Question: I'm 40 years old and suffering from some unexplainable mood swings as well as a sense of irritation at the slightest thing. Seem to be exhausted most of the time, even after getting a "good night's sleep". Have been fighting off Anemia brought on by very heavy menstruation. Taking vitamins and iron supplements as well as Ferrous Sulfate(Drug information on ferrous sulfate) three Xs daily. Is this a "normal condition" and just part of aging or could there be some underlying problems that I should be concerned about? During last physical exam, hormone levels were "normal".
Answer: There are several causes of heavy menstruations. And in case of anemia by heavy menstruation it is prudent to go for a proper diagnosis and appropriate treatment. Mood swings, irritation, tiredness can be symptoms of a depression. It is certainly not normal and not a part of aging.
Question: Throughout my entire life of menstrual periods I have never been regular. Some months missing completely and NEVER every 28 days.. usually 36 days. The last 2 periods have been 44 and 42 days apart in which the last one lasted 13 days. Now into my 17th day I have started to spot.. I am assuming I am going to have another period. I am bloated, irritable and tired. Is this normal and could this be the onset of menopause? I am 49.. This is very frustrating to me.
Answer: This is a typical story of anovulatory periods: irregular, long duration, spotting next cycle. The accompanying complaints are presumably caused by high estrogen levels. The best thing to do is a short course of a progestogen for 10-12 days. After that a withdrawal bleed will occur and the next cycle will start with a zero endometrium lining. For regular cycles you can repeat that every month from day 15 to 24 or 26 of the cycle.
Question: Have you heard of anyone having a burning tongue during peri-menopause? I have had this problem for several months. I mentioned this to my OB-GYN and she had never heard of this. What do you think? Everyone I mention this problem to looks at me like I am crazy and doesn't know what's causing this. Do you have any comments?
Answer: I know the symptom as a postmenopausal symptom not in perimenopause. Mouth complaints can occur with atrophy of the mouth epithelium. When that is the case, estrogen replacement will be helpful. If you have still periods, it is extremely unlikely that tongue burning will be caused by estrogen deficiency.
Question: I am 47 years and in the past year or so I have noticed that my breasts have gotten smaller without weight loss and my vulvar tissues have become "saggy" with some loss of volume along with an apparent decrease in clitoral size. I've not been sexually active for a while, so it's hard to say about vaginal dryness, but I do have a sense of irritation around the urethra (no infection) and a sensation of needing to void often, even when the volume is small. I've never heard any of these mentioned in discussions about menopause, but it seems they would be related to hormonal issues?
Answer: Smaller breasts and vulvar tissue are caused by a loss of adipose tissue. The size of your clitoris is maybe related to a lack of sexual activity. Vaginal dryness is not only a complaint manifesting at intercourse. Many women have also this sensation spontaneously.
Question: I am 41 years old and suddenly I am losing a good deal of my pubic hair. What could be causing this embarrassing condition?
Answer: Probably, a bad general condition. Do you live a healthy life? Enough nutrients and especially diversification of nutrients?
Question: 30 years, had a hysterectomy w/removal of a cyst from within L ovary 2 1/2 years ago, both ovaries still present. Experiencing for the last year, increasing in severity and frequency hot flashes, mood swings, joint pain, palpitations, headaches, back aches, lower abdominal pain (alternating sides) radiating down to groin/leg area at times. Skin changes, very irritable and irrational on some days, anxiety at times, hair loss, excessive facial hair, loss of concentration, forgetfulness, no sex drive, no energy, could sleep all the time. Breast pain and tenderness, also having a lot more problems with fibroid cysts in breasts. Have had two yeast infections in the last 8 weeks. Also, have gained 30 lbs since hysterectomy. Even though so young, could the hysterectomy and trauma to the L ovary be causing perimenopausal symptoms? Always have had hormonal "problems" PMS etc. Unable to take OC due to mood swings and depression associated with taking. Would really like some possible answers or at least something to start looking at.
Answer: I wonder what can be a reason for hysterectomy in a 28 years old woman. Do you had really problems linked to an abnormal uterus? Sometimes it is a cure for abdominal pains and so on, and many of that cases are in fact caused by psychosomatic problems. It is easy to find out if your ovaries are still functioning. With a FSH and estradiol(Drug information on estradiol) test. Sometimes blood supply to the ovaries are hampered by hysterectomy and ovarian failure can occur. But with normal FSH and normal estradiol, you have to find out with a psychologist/psychiatrist what can cause your problems.
Question: I have been asking my wife to ask her doctor about a minor problem, but she has understandably been embarrassed to do so. So I have taken it upon myself to ask. We have been married 5 years, and have had 2 healthy boys (ages 2 and 9.5 months). We have a healthy sex life, with only one minor concern: at the time of physical arousal, her vagina does not lubricate. We have employed the use of KY Jelly as a substitute for her natural lubrication. Is it possible to correct this minor problem?
Answer: No, lubrication is a problem for many women. Sometimes it will be helpful to prolong the length of foreplay. Women need more time to become excited than men. Sometimes, a sexuology problem will inhibit arousal and then the help of a sexuologist (medical or psychological) can be of help. Otherwise KY Jelly is a good substitute.
