Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Machair on November 06, 2015, 09:31:36 PM
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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!
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……. 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?
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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?
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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
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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.
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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?
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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!
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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!
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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?
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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
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Makes sense ;)
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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
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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 :)
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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
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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.
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Yes. Back at the start of peri I noticed that my PMS was kicking in straight after ovulation and not finishing until my period ended. Some months I would only get, maybe, 7-10 good/normal days.
Then there were months where I don't think I really ovulated at all (though it felt like my body tried to) and the PMS was truly dreadful with accompanying very low depression and crippling anxiety.
I also went from having a medium, red flow for 5-6 days, to having just 3 days of heavy brown spotting with just a token flow of red for half a day.
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Yes I have periods that are only brown spotting too- wonder if this is also caused by the hormones or lack of them that cause the prolonged PMT! Still I am not grumbling as it is better than the heavy ones I had when peri started a few years back.
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Sparkle I also wonder too about what you say about the ongoing clear mucus and lack of ovulation. I have this too and it no longer appears mid month but at random, and actually seems to accompany my bad moods. May be it is a reaction as you say to raised oestrogen levels. This article may be very helpful http://www.bcendocrineresearch.com/newsletter/v01/n01/Perimenopause_s01.php
This article is also very helpful
http://www.cemcor.ubc.ca/resources/perimenopause-time-%E2%80%9Cendogenous-ovarian-hyperstimulation%E2%80%9D
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I think that makes perfect sense as it is mentioned in the article I posted a link to - here is part of it!
"Perimenopausal changes are similar to changes caused by some infertility treatments. In vitro fertilization (IVF) requires laparoscopic surgery (through a small tube in the abdomen) to suck up ovarian egg cells that are nearly ready to ovulate so they can be grown and fertilized in a laboratory and then injected into the woman's uterus. In order to collect the maximum number of eggs, gynecologists override inhibin using a technique called “ovarian hyper-stimulation.†The woman is given daily injections of FSH until many follicles have been stimulated and estrogen levels are very high. She is then injected with another hormone (much like luteinizing hormone [LH], another pituitary hormone that stimulates the ovary) to mimic the normal mid-cycle LH surge and this triggers ovulation."
Maybe we are getting closer to understanding what is happening to some of us! Hope you are ok today. I am rubbish - very PMT like- although I was stuck in the car for 9 hours yesterday going there and back to see my daughter in Wales. I adore her, but not motorways for miles and miles feeling like this!
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I am relating to all this. I also read this article this morning that explains that sometimes the symptoms of low estrogen are in fact relative to having high estrogen for a while and then it drops and you get withdrawal symptoms. So that overall estrogen is dominant as progesterone is most likely non existent as the body tries harder and harder to ovulate! I certainly feel 'full' to burst at times, literally....water retention, fast flow periods and raging emotions. So much effort the body is going through, it makes sense to me how overwhelming it can feel with all this imbalance going on x
http://www.bcmj.org/article/clearing-confusion-about-perimenopause
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I have the same problem that GypsyRoseLee mentioned about - the PMS seems to start around the time of ovulation then finally finishes as my period ends. The PMS always used to finish as my period started but not any more. The gynae gp I saw last month suggested using oestrogel for the second half of the month to lift my mood but I have noticed no difference so far, only bloating? (Very early days yet, though). Some mornings my mood is so low that I find it a struggle to get out of bed (I am 48 & peri with very heavy periods for first two days then it decreases rapidly). I get one 'good' week per month.
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I have the same problem that GypsyRoseLee mentioned about - the PMS seems to start around the time of ovulation then finally finishes as my period ends. The PMS always used to finish as my period started but not any more.
Me, too... I used to feel so good when my period started but now that is sometimes my WORST day...
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Just wondering Sparkle do you feel worse when you notice the ongoing clear mucus discharge? I am wondering now whether this is days of higher then normal oestrogen caused by FSH trying to stimulate ovulation, and getting no joy if you see what I mean? Since normally this clear mucus should stop after ovulation, the ongoing signs of it probably indicates that ovulation didn't take place. I think this may be making me moody and confusing the picture making me think it is PMT.
I did ask Mrs Minkin the lovely Gynae who answers questions on Webmd, and she said that it is often impossible to differentiate PMT from perimenopause as the symptoms are similar. Eventually as we go further along hopefully this will all cease!
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Well Sparkle I am reasonable despite getting up at 6am and yes a poor night sleep with hubby snoring again!
I have still got this PMT type feeling going on, but am really thinking it isn't PMT but just repeated attempts to ovulate!
You sound a lot better- maybe the pink discharge will be all you get, my periods now are usually brown spotting for a week and only when I wipe mostly, so maybe we are heading to the end! Still got the ongoing mucus discharge today - hence the bad mood, but it has lifted slightly so maybe a period will eventually happen!
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I think it's true that often there's no real border between peri menopause and extreme PMS.
Back in the day my PMS was quite severe each month but pretty standard. So, I would feel grumpy and irritable 5-7 days before my period was due, then would immediately feel much better and return to normal as soon as my period started.
But a 2-3 years ago all that changed. The PMS started kicking in right after ovulation. Instead of the usual grumpy irritabity, I began feeling very depressed and hopeless inside and convinced I didn't love my DH anymore.
