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[Machair]

I ovulated on holiday- I know that as I recognise all the signs. Then 10 days later PMT started and 3 weeks later no period. Anyone had this prolonged PMT but no bleed and will this end? PMT is absolutely stellar and it is like you would expect it to be just before a period, but every day nothing just more PMT!

[CLKD]

……. which would stop with a bleed.  I had it badly during my menstruating years.  I was advised to eat every 3 hours 24/7, 7/52! which can ease some of the symptoms.  What's the worst symptom?

[Machair]

The worst symptom? hard to say - anger, rage- madness probably, but I manage to control that through sensible diet, eating as you say little and often of the right sort of food. Then there is bloating, head like cotton wool, clumsy-  (broke 3 glasses this week!), irritable, tired, restless sleep, it goes on! Hormonal headaches are also a problem. I just wonder if I will actually bleed or not, but wonder if anyone else has had this extended PMT and what happened next?

[Hurdity]

Sorry to hear about the pms symptoms Machair - but if you ovulated you would have a period two weeks later without fail as I understand.  Please someone correct me if I'm wrong and point me to the correct info. You need to produce a large enough amount of oestrogen in order for ovulation to take place - in addition to the other hormones that control the menstrual cycle (FSH, LH etc), and once ovulation takes place the empty follicle produces progesterone and 14 days later it runs out and the fall in progesterone tells the body that fertilisation has not taken place and therefore the womb lining is shed. Pms occurs  during the normal menstrual cycle either due to the fall in oestrogen, the rise in progesterone or the fall in progesterone depending on a woman's sensitivities. This does go haywire during the peri-menopause when you also get extreme fluctuation in oestrogen too.

You could still be having some sort of an irregular cycle and experiencing the increased oestrogen levels associated with ovulation (which perhaps your body is less used to now you are in late peri-menopause?)  - as your ovaries "try " to get an egg ready, but if this fails I assume the other hormonal changes still take place (??) and oestrogen falls ie there is still a cycle of sorts only without ovulation. The other alternative is your body is still trying to stimulate the ovaries to produce an egg which is what you are feeling ie the associated hormonal changes. That's my understanding anyway.

The hormonal changes are explained better in the article about the peri-menopause:
http://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php

Hopefully your symptoms will ease soon...

Hurdity x

[Machair]

Thank you for your thoughts ladies much appreciated 
I have always had horrendous build ups to periods all my life so maybe this is to be expected.

[Machair]

Thank you Sparkle- I wish we lived next door to each other as I would make you a cup of tea! How long does your PMT go on for - as long as 3 weeks or more?

[Machair]

Yes this is exactly the same for me too. I have had the build up that subsides as well which is weird.This month is so severe I am sure it will result in something! I feel at 55 this should be history but it seems not!

[Machair]

Sparkle the only hope on the horizon is what I read on Prof Studd's website. PMS peaks in the two years before periods end. I reckon that is you and me! Don't worry about your cupboards- mine are exactly the same- stuffed too!

One thought I had though is do your periods start suddenly when they start, or do you have a few days of almost nothing spotting first? Since becoming peri I have lost the sudden start to my cycle that used to wake me up in the early hours, leading me to having to be prepared, to a much more gradual and prolonged affair and lead in. I wonder if this light spotting is to do with the hormones struggling to actually start a bleed. Also I no longer have heavy periods now like I once did, with day 2 being difficult, they are much lighter, but don't give the relief that they used to on starting.

That prolonged start or splutter, together with days of stretchy mucus, and PMT madness seem to be the hallmark of where I am now. All very confusing and exhausting! Crumbs I am in a mood today!Looking forward to having a lavender bath - seems to help!

[CLKD]

That's interesting!  I'll need to go back in my history to see how relevant my anxiety/nausea surges were in the 1990s to when I got into peri ……. because true PMT only happens in the 10-14 days prior to a bleed.  Stops immediately the period begins.  Then the lady gets a few days symptom free before it all starts again ……

Have you looked at the NAPS site?

[Hurdity]

Machair - the decreasing amount of blood and slow start is due to less oestrogen being produced and therefore you have less of your womb lining to shed. If you ovulate then you will still provide sufficient progesterone ( as I understand) but if there isn't much (lining) there - then the blood loss will be low.  It's not the hormones struggling to produce a bleed as such, but there isn't anything to bleed due to decreased oestrogen. It's the last gasp of your ovaries - the small amount of oestrogen being produced compared to when fertile.