Question: I am 36 years old and from what I understand that would be quite young for perimenopause. I do have autoimmune issues: Hypo-thyroid (have been on Synthroid since I was 13. My mom, dad, sister & brother all have thyroid conditions.) Viteligo developed about 3 or 4 years ago (my sister lost all of her skin pigment in her teen years). I am unable to carry a pregnancy as I have a high level of NK cells - resulting in 3 miscarriages. Smoked for 20 years (just quit last year) & my periods have been on time, but very-very light & not really a blood color, more a rust color. I have been on & off of the pill for 20 years. About a year ago I started experiencing more mood swings than the normal PMS swings. I complained to my doctor last June of being really tired. I sleep quite well, but my muscles ache easily. My brain does not function as it once did. A lot of time I cannot speak a simple word or phrase that I can just about see sitting in my head, but won't come out. I would have to say that is the most frustrating thing to me. My family also has a history of depression, so finally when I felt totally out of control I had my regular doctor put me on anti-depressants (Wellbutrin). This is how I quit smoking. I have always been a hot-blooded person, but not so that I'm saturated when I wake at night or for that matter smack in the middle of the day. Everyone at my work has a heater under their desk, I have a fan. Anyway, the Wellbutrin has helped, but not as I thought it would. The brain still is not functioning properly, I still have mood swings (more in control though). My sister talked to me about perimenopause last year, but I went with the depression theory (made perfect sense to me), but now I'm beginning to wonder. I am on the pill as I do not want to have another miscarriage. Any information you can relay would be greatly appreciated.
Answer: In this story, I do not recognize perimenopause. I think your own idea is the best and not your sisters'. With birth control pills there are no manifestations of perimenopause and the scanty bleeding is nothing to worry about.
Question: I am 43 and for the first time in my life I had spotting around the 14th day of my cycle. My cycles are always 27 or 28 days and last from 5 to 7 days. My mother had a rare form of ovarian cancer at age 68, my older sister had Meigs Syndrome at 46. I had a normal pelvic and pap smear 2 months ago. I am not using contraception because I would like to have more children. Is this something to be alarmed about?
Answer: Mid cycle spotting can occur with the decrease of estradiol concentration
just before ovulation. Some women have this sign every month. It is essential that it is always in the middle of the cycle. When spotting occurs in other phases further investigation is necessary. Mid cycle spotting is not a sign for alarm, and certainly not when it occurs only once.
Question: I am 49 years old. Suffer from severe cramps for 2 days, and change pads hourly for the last 12 hours. Never had period the last 2 previous months. Is this the cause of my problem now? Is this to be expected? Thank you for any information you can give me.
Answer: This looks like anovulatory bleeding. During the 2 months without bleeding a thick endometrium is build and by missing the influence of progesterone(Drug information on progesterone) the growth goes further, and then (heavy) breakthrough bleeding starts. This can be stopped by a course of progestogens or a high dose (4 tablets a day) of a birth control strip (1 strip in 5 days). Anovulatory bleedings are often seen in perimenopause.
Question: I am a healthy and energetic 45 years old woman. I never paid too much attention to premenopause symptoms and always believed they were exaggerated. However, my body is giving me some signals to something I am afraid it is what I am reluctant to accept. I feel nervous (my nerves "jump" inside my body) and it takes me a while to go to sleep, but I am not sad, worried, hysterical or depressed and I do not have any hot flashes. This month something happened to me that never happened before: I had a regular period for two days and then spotting and light period for the next 11 days until now. My breasts were tender for many days, and I felt as if I were pregnant. Today is the 13th day and I have something that could be called a light menstruation with cramps. Yesterday I had a heavier menstruation with cramps. What could this thing be? It is very inconvenient to have the period for so many days. I have had checkups every two years and never had anything wrong. Is this the beginning of menopause? Does it mean I could have a prolonged period now every month? Is there anyway to stop it? What should I be expecting? Thank you for answering.
Answer: This looks like an anovulatory bleeding. Sometimes a follicle is growing in the ovary and when ovulation does not occur (and in perimenopause this will happen sometimes) the stimulated uterine lining will miss the effect of postovulatory progesterone. After a while it comes to so called breakthrough bleeding. Sometimes it is an isolated period, but sometimes it will happen for several months. The breast tenderness has the same origin. Oestrogens alone are the reason for it. To cure it, it is necessary to provide progesterone or progestogens in adequate amount. With a course of 10-14 days of progestogen (provera 10 mg or other progestogens as well) the proliferated uterine lining will go into the secretiopn phase and after stopping the progestogens a withdrawal bleed will occur. With birth control pills cycle disturbances like this will not occur. Also every month a course of progesterone from day 15 to 26 of the cycle will regulate your periods (day 1 is the day your period starts).
Question: I hear so much about menopause, I believe I am in Pre-menopause or perimenopause, are the symptoms the same just not as often or as intense? Can a hormonal imbalance be confused with perimenopause?
Answer: Premenopause has nothing to do with menopause. It is just the lifetime before perimenopause starts. So premenopause has no symptoms. Perimenopause starts with menstrual irregularity. A lot is said about hormonal imbalance, especially with premenstrual tension. But no one has ever given any proof of the hormonal levels involved. Usually birth control pills will overcome all kinds of hormonal imbalance. But many women complaining of hormonal imbalance have problems with taking pills.
