
fhs of
about 27. The
doc suggested hormone therapy (my sister has had breast cancer)
or the endometrial ablation with a d & c. I
am very hesitant to do the hrt and not
sure of the out patient surgery. How
long could I
let this
go on without serious problems developing? It
is taking away "quality of life"
as it is....could progesterone therapy help (either topical or oral?)
Thank you very
much. A: This is a question of how to manage menorraghia. Menorraghia can be cured with surgery (hysterectomy, endometrial ablation) or with medical treatment. Oral contraceptive pills can cure the problem as will the levonorgestrel-IUD Mirena or the antifibrinolytics Cyclokapron. Please check-out these articles by Paul D. Indman, MD "Perimenopausal Bleeding - what's normal?" and "Diagnosis of abnormal uterine bleeding, fibroids, and adenomyosis". |
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| Q:
I am a 38 yr. old female that
had her first child at the age of 16. Second child born at age of
21 and my tubes were tied at that time. I feel like the past 10
years I have been in perimenopause. I have hot flashes, night
sweats, mood swings, cramps, vaginal yeast infections before period, but
still have very heavy bleeding. It's like if it can happen it will
happen to me. Hormonal tests were done and as you could guess they
came back normal. Hello I am not normal. A woman knows when
there is something wrong with her body and this is not normal. Can
you please give me some advice. I have tried Birth control pills
and they do help for approximately 3 months and then all symptoms
return. I did pretty well on the Depo shot except I bleed every
day for 9 months so I stopped them. What about the Progesterone
IUD? Would that be an option to help my perimenopausal
craziness? Please write me to help the crazy woman that has
nothing wrong? Thank you so much. A: This problem has many signs of Premenstrual Tension Syndrome (or PMS). Please check-out the OBGYN.net PMS/PMDD Collection for more information. |
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| Q:
I am currently being
diagnosed with CFS/FMS. Along with the CFS/FMS symptoms, I have also had
laparoscopic surgery for "mild" endometriosis last Sep 2000. The endo
pains left up until
March, and since about April, I have had very weak periods. I used
to have
heavy 7 day flow of very red blood (normal), with much PMS; lately, my
period was coming 3 or 4 days late and only lasting maybe 2 or 3 days.
Since April, the only flow I have is black gook; it's like rotten blood.
This month, my period has not come at all. I have hot flashes, joint pains, small round balls inside my body in all areas that get bigger and smaller, IBS, severe abdominal pains, back pain, muscle pains, chronic fatigue, problems breathing, constant weight gain/loss regardless of food intake, cramps, and skin rashes, and am experiencing a lot of the same problems as my 52 yr old mother who is menopausal. I see several specialists, due to the CFS/FMS and endo, and recently the endocrinologist pointed out that because I am now having vaginal dryness and sometimes "leak" urine (very infrequently-usually is it's very hot), that I might be having early menopause. He had blood drawn to check my hormone levels. Could you suggest anything I might want to bring up or ask the doctor. I would appreciate it greatly if you could possible review these symptoms, and let me know if you have seen anything in the same category. Thank you so much for your time and assistance! A: In this story I recognize nothing that points to perimenopause. Perimenopause is extremely rare on your age. Your endocrinologist will discover that with certainty by the blood tests. |
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| Q:
I had my hormones tested a few weeks ago, estrogen and testosterone was high.
But my progesterone was very low,
so I was given a cream to apply daily. What role does the progesterone play in the change of
life? How long will I be able to tell a difference in the way I feel?
I am 50 yrs old, also had a hysterectomy at the age of 32 with ovaries
left? A: Progesterone is not necessary for women without a uterus. Furthermore, in all women progesterone is virtually absent during the first half of the cycle. Progesterone is present after ovulation during about 14 days and absent in the rest of the menstrual cycle. There is no reason at all for taking progesterone cream in your situation. |
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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. |
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