This is extracted from the link to the article I gave before:

Leading up to the menopause during the perimenopause, the follicles remaining are not only fewer in number but also of poorer quality and less able to respond to the stimulation by FSH. Occasionally, cycles occur where follicles have not developed fully and less estrogen is produced. Low levels of estrogen lead to menopausal symptoms, a rise in FSH, and a failure to trigger the LH surge leading to absence of egg release (ovulation). With no ovulation, progesterone production is also reduced, leading to irregular shedding of the lining of the womb and hence irregular periods. In the early stages, the ovaries fluctuate in how well they work, so that cycles may be normal some months and abnormal in others. Gradually the number of abnormal cycles increases so that eventually, no follicles develop, estrogen and progesterone production becomes very low, the lining of the womb is not stimulated at all, periods stop and FSH levels remain high. Finally, the menopause, the last period, occurs and is confirmed by having 12 months without periods. Following this, there may occasionally be episodes where the ovaries again produce a later burst of hormones, the womb lining is stimulated and subsequent bleeding may occur, but this is unusual and any bleeding occurring more than 12 months after a period should be reported and investigated. Generally, estrogen and progesterone levels after the menopause remain steady and low, unlike levels during the perimenopause. During the perimenopause, the ovaries are still working and producing hormones but are not producing the correct balance of hormones. In the early stages, the levels of FSH, LH, estrogen and progesterone fluctuate markedly and symptoms and period patterns may change from month to month.


Yes CLKD - true pms is defined as that - but if a woman is sensitive also to falling levels of oestrogen ( as part of the pms)  then in peri-menopause oestrogen can fall after an incomplete cycle and lead to that part of pms - but not a bleed - I think this is what gives rise the confusion ie it feels like a bleed should happen - but it's the oestrogen dip. Does that make sense? I think my understanding is right - haven't read anything that suggests otherwise but if anyone does please let me know! Doesn't make it any better though!

Sparkle - I had my last natural period at 53.5 years but a few months later started HRT - and it is quite normal. I may well have had another period or two before grinding to a halt at some point!  If you think that the average age for menopause is age 51 or 52 then there must be lots of women whose menopause is mid 50's and even beyond for an unlucky few (or lucky depending on which way you look at it).

Personally girls, make the most of it (not having reached menopause in your 50's) - despite the weird symptoms - you will have your own oestrogen which will only drop to its lowest around two years following menopause 

Hurdity x

[CLKD]

Makes sense 

[Machair]

Hurdity and CLKD you are absolute stars and your help is appreciated so much. I can't thank you enough for taking time to help. Also the kindness of Sparkle too is just amazing- thank you so much.xx

[CLKD]

Problem shared  - it's important to share and for others to take what might be suitable for their situation …… if it works/not, then come back and ask again 

[Hurdity]

Hi again I am just thinking aloud based on what I've read and (limited) knowledge of hormonal control of the cycle as I can't find anything written specifically about this ie the pms continuing and what causes it! So what I've read is that the luteal phase (the length of time between ovulation and period) only varies slightly ( from 9 - 16 days) but is generally pretty constant for a particular woman. You will know what yours was from your regular menstrual cycle ie if 28 days then luteal phase is 14, if cycle 24 days as mine was for much of my fertile life, then my luteal phase was then 10 days (that really was a pain having periods every 3 weeks 3 days!).

What I'm not clear about is when the eggs begin to decline in quality and there are fewer of them that start to develop - whether you can still ovulate with far less oestrogen so that only a small bleed occurs ( or even none). The amount of bleeding will be related to the amount of oestrogen but I presume in peri especially late peri there is not enough oestrogen to produce a thick lining. What I presume is if you ovulate very late on (near menopause) and the egg is poor quality (and low oestrogen) - well you would still produce progesterone but the bleed would be small because the lining hadn't thickened. However the luteal phase would still end 14 days after ovluation so any pms due to the rise, fall and withdrawal from progesterone would be over in 14-16 days. Therefore if pms continue it must be due to oestrogen. I also think if your body has not ovulated for ages, you might even notice the effect of the increase in oestrogen ( that your body has become acclimatised to be at a low level) - just as in pregnancy you notice the increase - so not pms as such but just reacting to the change in hormone levels.

I really am thinking aloud and I am genuinely interested and wonder precisely what is going on biologically/hormonally! I guess with everything packing up all sorts of things are happeneing!

The stopping and starting must be so annoying - I don't remember having that really although some of mine just trickled on for a long time. Hope it all eases soon!

Hurdity x

[BrightLight]

Thank you Hurdity from me too - I am trying to 'make sense' of ever increasing irregularity with PMS and periods and the thoughts about the stability of the luteal phase seems to tie in with what I experience.  My cycles when regular were usually about 24 days and the luteal phase 10 days.  I have just started spotting on day 17! I can now see that I definately had PMT.

I've read that in perimenopause the follicular phase can shorten, the FSH/LH working hard to release an egg - so maybe I ovulated early or didn't (?)  Other months I am having a longer follicular phase and cycles, again, I presume body trying to ovulate.  I am guessing really, but making notes and in hindsight the PMS is an indicator - I am not sure any of that makes sense actually - except to say that I somehow think my poor body is trying to continue to function effectively and it's just not able anymore.