Question: I am a 39 year old woman who had a hysterectomy 7 years ago. I still have both ovaries. For the past year I have been experiencing menopausal type symptoms. My mother entered menopause at an early age. I am also a smoker. Recently I have been noticing an increase in hot flushes and severe mood swings. I sometimes feel as if I'm losing my mind. My family doctor checked my thyroid and my fsh levels. They were normal but he also said this wasn't all that accurate since we don't know what part of my cycle I am in. He then told me I was too young and dropped the matter. Is it possible that I am perimenopausal and what testing can be done to check?
Answer: Yes it is possible, especially with smoking. Your mother had an early menopause and with smoking menopause will come 1-2 years earlier. There is no conclusive test, but a check for estradiol levels and FSH together is sometimes helpful. But it is rather the fluctuation than the level of estrogens(Drug information on estrogens) that is important. in case of doubt you can do a trial and error course of estrogens. Try it during 2 months and if you feel better, continue. If it does not help, stop.
Question: I am 47 years old and have a history of very large fibroids which have been surgically removed twice. The most recent surgery was exactly 1 year ago, at which time they also did a D&C. After my surgery my periods were fairly normal and regular. However, in the last two months I have not really had a period, but some very minute and light discharge that only lasted a few days. I do get severe cramping. Also, within the last year my breasts seem larger, and are quite uncomfortable. I have had a tubal ligation, so I don't believe I could be pregnant. Am I in menopause or perimenopause? Also, can I do anything to help the discomfort in my breasts?
Answer: Maybe your cycle is an anovulatory one. And with a persistent follicle the levels of estradiol can become very high and cause breast discomfort. The discharge you have had are possible breakthrough bleedings. It is likely that you call this perimenopause because this occurs on an age perimenopause starts usually. To cure it: a course of progestogens can counteract the endometrial problem. The breast discomfort will usually pass spontaneous with the disappearance of the persistent follicle.
Question: I am a 48 year Caucasian female that doesn't really have regular periods anymore; and is on Estratab for my mood swings. But since around January of this year I have had periods of short term memory loss. I am also on mysoline 50mg for a condition called essential tremors. My question is could this be part of the premenopause or possibly caused by the medication? I am scheduled to go through several tests next week and while I realize that you aren't my physician I am trying to give you some background on myself. I weigh 135 and am 5' 6" I exercise almost every day by either walking or an aquacise class. I also take Vitamins E, C, St. Johns Wart, Echinacea, every day. The vitamins in the morning and the mysoline and Estratab at night only. I am very concerned as I struggle every day with trying to remember simple things. Something I use to pride myself in was my excellent memory. Any ideas?
Answer: Estratab has to be combined with progestogens in women with intact uterus. In perimenopause the main problem is a shortage of progesterone and not a shortage of estrogens. And with extra estrogens the problem of your cycle is not solved and the risk for hyperplasia and prolonged bleedings become greater. Periods of short memory loss are sometimes seen in perimenopause but with already substitution with estratab, it is very unlikely that perimenopause will be the cause of it. I think that you can better consult your neurologist for this problem.
Question: I am a 36-year-old who has had a period since the age of 9. Until last year I was like clock work. Now I'm having two periods in one month. I was checked out and was told there is no way I could be even close to stopping. The women in my family have all had hysterectomy's by my age or a little older. I get big clots and really bad cramps. I'm being made to feel like I'm stupid or something. Is this a sign that I am going into menopause?
Answer: With these data I can not give any advice. Was it two periods in one month during one or two cycles or is this a persisting problem during many months. A disturbance in the cycle is possible in stress situations and with certain medication. You have to make a chart of the day your periods start over several months and deliver that for discussion to your doctor. He (she) will discuss with you if that particular cycle is a sign of perimenopause or not.
Question: I am a 41 year old woman with 2 children one at 35 by "c" section and the other at 38. Before I became pregnant with my last child I had 2 tubal pregnancies and I had to take the shot "that breaks down cancer", I forgot the name of it. I will be going to the Doctors as soon as I can get an apt, I have been spotting for over 11 days, and had a tubligation. My mother had cervical cancer at a young age in her 40's and I am also worried about pre menopause. My periods have been irregular and been coming about every 3 weeks for the last 3 months. I also want to make sure I don't have any type of ovarian cancer and would like to know the the name of the blood test I should ask for? And how can they check for cervical cancer? I had a pap smear about 3-4 months ago. If I am in pre menopause what do you suggest taking that helps with your bones and the heart?
Answer: Your bleeding problem has to be investigated by a gynecologist. I can not make a diagnosis without proper investigation. There is no routine test to rule out ovarian cancer. Both Ca125 and echoscopy are insensitive to rule out ovarian cancer, although they are worthwhile when a palpable mass is found. The test to rule out cervical cancer is a pap smear. For bones exercise and enough calcium is advised. look at our osteoporosis site. For heart: no smoking, exercise, fish oil. So general measures. Only when you have real risk factors a formal risk assessment by your doctor is prudent.
