Any clue as to what is wrong with my period? Thyroid? Perimenopause?
April 29, 2014 9:02 PM   Subscribe

I know you are not my doctor and this question may seem dumb but I could use some experience, answers, something. I'm just lost right now. I'm dealing with issues regarding my period. I got my hormone levels back but they don't point to anything specific or alarming. I'm worried because my periods have definitely shortened and I don't seem to ovulate the way I used to yet I'm running out of ideas as to whats wrong with me. Hormone levels and history included.

I tried the NuvaRing for a month last year in June to help with Endo. Since then my cycles have changed from 30/31 days and about 4-6 days of heavy bleeding (thought to be because of Endometriosis) to 24-26 (26 if I'm lucky) and I bleed light to medium for at most two days. I don't seem to ovulate regularly but when I do its around cycle day 13 and my luteal phase is not the 14 days that it used to be. Its been about 9 months with these changes. I've tried 5-6 different hormone pills and never had this reaction.

In the last month my cramps have increased in pain days ahead of starting my period (where I was already on the verge of passing out but not three days before). I'm a week before my next one and already cramping enough to know its gong to suck again. I feel like I get heat waves every once in a while, I'm weepy and overly sentimental, and generally sad or irritable.

My vitamin D was a 7 in the beginning of March and I started a prescription for that nearly 6 weeks ago. It will be rechecked in June. My RE doesn't think that's the problem and my PCP doesn't seem to think so either but we're trying it.

I was diagnosed with Rheumatoid Arthritis in 1997.

I have not had surgery for Endo (my doctors prefer not to do it due to scar tissue).

My HA1c is 5.9 but fasting glucose was 77. I've been watching my carbs and sugar as told by my PCP.

My hormones were fine to my RE (FSH 7.01, E2 88, LH 5.58 AMH 2.1 all on cycle day 4). Prolactin was good. Nothing stands out anywhere to her. Recent pelvic ultrasound showed nothing.

My iron blood saturation level is low but I'm not anemic anymore she said? I didn't understand this much. I had been supplementing with prenatals since I have been anemic most of my adult life.

My TSH is 3.78 and my T4 is normal. Negative for antibodies. I read that sub-clinical doesn't exhibit such bad symptoms but I'm not sure. It was .9 four years ago and tested as 1.9 last month but different lab.

My RE was worried about perimenopause since my mother was in menopause in her early 40s (I'm 28) but not so much now that my hormone levels are in. I'm going to do an iron prescription and she said I can take something for my thyroid if I want to but neither alarmed her. I'm going to get my TSH rechecked next month (since the results this month and last were two different labs) and then decide whether to treat it. My mother was hyper (removed) and my grandmother hypo so I am leaning towards getting a prescription called in.

My question is - what does this sound like? Is there a medical issue that I'm not thinking of? I'm planning an HSG to check my uterus and tubes too but I'm stuck other than that.
posted by grablife365 to Health & Fitness (18 answers total) 1 user marked this as a favorite
Are you on any other meds? My anti-anxiety medication made my cycle shorter and more irregular.
posted by slightlybewildered at 9:15 PM on April 29, 2014

I'm not on any other medications. I don't take anything for my RA and at most I take ibuprofen when I think it will work.
posted by grablife365 at 9:18 PM on April 29, 2014

You're referring to an RE in your question - does this mean you are consulting with a reproductive endocrinologist? Are you getting an infertility workup (i.e. the HSG)?
posted by treehorn+bunny at 9:18 PM on April 29, 2014 [1 favorite]

Yes a reproductive endocrinologist. Once my cycle starts I'm calling in to schedule the HSG. We've just started the baseline blood work since my blood tests from last month were done mid cycle.
posted by grablife365 at 9:24 PM on April 29, 2014

For what it's worth, a friend and I both noticed the same change to more difficult PMS and shorter/lighter periods when we got into our late twenties (starting around age 26 or 27, we're both 28 now). Neither of us have health issues that are likely to effect our cycles, and both of our mothers had menopause relatively late. Just wanted to chime in, in case that helps put your mind a bit more at ease!
posted by rue72 at 9:30 PM on April 29, 2014 [2 favorites]

OK, great. I was going to suggest you see an RE if you had not already.

The TIBC (assuming that's what you mean by the iron saturation level) is not the same as a measure of anemia. The only way to measure anemia is your hemoglobin and hematocrit, or in lay terms, your red blood cell counts. If your red blood cell counts are normal, then you are not anemic, regardless of what your TIBC is.

It sounds like you're getting a thorough workup. The cramping could certainly be a symptom of your endo. As for the mood stuff, one thing to look into is PMDD if you really feel like the mood stuff is bad.

