Possible perimenopause or other? Is it worth checking it out?
June 2, 2011 10:49 AM Subscribe
Menstruation every other month. Should I go to the OB or just chalk it up to craziness?
Prior to birth control, I've always had crazy periods (painful, hemorraging, etc). Endometrosis, adhesions, a few fibroids, but nothing alarming to the point of needing lupron/surgery. I did the infertility route, etc. and have a wonderful son (OB was shocked it was so "easy" for me). Birth control solved all of those issues and I pretty much have had regular periods. Sometimes breakthrough bleeding due to stress, messing up taking the pill, or needing of new birth control. I've been on Loestrin now since 2009 (prior to pregnancy too).
However, since having him, I've had wicked hot flashes (I'm 39). In 2008 my day 3 FSH was 9.2 so I was fertile but obviously getting up there. I don't remember my anterior follicle count (did clomid anyway).
And starting in Jan/Feb/March I had left ovarian pain which I totally blew off as typical cysts. Took a CT--no cysts although OB said they wouldn't show up anyway. The whole March/April stomach issues (upper GI; severe GERD), on Nexium, etc.
But now I'm getting this pattern:
March--no period/very, very light breakthrough
April--regular period
May (this month/now)--no period/very, very light breakthrough
WTH? I'm used to a period rollercoaster but I've never had "none to little" periods. I've been in and out of gastro/ER docs that I"m honestly fed up with going to anyone anymore and having a "you're fine, take Nexium" diagnosis. (not that I"m wishing anything bad).
So, should I call the OB or just chalk it up to stress, etc.? My mutliple thyroid and blood panels have said I'm 100% healthy.
My only concern is perimenopause/an ovary stopped working. Yes, despite my frequent past posts about marriage issues, fertility is still very important to me in principle. I'm having a very difficult time turning 40 and now with these symptoms (esp. the hot flashes) I'm realizing that menopause is a real issue for me.
Should I go to the OB and discuss these issues? Should I even bother with a fertility workup? (FSH/follicle count--not go all the way with HSG, etc at this point).
I don't know if the unknown/known is worth it if I'm stressed out now about 'what if'.
What other possibilities could it be? Cyst just stopping things? Overall I feel ok. Without a period this month (and the last time) I get sick--nausea, overflowing of hormone feeling, joints ache, etc. This I'm used to right before my period. But without a period, it's a week of this. Last month it was severe endo inflammation feeling (probably endometriosis) where I was begging the doc for some NSAID alternative (she never got back to me).
Prior to birth control, I've always had crazy periods (painful, hemorraging, etc). Endometrosis, adhesions, a few fibroids, but nothing alarming to the point of needing lupron/surgery. I did the infertility route, etc. and have a wonderful son (OB was shocked it was so "easy" for me). Birth control solved all of those issues and I pretty much have had regular periods. Sometimes breakthrough bleeding due to stress, messing up taking the pill, or needing of new birth control. I've been on Loestrin now since 2009 (prior to pregnancy too).
However, since having him, I've had wicked hot flashes (I'm 39). In 2008 my day 3 FSH was 9.2 so I was fertile but obviously getting up there. I don't remember my anterior follicle count (did clomid anyway).
And starting in Jan/Feb/March I had left ovarian pain which I totally blew off as typical cysts. Took a CT--no cysts although OB said they wouldn't show up anyway. The whole March/April stomach issues (upper GI; severe GERD), on Nexium, etc.
But now I'm getting this pattern:
March--no period/very, very light breakthrough
April--regular period
May (this month/now)--no period/very, very light breakthrough
WTH? I'm used to a period rollercoaster but I've never had "none to little" periods. I've been in and out of gastro/ER docs that I"m honestly fed up with going to anyone anymore and having a "you're fine, take Nexium" diagnosis. (not that I"m wishing anything bad).
So, should I call the OB or just chalk it up to stress, etc.? My mutliple thyroid and blood panels have said I'm 100% healthy.
My only concern is perimenopause/an ovary stopped working. Yes, despite my frequent past posts about marriage issues, fertility is still very important to me in principle. I'm having a very difficult time turning 40 and now with these symptoms (esp. the hot flashes) I'm realizing that menopause is a real issue for me.
Should I go to the OB and discuss these issues? Should I even bother with a fertility workup? (FSH/follicle count--not go all the way with HSG, etc at this point).
I don't know if the unknown/known is worth it if I'm stressed out now about 'what if'.
What other possibilities could it be? Cyst just stopping things? Overall I feel ok. Without a period this month (and the last time) I get sick--nausea, overflowing of hormone feeling, joints ache, etc. This I'm used to right before my period. But without a period, it's a week of this. Last month it was severe endo inflammation feeling (probably endometriosis) where I was begging the doc for some NSAID alternative (she never got back to me).
What's the downside of going to see the OB? It sounds like you've got insurance. I know that *I* would be on the phone making the appointment.