Please be sure to check-out OBGYN.net Osteoporosis Section for more information.
Question: I am experiencing perimenopausal symptoms off and on.....All of a sudden I'll start sweating in a store or I'll feel nauseous for awhile...I also get weepy at times and do have Bi-Polar Depression. My biggest problem is the sweating and nausea, I never know when they are going to come! It takes much of the enjoyment out of life, especially when I'm spending time with my college daughter. I am on a birth control pill w/estrogen which is supposed to help, but sometimes it doesn't. I tried a soy tablet and think I will go back on that for awhile. If there is anything else you can suggest, I'd appreciate it?
Answer: Sweating and nausea during the use of birth control pills have no relationship with perimenopause. The same symptoms can occur with panic attacks and maybe your depression can play a role. Extra estrogens are of no use for it when the problem is not a lack of estrogens. An exception can be when the symptoms are only in the pill free week. Sweating and flushes just in that week and not in the rest of the month can be a symptom of perimenopause.
Question: I am experiencing hair loss and hair thinning. Could these symptoms be related to perimenopause?
Answer: No, hair loss is usually a problem related to general health. With a poor general condition hair loss is seen. It is also possible, seldom, that an excess of androgens is the problem but then hair loss is on typical places and not a matter of thinning. There is no relation with estrogens.
Question: I am still menstruating, but have become more irregular since a rectocele repair 6 months ago. My 1st period was "normal" the next month there was none, then one that was 23 days, and the last 2 have been "regular" but decreased in duration and flow. My doctor ignores the initial issues, and says the recent irregularities are related to the surgery? I also have had a lot of memory problems, which initially surfaced as part of a major depressive episode, but the depression is well controlled and the memory has improved, but still is substantially less than previously. I'm not one to want to spend a lot of energy on paying attention to physical symptoms, but I don't feel right and can't help wondering if HRT would be beneficial. I've read that some physicians are prescribing it even if the woman is still menstruating. What do you think?
Answer: Surgery is a major event, and especially with ovaries which are functioning not as optimal as earlier (because of aging) irregularity of the cycle can be induced by surgery. Wait and see what will happen. Maybe a return to your normal cycle, maybe it is the start of permanent irregularity (perimenopause). I do not think that HRT will be helpful for your memory. It has most likely to do with your earlier problem of depression. Talk about this with your psychiatrist.
Question: For the past six months, I have been having periods that occur every 21-22 days. I am a 41 year old, 2 children, I had an ectopic pregnancy at age 20 which resulted in the loss of one of my ovaries. Night sweats were an issue 5-6 years ago and a blood test then indicated that my hormone levels were normal. With the inability to stay focused at work (or home sometimes), moodiness, irregular cycles, and what seems to be hot flashes occasionally. Should I be in the perimenopause period of my life?
Answer: It is possible that you are perimenopausal. With one ovary removed at age 20, the mean age of menopause is a few years earlier than in women with both ovaries intact. And the first sign of perimenopause is usually a shortening of the menstrual cycle. Normal hormone levels are sometimes seen during this phase, although high Follicle Stimulating Hormone is also possible. The FSH level is fluctuating often and the test of today will not reveal the same results as the test of two weeks ago.
Question: I'm 48 and have had irregular periods for 6 years. I have had 2 D&Cs and 2 ultrasounds and am now scheduled for another D&C. The results have always been a hormonal problem. My last D&C was 2 years ago and I took Premphase for 3 months but it didn't help my symptoms only worsened them. Before that I have taken provera for 3 months at a time but that didn't help either. The past 6 months my periods became very light and far apart, and I also experienced hot flashes. I assumed menopause was close but then I had a long period still not heavy but on and off bleeding for over a month. My next period and last was normal like I used to have , long but not heavy. I just had a regular ultrasound and my doctor says I should have another D&C because the lining of my uterus was between .6 to .7cm even though it was day 20 of a somewhat normal period. I have not been on any medication for 2 years. My main question - is this a normal thickness measurement seen in my age group and how soon can cancer develop since I have had a D&C just 2 years ago. My ultrasound also showed 3 small fibroids and my first ultrasound 2 years ago showed an ovarian cyst. It is very stressful to be constantly put through office D&Cs and constantly living with the fear of cancer. Do you have any suggestions for solving my problem and peace of mind?
Answer: Hormonal problems are not cured by a D&C. A D&C is only a diagnostic test. There are no normal values of the thickness of the uterine lining in women still menstruating. There are normal values for women after menopause. With the last bleeding more than 1 year ago, the lining has to be no more than .4cm. The most likely cause for your bleeding for a month is anovulation: a shortage of progesterone. My advice to women with bleeding problems during perimenopause is: a monthly course of 10-12 days of a progestogen (in Europe we have many progestogens and all are OK for use, but in US usually Provera is used but prometrium is also good). Take the tablets from day 15 of the cycle (day 1 is the day your last period started). A withdrawal bleed will follow 2 days after the end of the course. As long as your ovaries produce oestrogens and the uterine lining is reacting bleeding will follow progestogens. Only when there is bleeding between the periods further analysis (hysteroscopy, D&C) is advised. Without intermenstrual bleeding the
possibility of uterine cancer is extremely low.