As far as the changing of your periods, it looks like you've gotten a workup for PCOS and that looks negative. It's possible that the HSG could find something in your uterus like polyps or fibroids (although fibroids would be often picked up on a pelvic ultrasound) which might explain wacky periods. Period length/heaviness can also change with age. I used to get heavy periods for weeks on end, like what you describe and worse when I was younger. I am incredibly grateful that now I have a light period. In any case, if you are not trying to get pregnant at this moment, hormonal birth control may help with some of the symptoms you're experiencing this past month - something to talk to your doctor about.
posted by treehorn+bunny at 9:36 PM on April 29, 2014

To answer your title question, I think it's highly unlikely your symptoms are due to perimenopause because your FSH was normal. That's pretty much all you need to know about perimenopause from my understanding, although I am not a RE. I think thyroid is also unlikely given what you've said about your lab values, but I know there are stories of people with some nonspecific symptoms that improved significantly on thyroid replacement even without test results in the abnormal range (including infertility). I would wait for the retest before starting a script with potential unpleasant side effects.
posted by treehorn+bunny at 9:59 PM on April 29, 2014

Thanks for the answers.
Rue72 - I would be a little happier about my cycles being lighter but that ovulation part throws it for me. I love to buy one pack of pads and have it last so long but it's such a crappy tradeoff right now. It is helpful to know the cramp increase happens.

Treehorn+bunny, thanks for the clarification. We thought at first that it could be related to my anemia but that's no longer an issue. I think she was saying that my tibc is low so yeah that make sense if I'm reading that right. I'll look into PMDD and see if that lasts all month cause that's how I feel all the time. I was hoping to try to get pregnant soon but have to figure it all out first.
posted by grablife365 at 10:00 PM on April 29, 2014

PMDD should not last all month. One other thought, though - going through a medical workup like this (I'm still a little unclear if any of this is an infertility workup or just a workup of your symptoms, but if it's for infertility, even more so) can put a person on a pretty emotional roller coaster too.
posted by treehorn+bunny at 10:30 PM on April 29, 2014 [1 favorite]

I definitely agree with that. It's one reason why I didn't mention those symptoms to her early on when we talked about peri. It's hard to separate emotions from symptoms sometimes. It takes a toll and then there's no clear directions. It's very frustrating.
posted by grablife365 at 11:41 PM on April 29, 2014

Has your weight been stable the last year or two?
posted by Sequence at 3:55 AM on April 30, 2014

Honestly, what you wrote does not sound unusual to me. Sure sucks that you have cramps and pain, so I would focus on the endo angle and pain management. But as far as cycle length goes, I second what rue 72 said. It changes over a lifespan and also due to hbc. It might take more than 9 months for your body to get back on track. And even if you started out with cycles of 31 days, your late-20s normal can totally be shorter.
Anything between 21 to 35 days (with a flow of 2-7 days) is considered normal range. And it's also normal to have longer, heavier periods in younger years, whereas the menstrual cycles tend to shorten/get lighter with age. That does not necessarily affect fertility.

As for the emotional ups and downs - your vit D was at 7. That's super low, it should be anything greater than 30 ng/mL, ideally between 50 and 80. Vit D has a connection to mood (activates genes that release neurotransmitters like dopamine and serotonin), low levels can make one all sorts of emotionally off. Luckily, you already started treatment. Hope you'll feel better soon.
posted by travelwithcats at 5:59 AM on April 30, 2014 [1 favorite]

Sequence, yes my weight is stable. No real changes there.
Travelwithcats, thanks. the change with age makes sense but it's the irregular ovulation that really worries me.
posted by grablife365 at 7:32 AM on April 30, 2014

I understand. At least you know (?) it's not anovulation. Have you been diagnosed with oligovulation before? Or is this based on home tests? If you ovulate irregularly, you still can get pregnant, it might just take a bit longer. Have you tried to conceive for more than a year?
Anyway, try to relax and not worry too much. Stress is not healthy either way. Hope there is a nice vacation coming up for you!
posted by travelwithcats at 8:16 AM on April 30, 2014

I haven't been diagnosed. We're still doing the whole work up and just started with the change in cycle length. My RE isn't as concerned about my ovulation. She said it's off but they would control it anyway. It's based on charting, fertility monitor, sticks and watching for signs. I could be missing them but that's why I've been using more than one method. In case I'm off somewhere.

I guess it's just the thought that something is off that's causing me to worry too much. I think if the TSH hormones and iron don't straighten me out then I won't worry anymore. I'm single so no trying for a year. I would like to get pregnant this year but she did say they would control it so I'll just let that go.

I think at least mental vacation is in order!
posted by grablife365 at 8:41 AM on April 30, 2014

When my vitamin D was low, I was tired all the time, and when I started taking Vit D+calcium+magnesium supplements I noticed some improvement in period-related symptoms like cramping and fatigue. It took a few months before they improved significantly enough for me to notice.
posted by bedhead at 8:44 AM on April 30, 2014 [1 favorite]

Just to mess with you a little bit extra - my RE told me that for a certain percentage of women, ovulation monitors simply do not work. And indeed I was ovulating (confirmed via ultrasound) even while getting month after month of negative results with a fertility monitor.
posted by bq at 6:12 PM on April 30, 2014

I would not be surprised on that bq. I would be that person. Aside from my temps not showing ovulation though, last month my hormones were checked around ovulation time and my doctor said they didn't seem to match for the phase that I was in. Too low. Didn't say anything further though because we thought vitamin D was the problem.
posted by grablife365 at 7:47 PM on April 30, 2014

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