And even if it is stress (and I remember you've got a lot to be stressed out about! I hope that is going ok), these kind of physical symptoms need to be addressed, I would think.
posted by leahwrenn at 10:55 AM on June 2, 2011
And even if it is stress (and I remember you've got a lot to be stressed out about! I hope that is going ok), these kind of physical symptoms need to be addressed, I would think.
posted by leahwrenn at 10:55 AM on June 2, 2011
Yeah I'm thirding that I can't figure out any reason why you wouldn't go... The worst case scenario is the doctor confirms that there's nothing wrong, right? How would this be a bad thing? And if there IS something wrong then your doctor can help fix it, which is a good thing.
posted by brainmouse at 11:04 AM on June 2, 2011
posted by brainmouse at 11:04 AM on June 2, 2011
Hormones regulate the menstrual cycle and it's supposed to last 28 days. The fact that it's not even near to normal indicates the potential for a hormonal imbalance. There are any number of things that could cause this. It's definitely worth going to the OB and at least talking about it. (I'm not a doctor, I don't even play one on TV.)
posted by Apoch at 11:12 AM on June 2, 2011
posted by Apoch at 11:12 AM on June 2, 2011
Menstrual cycles do vary in length for different people, but I genuinely don't understand why you would ask the internet this question given your somewhat complicated history instead of your OB.
posted by Kimberly at 11:36 AM on June 2, 2011
posted by Kimberly at 11:36 AM on June 2, 2011
I had the same problem for years and was diagnosed with PCOS at 35yrs old. It is often common in women who have thyroid issues, too. I don't like taking meds and have been pretty great health otherwise.
Since hormones were out of the question due to a long family history of cancer,
I take a med. called Glyset (similar to Glucophage) that, per my endocrinologist and OB, regulates my insulin which regulates my estrogen and now I have normal periods, no cysts on my ovaries and had a healthy first pregnancy at 40.
Seems like an easy solution to a problem that plagued me for over a decade.
posted by flesti at 11:44 AM on June 2, 2011
Since hormones were out of the question due to a long family history of cancer,
I take a med. called Glyset (similar to Glucophage) that, per my endocrinologist and OB, regulates my insulin which regulates my estrogen and now I have normal periods, no cysts on my ovaries and had a healthy first pregnancy at 40.
Seems like an easy solution to a problem that plagued me for over a decade.
posted by flesti at 11:44 AM on June 2, 2011
Response by poster: @Kimberly, because lately (and cycle wise-historically) they never did have an answer. All blood work and even infertility testing came up with a big fat "beats me". Kind of leaves you with a "hypochondriac, never go to the doc because it's always not a big deal feeling".
posted by stormpooper at 11:45 AM on June 2, 2011
posted by stormpooper at 11:45 AM on June 2, 2011
Response by poster: @Blahlah--two different docs, two different hospitals, two different reasons. OB/GYN--general ultrasounds, etc. Reproductive endocrinologist--FSH, HSG, more ultrasounds to shake a stick at, blood tests galore trying to get preggos.
Final determination--unknown, all tests normal, suspected endo on left ovary, nothing notable to interfere with pregnancy since clomid challenge + trigger + IUI worked 2nd time around.
So no PCOS. FSH = 9.2 (I'm old but not THAT old yet).
posted by stormpooper at 12:01 PM on June 2, 2011
Final determination--unknown, all tests normal, suspected endo on left ovary, nothing notable to interfere with pregnancy since clomid challenge + trigger + IUI worked 2nd time around.
So no PCOS. FSH = 9.2 (I'm old but not THAT old yet).
posted by stormpooper at 12:01 PM on June 2, 2011
Response by poster: Aug is as soon as I can get in. I guess we'll see.
posted by stormpooper at 12:01 PM on June 2, 2011
posted by stormpooper at 12:01 PM on June 2, 2011
I had the same experience on Loestrin with the breakthrough bleeding. I had to switch pills. After a while, my body chemistry changed and I needed a stronger hormone. I am now on Natazia, which is a newer pill, and have had good results on that. Sometimes, it's just a matter of trying a new or different pill.
posted by FergieBelle at 12:17 PM on June 2, 2011
posted by FergieBelle at 12:17 PM on June 2, 2011
What other possibilities could it be? Cyst just stopping things? Overall I feel ok. Without a period this month (and the last time) I get sick--nausea, overflowing of hormone feeling, joints ache, etc. This I'm used to right before my period. But without a period, it's a week of this. Last month it was severe endo inflammation feeling (probably endometriosis) where I was begging the doc for some NSAID alternative (she never got back to me).
I hesitate to mention this, given your history, but any chance at all that you managed to get pregnant the old-fashioned way? Was nausea normal for you before you baby? Sounds a little bit like the kind of thing you see in a pregnancy with placenta issues (ie: pre-placental abruption) - nausea and overflowing of hormones from the pregnancy, bleeding and moderate to severe abdominal pain from the placental issues.
