Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Diabolique on January 16, 2016, 08:57:58 AM
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Hello,
New here. So, I am 40. I have been have increasingly short periods since I was 37. Before this, my periods were every 28 days, lasted five days long, I used about 7-8 "regular" sized tampons per day, and I had no PMS symptoms (I know that's lucky; I had these as a teenager, but after giving birth 16 years ago, they stopped). I also had severe ovulation pain each month that, as my periods decreased over three years from five to three to one days of light periods, and this pain worsened to the point that I could not get out of bed. I've had ovarian cysts in the past, one of which was grapefruit-sized and ruptured, and this felt like I had one of those every month. I did not go to the doctor because they were unconcerned and often credited my problems to "stress," encouraging me to take antidepressants when I was not stressed out or depressed.
For the past six months, I have stopped being able to exactly always tell when I have my period at all since I bleed more or less lightly all month -- not red blood, but brown thick blood -- I might stop bleeding for a week sometimes, and I might bleed more heavily on a particular day. This is accompanied by SERIOUS PMS symptoms that never go away, like extreme water retention which has caused me to gain ten pounds, extremely painful breasts and swelling, swelling around my eyes and face and belly, a complete loss of libido (it sounds gross to me to think about sex after no reason for this at all; I am happily married for a while), and some cramping that can be severe but then produces nothing more than a scanty thick brown blood. I'm barely using pads. Occasionally, I've had a day-long period that comes on thick and clotted in a big, big way, but it will go away in a day. Thus said, two days later, and it might come back.
It's completely crazy to me.
My medical history is a little hard to convey, but basically, I had thyroid cancer 27 years ago, had it removed, am in full-remission, and take a full replacement dose of thyroid hormone. I also had my gallbladder removed. I've had one child, but I've also had an addition five miscarriages :/ This was reportedly due to a "touchy cervix" but not sure what that means. He was born healthy. I've never been pregnant again despite using no birth control, but I think my spouse may be infertile since I used to get pregnant easily.
My health history is fine: I am 5' 2", Jewish, 40 years old, 113 lbs (I used to be much skinnier, like naturally ballerina thin without dieting), no formal exercise but I work on my feet during the week, I drink plenty of water, do not smoke or take drugs, have one glass of white wine per day, and do not eat red meat. I mainly drink herbal tea and eat yogurt and fruits and vegetables. Sometimes I eat sushi as well. I am pretty stress-free in that I am my own boss.
I went to the gynecologist three years ago at the start of this and was very dismissed.
I went again today, and she heard me and took some blood work and ordered an ultrasound for next week to rule out fibroids. She wants to also rule out endometrial something and cancers. One involves a test that is too painful, so she wants to check everything out first. She thought I may be in perimenopause.
I feel too young to be in perimenopause, and also, don't you have hot flashes? I have not had those? If it is perimenopause, how can you treat it without side effects (medication, like the pill, give me unacceptable side affects, like vomiting every day).
I called my mother, and she said she only had her periods get lighter. She had hot flashes. Concentration problems. But no extra PMS like I am having almost the entire month now.
Has anyone had perimenopause with these kinds of symptoms. My bloodwork will be in next week, and a pelvic ultrasound as well, but the doctor said she did not anticipate finding anything this way since hormones fluctuate so much in pre-menopause. She said she might try me on progesterone, and I'm nervous it will make me vomit like the pill has.
Thanks so much for your thoughts!
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Hi and welcome to MM Diabolique
Sounds like peri menopause to me. My peri meno started in my mid 30s and it is certainly not unusual. It's good they are checking everything out - often the womb lining thickens if you are not ovulating and this can cause erratic bleeding as you are experiencing. You are too young to oestrogen deficient so HRT may be appropriate if you have entered the meno - HRt will protect your heart and bones for the long term. HRT is different to BCP (these days it's more natural hormones) but you often have to try different ones to find the best option. Do browse around to get clued up - we're here to support you. DG x
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Hi Diabolique
Love the name!
Welcome to MM :welcomemm:
Sounds like peri to me too.
I had very similar symptoms from my early forties but didn't know I was anywhere near meno at the time.
It was only looking back, when I was actually post meno, that I realised what it was ::)
I didn't get hot flushes till I was post meno, during peri it was the feeling very crabby and totally non lustful that stick in the memory.