Question: I am a 37 year old white female. It took me 4 years to become pregnant with my daughter who is now 8 years old. I was told then that my progesterone level was quite low, and that that could be the problem. I find that I am having problems again. Before, my periods were always erratic (sometimes my cycles would be 30 days, sometimes as many as 45 days). My periods always were and still are very heavy for about 3 days and linger for 4 or 5 days afterward. I have the same achy kind of breast pain I had while experiencing infertility. I was told then that it was probably due to low progesterone. My cycles now for the first time ever are sometimes as few as 25 or 26 days. I experience the emotional part of PMS and breast pain most of the month sometimes, even during menstruation. What do you think could be wrong?
Answer: It looks completely normal now with your cycle and PMS and breast pain. Maybe in the past PCOS was the problem: polycystic ovary syndrome. Your periods and fertility problems indicate that. However without further data I can not diagnose that now. But PCOS will resolve spontaneously with age. And it is not unusually that women with PCOS have normal periods 26-28 days later in life. The PMS and breast tension is usually seen only in women with normal ovulatory cycles. But when it is troublesome, you can try a birth control pill. That will help usually.
Please be sure to check-out OBGYN.net PCOS Pavilion for more information on polycystic ovary syndrome.
Question: Hello I am 42-years-old and in the last two years my periods have been every 26 days, prior to that every 28 days. In the last two months I started taking metab-o-lite to help me lose some weight which I have lost 30 pounds and feel good. But now I am 4 days late on my period and I did ovulate and I am still cramping no bloating no tender breast but some headaches. I quit taking metab-o-lite yesterday cause I can't figure out why I am not having a period. I did a pregnancy test yesterday and it showed negative so what could be wrong? I had a pap smear 4 months ago and it came out fine. Please get back with me. Thanks.?
Answer: I cannot give you a proper answer. Maybe it is only this time that your period was to late and everything is fine now. But it is also possible that it is the very first sign of perimenopause. At the age of 42 you can expect some alterations in the cycle. Nothing to worry about. Complete normal physiology.
Question: I am 25-years-old. I was first diagnosed with endometriosis at the age of 18. At this age I went through a laparoscopy (laser surgery). I had a 6cm cyst adhere to my right ovary in addition to all the endometrial tissue all over my reproductive system (specially the right side). I was then, put immediately on Zoladex treatment for six months. One year later, I went through another laparoscopy (same ovary having problems). After that, I had 2 children, ages 2 and 1. All my life I had very regular menstrual periods. However, last month I got my period twice. This month I spotted on the 20th (experiencing leg cramps, lower-back pain, and marked hot flashes). Then, no more bleeding 'til the 24th, and then, 'til the 30th (although the associated symptoms have been constant all this period of time - the 10 consecutive days). I know it is maybe too early, by is there any possibility that these are the first symptoms of a very premature menopause?
Answer: It is quit unusual to have a premature menopause at the age of 25. It is impossible to suggest a diagnosis from this story. Maybe it is only this month a little problem and everything goes fine spontaneously. When your next cycle is again with problems then it is wise to consult your doctor.
Question: During perimenopause, can you get light-headed and dizzy for 4-5 days? I am currently experiencing this light-headedness and the doctor does not fine anything wrong. I have had a partial hysterectomy nine years ago and am now 48 years old. Thanks for your time.
Answer: Light headed and dizziness without other climacteric symptoms, such as hot flashes, are not known as perimenopausal symptoms.
Question: I am 52 yrs. old, had a hysterectomy when I was 25 (hemorrhaged after my son was born and the operation was an emergency to save my life). I was left with my ovaries and never put on any HRT. I have many seemingly unconnected symptoms, and don't feel sick, just not right. I have periodically aching hands and feet, fatigue, low body temp. (96.7), very low blood pressure (98/56), depression, weight gain, dry eyes, terrible memory, foggy feeling and loss of concentration. My sister has Hashimoto's and this sounds like thyroid to me, but the tests show normal. My doctor has put me on estrogen and progesterone for a month. Does this makes sense? He is doing an FHS, but having me take the medication before he gets back the results. What do you I think?
Answer: Ovaries are functioning after hysterectomy completely normal, usually until the normal time for menopause. Your symptoms now are not quite typical for perimenopause, but they might be caused by it. Given your age and this set of symptoms it is a good decision of your doctor to prescribe estrogens to see what effect this has. Try it for 3 months and you will know if it is helpful or not. There is no reason to wait for the results of the FSH test. FSH can fluctuate and the result is not worthwhile. It contributes nothing to the decision to treat or not to treat Progesterone is only useful to protect the uterine lining. There is no reason to use that without an uterus.
Question: I have been diagnosed at hypothryroid for about 13 years and have been on Synthroid. Within the past 2-3 years my thyroid levels have been unable to be regulated. My general Dr kept changing my dosages, trying 2 different strengths, etc. etc. etc. Finally referred me to endocronologist. Still changing my dosages around. I'm 40 years old. I keep asking about menopause/hormone levels/perimenopause and could any of this be affecting thyroid probs. They all dismiss this, but new Dr. has put me on same road of changing dosage of synthroid for 3 months, re-check, change dose, etc. I feel like my thyroid is low most of the time (tired, unable to concentrate, dry skin and hair, "clotty periods", sleep irregular, moody/depressed). Can some of these symptoms be perimenopause? Does it matter? What are treatments for perimenopause that might help thyroid issues? Am I crazy?