I'm sure it's not that, but it is what is sounds like (IANAD). I might pee on a stick just to be sure.
posted by anastasiav at 12:20 PM on June 2, 2011
I hesitate to mention this, given your history, but any chance at all that you managed to get pregnant the old-fashioned way? Was nausea normal for you before you baby? Sounds a little bit like the kind of thing you see in a pregnancy with placenta issues (ie: pre-placental abruption) - nausea and overflowing of hormones from the pregnancy, bleeding and moderate to severe abdominal pain from the placental issues.
I'm sure it's not that, but it is what is sounds like (IANAD). I might pee on a stick just to be sure.
posted by anastasiav at 12:20 PM on June 2, 2011
Response by poster: Pee stick said no dice. These hormone/queasy/etc. feeling is fairly normal for me (supposedly it's part of the endo symptoms). Right now it's a perpetual car sickness/migraine aura feeling.
Not having a period is the only unusual symptom.
Yea my girly parts are a non-stop party.
posted by stormpooper at 12:42 PM on June 2, 2011
Not having a period is the only unusual symptom.
Yea my girly parts are a non-stop party.
posted by stormpooper at 12:42 PM on June 2, 2011
Aug is as soon as I can get in. I guess we'll see.
If you really wanted to get in, you can probably get in. Now.
According to my wife, all (but probably just most) offices have slots they keep open for people who need them. My wife has had many "the very next morning" appointments for various reasons when she simply called and asked for one, even if didn't seem all that important. Regular appointments...yes, she would have to wait four months sometimes.
posted by TinWhistle at 12:43 PM on June 2, 2011
If you really wanted to get in, you can probably get in. Now.
According to my wife, all (but probably just most) offices have slots they keep open for people who need them. My wife has had many "the very next morning" appointments for various reasons when she simply called and asked for one, even if didn't seem all that important. Regular appointments...yes, she would have to wait four months sometimes.
posted by TinWhistle at 12:43 PM on June 2, 2011
Please read the chapter in Malcolm Gladwell's latest release "What the Dog Saw" entitled "John Rock's Error." Very enlightening info about birth control in general, but my favorite insight was regarding Beverly Strassmans research about menstrual cycles in pre-modern societies.
If that's tl;dr, the point is that in pre-industrial societies, women menstruated about a hundred times in their lives. The contemporary western woman averages between 350 and 400 periods in her life. Now, a lot of this can be chalked up to the fact that more pregnancies and more time breastfeeding leads to suppressed ovulation, but not all of it. The invention of oral contraceptives has us believing that all women follow an exactly 28 day cycle, which apparently is biologically silly.
Anyway, you're probably totally fine.
posted by Idafolk at 1:29 PM on June 2, 2011 [2 favorites]
If that's tl;dr, the point is that in pre-industrial societies, women menstruated about a hundred times in their lives. The contemporary western woman averages between 350 and 400 periods in her life. Now, a lot of this can be chalked up to the fact that more pregnancies and more time breastfeeding leads to suppressed ovulation, but not all of it. The invention of oral contraceptives has us believing that all women follow an exactly 28 day cycle, which apparently is biologically silly.
Anyway, you're probably totally fine.
posted by Idafolk at 1:29 PM on June 2, 2011 [2 favorites]
Probably not what you wanna hear but being in the same boat (endo sufferer, fertility treatment, similar age, same FSH reading, similar current symptoms, same psychological profile etc) it is likely you're perimenopausal. Endometriosis sufferers tend to go through earlier menopause. I've recently had all this checked out and that's the story. It feels way too young and it sadly puts an end to fertility hopes, so I relate to how you must be feeling right now.
posted by honey-barbara at 5:08 PM on June 2, 2011
posted by honey-barbara at 5:08 PM on June 2, 2011
Sorry for double post, forgot to say: When you've got a history of ovarian cysts, it was explained to me, the ovarian reserve and function is affected causing things to slow down.
You can memail me if you like, as your symptoms are almost the same as mine :(
posted by honey-barbara at 5:15 PM on June 2, 2011
You can memail me if you like, as your symptoms are almost the same as mine :(
posted by honey-barbara at 5:15 PM on June 2, 2011
If you really want to see the doctor, call them back and ask to be put on a list for cancellations. Also explain that you're having a problem and need to see the doctor as soon as you can. I did this for a very busy doctor when I was moving out of the area (poor planning, late decision to actually move) and she was able to squeeze me in during lunchtime. If you don't feel like you're getting anywhere with the receptionist, ask to talk to a nurse. They can sometimes determine that it would be inappropriate to wait until August.
posted by eldiem at 11:34 AM on June 4, 2011
posted by eldiem at 11:34 AM on June 4, 2011
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posted by katillathehun at 10:53 AM on June 2, 2011