You are not alone :)
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Sounds like peri to me too, though it's good your GP is checking other things too. I started at 35 (now 40), and my first symptoms were period fluctuations, tearfulness, weight gain, mood swings, tiredness. Closest I got to a hot flush at the start was just feeling a bit 'warmer' than usual & not being able to wear thick jumpers like I used to as I got too hot. It was a while before I had a 'traditional' hot sweat & even now, I tend to have fairly 'dry' flushes most of the time.
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Hi Diabolique - welcome from me too.
Peri-menopause can last between eight to ten years and as the "normal" age of menopause is put at around 51 then you can see that peri (which only means before menopause anyway!) would usually begin at around 40.
As for hot flushes - a lot of women don't begin to suffer from these until their periods have almost stopped as the oestrogen levels become low enough to trigger them. It's best to hang on to your periods for as long as possible in my experience as they can keep lots of meno symptoms at bay.
Taz x :welcomemm:
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It's best to hang on to your periods for as long as possible in my experience as they can keep lots of meno symptoms at bay.
You mean we can choose when they stop? ;D Do tell me how! ;)
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Hi Diabolique
Trouble is everyone is different. Some get their worst symptoms post meno, and others like me suffer during peri. I actually improved no end post meno.
It's brilliant that your gp is checking you out properly though. There is no substitute for peace of mind.
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It's best to hang on to your periods for as long as possible in my experience as they can keep lots of meno symptoms at bay.
You mean we can choose when they stop? ;D Do tell me how! ;)
Wouldn't that be good!! ;D I should have said don't wish them away too quickly I think!
Taz x :burn:
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Hi blossom60. It's really great to hear from women have have improved post-meno. Welcome!!
How far post-meno are you and do you mind saying which symptoms have improved? I'm especially interested in how quickly hot flushes and vaginal symptoms improved once your periods stopped.
Taz x
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Hi Taz2
I'm about 3 year's post meno. I would say flushing is much improved as are general energy levels. The only thing that has stayed the same is intermediate anxiety. However, as I have had a particularly bad year with family trouble's, it's hard to say if the anxiety is meno related. Luckily had so far avoided viginal problems.
Hope that helps
PS. Have joined mainly for female chat, but am happy to pass on my meno experience.
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Hi. It does sound like it could be peri. I'm 39, so I understand the feeling of being too young and worry that it must be something else. It sounds like your gynecologist is running the same tests mine did. And for peace of mind for you, the biopsy is nothing compared to the pain of a cyst bursting. Nothing. If I remember correctly, I took ibuprofen before I went in, and the painful part of it lasted only a few seconds, maybe like a burn but it doesn't continue to throb afterwards. You and your doctor may decide that knowing it is hormonal and should eventually settle on its own is enough for you. This seemed to be the path my gynecologist was taking, but later I decided I needed help and went to my gp to beg for hormones. I could never do the pill in my 20s, it screwed up my otherwise clockwork cycles and healthy libido. The hrt isn't causing me any problems so far, so you may still be able to do it. As you can observe, you're body has changed from how things used to be. Ultimately, it's your choice and may take some trial and error to figure out what's the best way for you to get through this stage. This board has been a great resource for me as I'm just getting my feet wet in this peri business too.
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:welcomemm: both
Rockhopper - even if thyroid function tests are 'within normal limits' with the symptoms you complain of, your GP should request further blood screening! To check that your thyroid isn't borderline out of control: am sure someone will be along who has thyroid problems!
Or you may have Reynaud's syndrome? there is a good web-site so it may be worth your while having a look-see there? Do let us know!
I had a few years when, after my bath and after I had taken my evening medication: Anti-depressnat (AD) and Beta-blocka (BB) I would have an all over 'sheen' from behind my neck to my waist line. It would feel as though water was running down my back ::). Tamoxifen caused cold flushes :-\ …….. but many ladies don't have hot flushes but many GPs *still* say that a lady can't possibly be peri/menopausal if they haven't had flushes >:(!
I think that I was about 43 when my periods became erratic ……..
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Hello again! Thank you for your many replies! I am very happy to have found such a warm and active forum here. What a wonderful place.