But these feelings didn't lift when my period started. They lasted right through until about day 5-6 of my cycle. So basically my new PMS was lasting nearly 3 weeks of each month. It was so debilitating and I felt I was only living half a life, or even a third of a life, really!
And my periods dwindled to just heavy brown spotting that was only really there when I wiped too.
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That is so helpful GypsyRoseLee - thank you so much. Yes this is really the same way I feel. Do you mind me asking how old you are and if you are in late or early peri? Do you feel better on hormonal therapy?
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I am 45. Looking back my PMS started to change dramatically maybe 3-4 years ago? I know it was definitely more than 3 years ago that I had to start planning my social life around my menstrual cycle and try not to plan anything much in the 2nd half of my cycle, or during my actual period, because I knew I wouldn't be able to enjoy anything at all.
But, there had been definite warning signs as far back as 6 years ago, I think? I remember a summer holiday where I ruined the whole week with my totally irrational conviction that my lovely DH was plotting to divorce me. I broke down in tears several times and my poor DH was very confused (probably because I didn't tell him about my crazy suspicions). Then the minute my period started I felt perfectly fine again.
But it was exactly 2 years ago that one month my PMS didn't lift after my period finished. It just carried on and on, and brought new and horrible surges of anxiety/dread with it. It totally floored me and I was unable to cope, then pretty soon the insomnia started and that was when I made the first of many, many visits to see my GP.
I don't know if I am in early or late peri? Very early menopause runs strongly in my family. One close relative was only 28 when she went through menopause. Another was only 38. I don't know about my Mum because she had a surgical menopause at 43. But in the 2-3 years running up to her hysterectomy she suffered with inexplicable anxiety and depression, which magically disappeared after her operation and she went onto HRT.
Back in the Spring I started HRT. Just a 25mg patch with separate Utrogestan. It didn't do a thing to help. I increased the patch to 50mg, and things improved slightly. But after 4 months I was still getting far too many bad days/weeks so swapped to the BCP. My GP explained that as I was still relatively 'very young' HRT just wasn't nearly as potent enough to control my symptoms. The first brand I tried was Microgynon, the cheapest type (with the most androgenic progesterone, so most likely to cause spotting, greasy hair, acne etc) There was a definite overall improvement, but I had constant spotting every day and quite a few facial spots.
So a month ago I swapped to Gederal (Marvelon) and within days I felt so much better, it was untrue. Mood much more positive and stable. Skin really clear and smooth (I'm not joking, my skin feels like silk and hasn't looked this good since I was 17). No more brown spotting. It really has been a life saver.
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Machair, just to add that Gederal (Marvelon) has better tolerated progesterone than most BCPs, and is well known for giving you nice skin and shiny hair again, anyway.
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Thank you so much for taking the time to reply GypsyRoseLee, and I am just so glad that you are feeling so much better now. I wish you all the best and hope your future is brighter now!
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Just wanted to add to the thoughts from Machair about the clear mucus thing - I have had this - copious amounts and it has always been accompanied by the symptoms I now recognise as horrific versions of my 'old' mild PMT symptoms - for me, that is water retention, bloating, general digestive issues, rage, anxiety etc and it carries on throughout the period that eventually happens and yes, it is often blood mixed in with the mucus - I think this is definately estrogen having an action all on it's lonesome.
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I love this forum! Nice to know I'm not alone...even though I don't wish these confusing symptoms on anyone else!
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Bleeding has increased to what looks like a 'normal' period plus mild period pains. I now realise that I had been feeling increasingly bloated including boobs and today I feel less bloated, not perfect just better than I did. I'm just amazed at how all my symptoms reared their ugly heads big time last week particularly the migraines and muscle tension in my neck and shoulders and the most awful anxiety and depression which started to lift yesterday and today has gone. I'm not for one minute thinking this is it, I know it can change in a flash but for now I'm just glad I feel better than I did.
S x
Now that is the sound of sweet relief - long may it continue for you :)
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So pleased for you, and also wanted to say a really big thank you to you Sparkle and to all the ladies on here, your help has meant so much to me and is appreciated more than words can say. I have the disease ME, and some days feel absolute rubbish, so it is hard to say what is hormones, and what isn't, but being able to talk about things so openly here has helped so much.
In an ideal world we would also have sisters close in age, or friends going through this at the exact same time in the same way, but sadly for many of us this is not the case. I am an only child, and in the last few years Mum has developed dementia, and doesn't even know who I am, let alone be able to ask my questions about menopause. My close friends were all early and under 50 having their last periods, so they are amazed at me being 55 and still in the throws of it all. I really hope I am still here in reasonable health when my daughters enter perimenopause.
This forum is so lovely, and I wish you all a calm journey on through this transition, and let's hope there is a wildflower meadow waiting for us on a sunny day just around the corner as our hormones become more stable. :)
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Add me to the gathering in the meadow please :) Lovely post Machair.
I have lost my mother and my elder sister lives in Australia and wouldn't be easy to talk to about this, so I am pretty much walking in the dark here, except for this forum and google (which isn't helpful really).
Thank you x