Answer: There is a relationship between thyroid problems and menstrual bleeding problems. The combination of your symptoms are likely to be caused by your thyroid problem and not to menopause. When you will take birth control pills, your cycle will be absolutely regular and for certain there is no sign of perimenopause. Try it and then you will know what symptoms persist.
Question: I am a 39-year-old woman who has begun experiencing periods with a strong odor. I also find myself sweating at night at times and that also smells strongly. Are these symptoms of Perimenopause? Thank you!
Answer: I can not find any study on perimenopause and strong odor. Bad odor is usually a symptom of bacterial overgrowth, especially intestinal bacteria can cause a bad odor from sweating and so on. Sometimes a short course of antibiotics (such as metronidazol) will be helpful. But you have to discuss this with your doctor.
Question: I have been experiencing severe night sweats...no other symptoms and get my period every month. Been taking all kinds of herbal remedies...not much relief. I wake up several times a night... soaking wet. Is there anything that relieves the night sweats?
Answer: Maybe it is caused by herbal medicines? Especially St. John's Wort can interfere with estrogen levels. But also you have to check thyroid hormone levels. And Panic attacks are also seen in combination with night sweats.
Question: I plan to see a doctor if I don't get my period. It's usually every 28 days but right now I'm up to 36 days. I feel fine and a home pregnancy test is negative. I'm 39 and wonder if this is just part of my getting older and progressing towards menopause? Thank You.
Answer: It is possible that this is a first sign of perimenopause. But usually a phase of shorter cycles come first. But 36 days is still within the physiologic range for bleeding. And sometimes it occurs once and after that you have to wait for many years before it happens again. You have to wait and see what the future holds for you.
Question: I have experienced irregular periods for the past 3 years of my life. I thought that after I had my first child that my system might correct itself. I have tried a variety of birth control pills, however they make me extremely depressed and moody. By the time I take Provera I am well into a 51 days before I start my next cycle. I swear that sometimes I get so emotional I can barely stand myself. I am a very friendly fun-loving person & I hate what is going on with me. Is this maybe a sign that I will go through early menopause? Should I suggest a possibility of hormone treatment to my OBGYN? Thanks.
Answer: What do you mean by irregular periods? Every 3 weeks or once in 3 months? I can not form an opinion without adequate data. What is your age? Have you had any endocrinological tests done and what were the results?
Question: I am 43-years-old and am having perimenopause symptoms - hot flashes, night sweats, and irregular periods. I am taking Prozac and I am wondering if this medication might be exacerbating the perimenopause symptoms? Also, is 43 too young to be experiencing perimenopause symptoms? I have not had a period in three months and I am not pregnant.
Answer: I have heard recently that Prozac is helpful for decreasing the number and severity of hot flushes, but nothing is published about that until now. There is certainly no reason to think that Prozac exacerbates the problems. 43 is not too young to start with irregular cycles. The mean age of menopause is 51 years. The mean duration of irregular periods is also 4 years, but it can vary from 0 to 8 years or even longer. Menopause as early as 46 is regarded as within the normal range. So 43 can be completely within the normal range for the start of irregularity. Only the future will tell us the truth.
Question: I don't know if you can answer this sort of question, or how you feel about "natural" remedies, but here goes: I am a 51 year old post-menopausal woman (went through it at 41) who happens to be married to a wonderful, loving man who still finds me very attractive; problem - I don't have any interest in sex. I don't mind it; it simply doesn't "turn me on" any more (it used to - very much!). I did try hormone therapy for a little over a year, but didn't like the side effects, and it didn't seem to help much with the hot flashes (which I still have, by the way). Please help - are there any herbs that will help me?
Answer: I am not a specialist in herbal medicine. As far as I know, no herbs have been tested to prove their efficacy for these symptoms.
Question: I am very interested in knowing a lot more about natural progestrone and its uses. Does it help in preventing osteo? Is it best used with estrogen replacement? Is it safe for the liver? Some of the claims for natural yam-based creams seem just too good to be true. Is there real research to show what progestrone can do?
Answer: Natural progesterone has two faces. One is the herbal medecine hype with unproven claims of everything goes well with natural progesterone. Search the net for the books of Dr Lee. And all your problems are over when using natural progesterone. The other is the use of progesterone as drug treatment with estrogens. Progesterone protects the endometrium and is necessary with estrogen treatment in women with an intact uterus. You can take Provera but natural progesterone is also useful. The usual dose is in sequential use 12 days a month 200-300 mg oral, preferable in the evening because a side effect is drowsiness. Or 100 mg a day in continuous combination with oestrogens. Tablets are available as Prometrium. Progesterone alone does not prevent osteoporosis (Dr. Lee's progesterone cream is the exception). It is safe for the liver..