So, my blood work is in today -- they send it online (no anticipation to see the doctor there, sigh…). It doesn't give me reference ranges for the first three, but here's what it says… also I am currently lightly bleeding and have been for what seems like ages, but I am unable to say for sure when I last had a period anymore. I am also having serious PMS symptoms like breast pain and water retention. So it's hard for me to understand where I really even am in my cycle right now.
Here are the numbers from my blood work if anyone can tell me what they could possibly mean? I have tried to look these up online but really can't understand them since I just do not know where I am in terms of my period. Does anything stand out or look off?
FSH - 2.6 mIU/ML
Estradiol - 154 pg/ML
Progesterone - 5.4 ng/ML
They checked my thyroid too, which is good. I am on thyroid pills already and used to having this checked. It was really perfect -- although I wish that was what was off since it would explain my weight gain. They checked my TSH, T3, and T4 since I have a pre-existing condition here. They also checked my iron, which was okay. They also of course checked to see if I was pregnant, which I am definitely not.
If anyone knows more about the FSH, Estradiol, and Progesterone #'s, I would be very grateful to not sit around all weekend wondering about them. I wish the doctor's didn't send the lab results to my email before I could talk with anyone about them. ::)
P.S. thanks for the "name" like! I was so unsure of what to use! I have hardly felt like much of a femme fatale lately, given that I am a bloated, weird, miserable mess, so I thought it might lift my mood :)
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Hi Diabolique - I am certainly no expert but your results seem a bit baffling/contradictory!!!
You FSH level is low which I believe indicates that your ovaries are working well so doesn't indicate menopause - usually if the FSH is high this can indicate menopause even if the oestrogen levels are reasonable.
However, your oestrogen level is very low!!!!! As blood tests for hormonal levels are notoriously unreliable I would hope they might repeat these tests once or twice more over the next few weeks to get a better picture of what is going on. To be that low on oestrogen is not good at your age and the fact you are getting erratic bleeding indicates something is not right - possibly very early peri meno ???!!!
Hopefully somebody with a more scientific back ground will be along with advice and support. DG x
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Hello Diabolique and welcome to MM!
Sorry that you are having problems but you are not alone. Looking back, I now realise that my hormones starting dropping off when I was 35 which was ten years before menopause although I didn't know it at the time. It was only subtle changes but nonetheless, that is what it was. The good news is you are only 40 and therefore you can start taking oestrogen to combat future problems.
Re your blood tests results, I have just looked through my huge pile of test results and set out some of my details which I hope are helpful.
I am 54, about 9 years post menopause and take two pumps of Oestrogel every day.
My test results in December showed my oestrogen level at 238 pg/mL while taking two pumps of Oestrogel every day.
If I up the dose to 3 pumps of gel, it shoots up to 291 pg/mL.
When I was taking Angeliq with an oestrogen patch top up (oral continuous combined hrt) it was only 75.4 pg/mL which was completely useless.
When I didn't take any HRT at all for a year and had a blood test, my level was 20.0 pg/mL which is exactly the same as it was when I was post menopause so my base level hasn't changed at all.
I have to make sure my level does not go below about 190 to avoid any symptoms.
Just found this and tagged it on:
Normal estrogen levels
The range of normal varies widely depending on a person's age. For those between 20-29, the average is 149 pg/ml and will increase to 210 pg/ml for females 30-39. The level falls back to 152 pg/ml for women over 40 who are not yet in menopause.
Low estrogen levels
Severe deficiency of estrogen can result in levels as low as 10-20 pg/ml and produce a variety of symptoms including fatigue, night sweats, vaginal dryness, and memory impairment. Some women will experience irritability, mood swings and feel drained and exhausted.
High estrogen levels
Excess estrogen levels are typically noted when estrogen is in excess of 200 pg/ml.
Opps, looks like mine is too high!
Hope that helps.
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Thanks! It sounds like my estrogen level might be okay? I am 40 years old.
At this point, I cannot wait to just see the doctor again already to hear what she might say. Tomorrow, I have an ultrasound to rule out fibroids and ovarian cysts or tumors.
And now for the first time in months, wouldn't you know it, I have a "normal" period this morning. So weird!
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Let us know how you get on!
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Early menopause and thyroid disorders are linked, so this could well be peri menopause... each can be the cause of the other and symptoms can be similar, making each difficult to diagnose reliably lol.
Let us know how you get on. Good luck.
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Hi Diabolique
:welcomemm: from me too!
