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[Sarahkins]

Me again! I'm back with another panicky post 
Over the last 4 months I have been experiencing periods which last for around 12 to 17 days. However the last two months have also been accompanied by continuous light spotting which has been almost every single day with the odd day or two off.

I had a TV scan and Ultrasound about 18 months ago which came back clear apart from a small ovarian cyst on my left side. The reason for the scans were unusual chaotic periods and pain in my lower right abdominal area. Unpredictable and lengthy/missed periods, hip and abdominal discomfort continued.

Last month I had a full blood count and a smear test. Both tests showed normal but my blood count says my iron, B12 and lymphocytes are very low. GP hasn't been in touch about it however and doesn't seem concerned.

I am fed up with the constant bleeding and also worried about the continuing spotting as I haven't read anywhere that this is a normal part of peri. When not taking HRT.  I keep repeating my concerns at the GP and feel like a hypochondriac. I'm 43 but she still seemed to think I would be too young to be starting menopause.
I keep worrying about cancer and other serious illnesses, health anxiety through the roof and just feeling very down and fatigued by it all. Can anyone offer any advice or share similar experiences? I'm driving myself mad and don't know what my next step.should be!

[Seasidegirl]

I'll leave others to comment re the bleeding etc.

 One of my peri symptoms was a lot of pelvic and gynae pain,  I was older but your age wouldn't be unusual for the start of peri. 

Re the vitamins and iron,  deficiencies and sub optimal levels (ie the NHS say you are in range but levels aren't high enough to make you feel well) can make you feel shocking.   What we're your levels including the ranges? 

Use Chat GPT to give you some info based on your numbers,  inform yourself and go back to your GP and be clear about what you need.    If your B12 is in range the GP is unlikely to do anything and most don't recognise the issues around low vitamins.   There are good methylated B12 and B9 folate supplements.   Post your figures.   Did they test Folate & D?     

Ask Chat GPT about your iron levels,  ferritin is also relevant to that. 

You do need to be informed and then clear with your GP  book a double appointment if needed x

[bombsh3ll]

It sounds like you have been thoroughly investigated and you should be reassured by this. Menstrual irregularity is a hallmark of perimenopause but this doesn't mean you have to just put up with it.

The best treatment in my opinion at your age is a combined oral contraceptive pill (or patch or Nuvaring). If taken continuously ie active pills only no placebos or breaks, this can have most women bleed free.

This can also be easier to access if your GP "doesn't believe in" perimenopause.

If you don't want or cannot take CHC there are other options you could discuss with your GP but they are more complicated and won't be necessarily get rid of bleeding.

As above, I would compare your blood results for iron, b12 etc to the optimal ranges not the minimal levels accepted by the NHS as this model of care is based on economic rationing of treatment to only the absolute sickest, rather than seeking the.best health outcome for each individual.

If it were me I would self fund appropriate supplementation for deficiencies if you can't get these through the NHS.

[Sarahkins]

Thank you both for your replies. I did look into this with Chat GPT and a Google of the optimal ranges for B12, ferritin and lymphocytes. My numbers:

B12 - 202 Optimal  is upwards of 300 and deficient is anything below 200
Lab range is 200 - 910

My ferritin is 28 which is not deficient but below optimal between 70 - 100
Lab range is 12 - 160

Lymphocytes are at 1.19 which is slightly low but not yet concerning.
Lab range is 1.0 - 4.0

I completed an electronic form with my GP surgery to ask some questions about the above numbers and was sent a message to say the GP was going to call back. This was last week however and I'm still waiting.

I'm still spotting and just fed up with it. I will likely book another appointment this week to ask about the pill.if it can help with the bleeding. Surely this is not just how I'm supposed to live now? I'm just confused as to why nobody seems to think anything needs to be done! I feel tired, anxious and frankly muddled every day. My thoughts race and my memory is absolutely appalling at the moment. Work is a nightmare!

[bombsh3ll]

I would definitely want treatment for the iron deficiency and the low b12.

You are likely to feel better with restoration of these.

Benign spotting is a nuisance not an illness but can usually easily be got rid of with hormonal manipulation.

The pill also contains a more generous dose of estrogen than MHT and in my opinion for this and the reasons above is more appropriate in your early 40s.

I take combined pill Zoely continuously and am nearly 46, I love it and don't bleed at all 🙂