Question: I was placed on Evista just about two months ago. I was also put on Fosamax. The Fosamax was dropped within 20 days as I developed a blistered itchy rash. I am 50 years old, had a hysterectomy at 37, left with only one ovary. Was never tested for hormone levels until this year. Also had Dexa scan which showed osteoporosis in hip early stages in lumbar spine. About the Evista, can that be causing my depression, weight gain (8 pounds in about 6 weeks) and hair loss? I have to clean hair from the sink after brushing my teeth. I am sweeping it from the bathroom floor every couple of days. Any experiences with this drug? Any similar complaints? Thank you for your consideration?
Answer: Evista is good for osteoporosis. The side effects are leg cramps and a small risk of thrombosis. Depression is not a side effect of Evista. Weight gain can be a symptom of depression. Hair loss has very seldom anything to do with hormones and are a sign of a bad general condition.
Question: I am a 41 year old female who has just recently been put on a medication called Tri-est 5 mg. and testosterone 1 mg. Could this medication cause my blood pressure to be higher, and cause heart palpitations? I have had a complete hysterectomy in 1992. I have never had trouble with my blood pressure before, I have been on this since December of 1999. Thank you for any help you can give.
Answer: I do not know the composition of Tri-est 5 mg. But I suppose that it is an estrogen brand. Estrogens (in dosage usually prescribed) do not increase blood pressure. They will lower the blood pressure a little. The same holds true for testosterone. Palpitations are also not caused by estrogens. You can get palpitations when you work to hard, or with another to heavy burden. It usually starts when you take a rest. It has nothing to do with cardiac disease.
Question: I am 51, have been perimenopausal for 2-3 years. Blood workup reveals I am menopausal with estrogen at high levels. I have cyst on one ovary which has increased (slightly) since 1993, have heavy periods with clotting 2-3 days during cycle (periods are irregular). I recently began taking HRT at my doctor's recommendation. I have tried 2-3 different types. I would prefer not to take HRT but am concerned about the cyst and heavy periods/clotting. Should I request my doctor remove the cyst and is there an alternative to HRT?
Answer: In perimenopause high levels of estradiol are often seen. And what is the reason to take extra estrogens when you have already high levels. Heavy periods can be caused by many reasons. But when local uterine problems are ruled out, a hormonal cause is likely. In perimenopause heavy periods by a shortage of progesterone is often seen. You can regulate the menstrual cycle by taking birth control pills, or by taking progesterone in the second half of your cycle. Provera 10 mg from day 15 to day 26 of the cycle will almost certainly induce a regular cycle and often without heavy clots. When your ovaries do not produce estrogens anymore, so with low levels of estradiol, this courses of Provera will not give a withdrawal bleeding, and maybe that is the time to start estrogens. A small cyst has to be evaluated by echoscopy. We usually remove cysts larger than 5 cm and cysts with septa and irregularities of the wall. But a solitary cysts completely black with ultrasound is nearly never malignant.
Question: I am 48 and perimenopausal as night sweats, hot flashes, and all that good stuff indicate. I had to fight with my doctor to get Estratest but finally did. But he also gave me progesterone. The dose is one each every day. Why the progesterone? Wouldn't the Estratest be plenty?
Answer: Estratest is a combination of estrogen and androgen. Estrogen will stimulate the endometrial lining and unopposed estrogen has the risk of endometrial cancer. Androgens do not oppose estrogens. You need therefore progesterone or progestogens. In perimenopause the continuous combination of estratest and progesterone will give a lot of bleeding problems. We do not usually advise a continuous combination before menopause, only after menopause. Before menopause our advice is: continuous estratest and monthly 10-14 days progesterone 2-3 tablets of 100 mg a day. Without the androgens, there are fixed combinations on the market like Premphase and others.
Question: I am 50, blood test results - post menopausal. 8 months no period, last month a period. Medications - Hyzaar and Allegra, good health, fibroids in breasts - no hormone treatment. About 9 months ago gums started swelling, dentist had me on low grade antibiotic program, kept it under control. Stopped treatment a week ago, gums swollen again. When I got my period last month, I was on the antibiotic and my gums really flared up. I have started taking soy supplements because of hot flashes and night sweats, it has really helped. Is there any information you can give me or suggest a treatment? The only thing my dentist suggested was looking on the net for information, which I have been doing, without much success. Should I be on HRT??
Answer: I do not expect any benefit from the use of HRT for this problem. Swollen gums are usually caused by paradontological problems, but your dentist can diagnose that easy, so this is ruled out. I am also aware of oral manifestations of infection with herpes simplex. This virus can live quietly for very long times in the knots of the trigeminus nerve and break out periodically. Do you have also have herpes labialis (herpes lesions on the lip).
Question: I have tried several HRT, but they all give me to much bloating and I feel as I need to urinate all the time. So my GYN tried me on Prefest. I felt okay at first but it made me feel real anxious and nervous - like being on birth control pills. I still have a uterus and stopped periods about 1 year ago, and age 51. Any suggestions for alternatives?
Answer: Bloating is a side effect of estrogens Lowering the dose will usually resolve the problem. I cannot tell anything about Prefest. In my country this brand is not available and on the net and in Medline I have not found anything about that medication. Do you have complaints that make HRT necessary? How is it without any treatment? Sometimes no treatment is better than the troubles with treatment.