A note re the oestrogen levels - in US and I believe some private gynaes in UK, estradiol is measured in pg/ml but in NHS in UK it is in pmol/l - which is what I'm used to thinking in terms of! This means they are 565 pmol/l. To convert from pg/ml to pmol/l you multiply by 3.671 so you oestrogen levels are fine - although depends when in the menstrual cycle they were taken which you don't know. However as your progesterone is also low then you will be most likely in late follicular phase ( first half) before ovulation. However low progesterone could be the cause of the bleeding as could other problems in your uterus eg fibroids, thickening of the lining etc. It may be that you are not ovulating and your oestrogen is increasing suddenly causing the side effects? As others have said FSH is low so this is all normal.
I've just looked up the ref ranges for UK and there are here:
Estradiol ( in pmol/l)
http://www.gpnotebook.co.uk/simplepage.cfm?ID=570818627
Progesterone:
http://www.gpnotebook.co.uk/simplepage.cfm?ID=-2127232957&linkID=27643&cook=yes
FSH:
http://www.gpnotebook.co.uk/simplepage.cfm?ID=436600899
The definition of peri-menopause is quite tricky because as you will see from this forum women begin to experience changes and especially in relation to pms when offocial peri-menopause has not yet begun ( ie when periods start to lengthen) and this is what causes most of the problems especially when moving from one stage to another. HRT does not necessarily help all women at this point - because it is often the extreme fluctuations that lead to symptoms - although preventing oestrogen from dropping too low at the end of the cycle by giving low dose hRT can help some women.
I'm sorry this is probably not of much use but hope you get something out of it!
Mary G - that is an extremely high level of oestrgoen from two pumps! I'm thinking you still have some of your own oestrogen!! Also 75.4 pg/ml is not completely useless!! It is 276 pmol/l - which for some women would be more than adequate to eliminate symptoms. Mine were 212 from what I remember and I have no symptoms.... I know there is no absolute level at which symptoms disappear but even so that is very high!!!!!
Hurdity x
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Hurdity, yes, that is what the gynaecologist said but she also said it fluctuates. It is very strange but for some reason, I really soak up the gel. I have temporarily come off HRT several times over the years for base line blood tests and the result is always the same, 20.0 pg/mL.
I do take 25mg DHEA tablets every day and also a tiny bead of testosterone daily so perhaps that makes a difference because apparently testosterone can convert into oestrogen?
I have already reduced from the prescribed 3 pumps of gel to 2 but perhaps I will reduce it further not least because I still have heavy periods which is not surprising. It is certainly baffling.
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So, I have finally had an intravaginal ultrasound and have spoken with the doctor. She said my hormone levels were great but a few things -- and I am trying not to freak out since I have previously had cancer:
1.) I may not be ovulating, thus the heavy periods, and this is because I have a growth on my ovary that was 2cmX1cmX2.5cm that confuses me: she called it a "complex hemmhoragic cyst." She said it was a guess only because part of the cyst that was imaged on the ultrasound was fluid, which is a "simple" cyst" but part was not "simple" so it was complex. Everything I have read on line about hemmhoragic cysts say that they are "simple" and just filled with blood. She said maybe some of the blood coagulated. But either way, she thought this was the source of my problems. I also have a simple cyst on my right ovary that is 8cmX8cm or so. Additionally, she said my FSH was low, and that it was because I was probably not ovulating? However, I feel like I AM ovulating since I have severe mittelschmirz that leaves me gasping in bed, after which I begin with the brown, bleeding.
I actually had a "real" period this month. It lasted one day and was bright red but then stopped. It wasn't clotted.
The doctor said I would have another ultrasound in 3months to see if the complex cyst grew; she said she wasn't worried about the simple cyst even though it was large. She asked me to track my periods for three months for her to review.
She said I was not in pre-menopause.
None of this explains my extreme PMS feelings though! Which I did not have before.
It does, however, explain why I cussed out loud when the ultrasound tech pushed against my left ovary.
I also found I have three small uterine fibroids which I have never had before. She said they were normal and were the size of cherries.
Thanks to everyone here, and now I am going to sit around hoping I don't have to have my left ovary removed, or worse, that it isn't more than a "complex hemmorhagic cyst" because I can't understand what that is. They are usually the opposite of each other. I am worried of course that it is a tumor, and that's causing me a lot of anxiety since I have played the waiting game before and wound up having cancer that time.