Question: What are the possible side effects of using Premaphase? Has it been linked to an increase in breast cancer or uterine cancer? Where can we get more info on the drug and its expected results?
Answer: This website has information from the manufacturer, American Home Products: http://www.premarin.com/newindex.html
Question: I am a 51 year old woman in generally good health, 5' 2" and 10stone 4lbs. My last period was 5 months ago and after consulting my GP regarding vaginal dryness I was prescribed Oestradiol 0.6% Gel. When reading the instructions I have become worried about blood clotting and other side effects (I have a tendency to bruise easily) and to date I have not used it. Can you advise whether there are any risk to the use of this Gel, and if there are what are the risks, side effects of use and probability of risk occurring. Please also advise of any other information sources or if applicable more suitable products.
Answer: With estradiol gel it is necessary to take also progestogens for the protection of the endometrial lining just as with other methods of administration of estrogens. Blood clotting is a seldom seen complications with estrogens. The normal incidence is yearly 1 in 10000 women and with estrogens 2-3 in 10000 women. One is suggesting that with transdermal therapy the risk is somewhat lower than with oral estrogens, but this is as yet not proven. So the risk is extremely small, unless you have a history of thrombosis or familial inheritant trombophilia.
Question: I am 53 and have been on HRT for several years now. I started taking Prempro which seemed to cure my hot flashes for awhile. Then about a year ago I started experiencing them again. My GYN has taken me through several dosages of patches, cream, Premarin & Provera, and finally an injection. But nothing has relieved my feeling of hotness. My GYN has thrown up her hands and suggested I see another GYN because she has run out of things to try. Can you help me?? This almost constant feeling of hotness is driving me bonkers! Could my "hot flashes" really be something else and not part of menopause at all?
Answer: This is a constant feeling of hotness. Hot flashes are attacks of hotness. Hot flashes are there just for a couple of minutes and then vanish again. It is likely that this feeling of hotness has nothing to do with menopause, especially not when occurring during Prempro.
Question: I am 31, and had a total hysterectomy due to chronic pelvic pain that began 5 months after a tubal ligation. Since the hysterectomy, I had transient hot flashes that went away and now are back... I have insomnia, hot flashes, night sweats, joint pain and fatigue... is this perimenopause? Can this be caused by the hysterectomy? My estrodial levels are within normal levels, my FSH is 3.3, serum estrodiol 51 and my T4 is 6.5, T3 uptake 29.0, T7 calculation 1.9. I can't get any answers from my Primary MD and he won't refer me to a OBGYN. I am miserable. I now take Effexor ER at 120mg/QD for the mood swings, difficulty concentrating and my MD says the hot flashes and other symptoms are from the Effexor. My mother went into menopause at 43 and was post menopausal at age 51. Is it possible that I am perimenopausal or maybe my estrogen is within normal limits for the lab report but I need a supplement because I am symptomatic? Could the lab range not be normal for me and I need more estrogen or could there be something going on besides estrogen loss?
Answer: A hysterectomy for pelvic pain on the age of 31 is usually not done in my country (The Netherlands). It seldom cures the problems. The test results of your hormones are perfectly normal. So ovarian failure and menopause is ruled out definitely. Your symptoms may have a psychological source. You have to discuss with your primary doctor if a referral to a psychologist will be helpful.
Question: I had a vaginal hysterectomy 5 months ago for extremely heavy periods and a large fibroid, I had been on iron tablets for years. I am 42 and had hot flashes and palpitations about 5 years ago for a period of 6 months and since then have only had occasional hot flush (no palpitations) . I have also suffered from PMT for the past 13 years (since the birth of my youngest child). Physical and emotional symptoms for 15 days out of my 25 day cycle which was very regular. Since about 6 weeks post op I have had an increasing problem with hot flushes and night sweats every day - up to 5 a day and quite severe. My FSH & estrogen levels have been tested and are OK. My thyroid and blood counts are OK. But I have these flashes, night sweats, anxiety, mood swings, urinary frequency, also at times an exaggerated increase in sex drive. I don't have a problem with vaginal dryness. I am currently on a GNRH agonist with ERT. After only a couple of days on this my night sweats and hot flushes diminished substantially. I know that the GNRH agonist may not reach it's full effect until the 4 week mark. My question is that the ERT seems to have made a huge difference - perhaps that is all I needed? Because my levels were in the 'normal range' my doc thinks that I am unusually sensitive to the fluctuations in my hormones and that has worsened my PMT - but he has no answer for the night sweats and hot flushes. We are discussing the possibility of oopherectomy if this current treatment works - which it seems to be. Can one hormone test be conclusive - especially as it seems that I am fluctuating wildly since the operation? Any clues you could give me would be very much appreciated - I don't relish the thought of another op and am not convinced that ERT alone would not have solved the problem. What do you think?
Answer: Fluctuation of estrogen levels are more important for hot flashes than the absolute level. Try to have a constant level of estrogens and the best way to do that is with transdermal estrogens. But be aware that also depression and panic attacks can cause flushes. But with GnRH and ERT the real postmenopausal situation is mimicked. It is not easy to continue that medication for ten years. I suppose that this is a trial for oophorectomy. But after oophorectomy, you need also ERT for a very long time. So think about that before deciding such an important event.