And why is she not concerned about the simple cyst the size of an orange on the right side? Okay, it's fluid-filled. But I have these EVERY TIME I go get an ultrasound? One was larger. Some are smaller. But I literally always have them.
Are fibroids really no big deal? I don't know anything about them.
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Hi Diabolique. Your symptoms sound very similar to mine and I too started in my late 30's. Symptoms 'hit like a brick' at 40 and went through 2 years of absolute HELL while doctors kept telling me it was 'stress and anxiety'. If only they would learn that 'stress and anxiety' are just symptoms of perimenopause instead of the cause of all the problems we'd be so much better off :(
I too had no hot flashes during that entire period, but hey have started in the last 6 months and I am currently in the process of missing my first period. Prior to this they were all over the map, but generally coming closer together initially ( very early peri) and much much heavier (with clots). So far for me I have found peri to be sort of a mountain. Symptoms started manageable, grew increasingly worse until there was a crescendo ( the Hell I mentioned) and for the last year or so I seem to be coming down the other side ( I pray this persists and my body is just not lulling me into a false sense of security :(
During the entire time my FSH was in the NORMAL range, estrogen always consistently low. FSH varies day by day and hour by hour and is VERY unreliable in predicting perimenopause. Anti-Mullerian hormone might be better but the labs have no consistent criteria at the moment, and the test is not generally run. Diagnosis should be based on symptoms, and ensuring there's nothing else going on ( i.e. thyroid, fibroids, iron levels etc). I have had every test in the book ( all normal) and yet here I am three years later with the hot flashes etc. They told me it was DEFINITELY not peri ( too young). I wanted to scream from the rooftops....speaking of which I highly recommend "SCREAMING TO BE HEARD".. it's validating if nothing else.
Good luck....at my worst I thought it would NEVER get better, but I maybe can glimpse the light at the end of the tunnel.
tara
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Yes Sparkle. I'm still having blips of anxiety, weeping, generally feeling unwell but compared to 2014 its practically paradise. Hot flashes start in the wee early morning hours and almost all the anxiety, negative thinking and mood issues are isolated to a few hours in the morning when I get up...thinking it's the high cortisol in the morning which is 'normal' but i'm guessing out of whack.
I pray for both of us, and all the other 'peri ladies in the middle of the hell time' that the mountain has been climbed, conquered and that it'll be much smoother sailing from here on out. If there is one thing that peri has taught me however is you never know what's coming next.... ::)
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Dogdoc can I ask why is it that our cortisol surges so much in the early morning?
I go to bed feeling calm. If I wake in the small hours to use the loo, I feel perfectly calm. But when I wake at 6am (it's always dead on 6am now) within 15 seconds I can feel the cortisol surging and I HAVE to get up.
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It is normal to have a cortisol surge in the morning. Everyone who has normally functioning adrenal glands has one. The problem with hormonal imbalance is everything is exaggerated. All our hormones are interconnected ( for instance lower estrogen often can cause low serotonin, which is why some women are helped by SSRI's during this time). My theory is that my entire endocrine system has been thrown out of whack. Cortisol, estrogen, progesterone ( and their ratios to each other), testosterone, even T4, serotonin etc. all of them. Makes sense when you think about what 'master hormones' estrogen and progesterone are. They have an effect on virtually every tissue in our bodies, including our adrenal glands, pituitaries, and neurons- the very tissues that produce most of our chemical messengers.
Fun times for everyone :)
Tara
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That makes sense dogdoc. I also feel that my previously delicately balanced hormonal system is now just fizzing and exploding willynilly.
I had a couple of days last week where I woke feeling nicely calm, and just 'normal' inside. This proves to me that just occasionally my confused hormones align correctly with themselves, and the HRT, to create normality again, but only briefly.
I think probably the most effective treatment for me would be to just have my own ovaries completely shut down, with that injection. At least then HRT would have more chance to work without my own hormones creating havoc in the background.
I think taking the HRT I am at the moment is giving me too much oestrogen on some days, and too little on others, and only occasionally are the levels alright. Then when you factor in the effects of synthetic progesterone... well, it's just chaos, really.
Good days, bad days, evil days, desperate days, bland days - with no respite. Since starting peri I have never enjoyed more than 2 weeks of feeling consistently okay and normal.