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Menopause (Expert Forum)

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Menopause, or something else?

Answered by

Machelle Seibel, MD - Women's Health, menopause, ReproductiveMedicine

University of Massachusetts Medical School MA

Questions in the Menopause forum are answered by Dr. Machelle Seibel. Topics covered include menopause issues, depression, hormone replacement therapy, hot flashes, joint or muscle problems, memory problems, mood swings, osteoporosis, sexual problems, skin changes, sleeping problems, vaginal problems, and weight problems.

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MedHelp Member's Question

Menopause, or something else?

by missers, Dec 23, 2006 12:00AM

Tags: menopause, fertility, test, years, hair loss, fertility treatment, Dry Skin

I hit puberty at age 12. Always had heavy periods and bad cramps. Periods pretty regular. At age 36 had a myomectomy due to fibroids causing very heavy bleeding and severe abdominal pain. Was told chances of conceiving were low due to some ovary damage from fibroids. One live birth at age 38. A few months after giving birth (c-section) my periods starting becoming irregular and I started experiencing menopausal symptoms (i.e. hot flashes, night sweats, loss of concentration, mood swings, dry skin and hair, vaginal dryness). Also experiencing hair loss, joint pain, nausea & headaches. GYN did withdrawl test, TSH and FSH. All normal. At age 40, periods became almost nonexistant (only 3 in one year, all lasting about 10 days). GYN did another withdrawl test (failed), TSH and FSH (normal). GYN put me on the pill and said if I wanted another child, to go off pill and try clomid. At age 43 went off pill because wanted to conceive. No period since stopping pill (10 months ago). GYN shrugs shoulders. Says unlikely that preimenopause would only last a couple of years. My maternal grandmother was in full menopause at age 35. My mother went into menopause at a normal age, and my three older sisters all still menstruating. So, if no period in the next two months, am I in menopause? GYN said no chance to conceive now and wants to put me on HRT. Should I put the maternity clothes in the donation box? Is it possible it's a pituitary problem or thyroid issue?

Doctor's Answer

by Machelle Seibel, MD

, Dec 23, 2006 12:00AM

A. It is hard to say with certainty where things are given your history. However, it seems very unlikely that you will be able to conceive again. It might be that the FSH level is incorrect. Your age and symptoms seem to be menopause. It is worth checking a blood test for TSH (thyroid stimulating hormone) and prolactin as they can stop periods and FSH can be normal. But not having withdrawal bleeding also suggests menopause and that is your most likely diagnosis. If you do try to conceive again (and I�m not recommending that you do) I would suggest you not try Clomid but go to a fertility specialist and try using injectable medications called gonadotropins. They contain LH and/or FSH and are more likely to succeed in women over 40.

Machelle M. Seibel, MD

Member Comments (4)

by billeen, Dec 31, 2006 12:00AM

Missers - I am 44 years old and have gone through extensive fertility treatments, starting at the age of 38. I ended up conceiving with donor eggs at age 42. Perhaps a reproductive endocrinologist rather than a ob/gyn can give you more concrete answers. My problem was slightly elevated FSH. My RE said that I had a higher chance of getting pregnant with donor eggs. Statistics in the fertility industry state that by the age of 46, a very small amount of women conceive with their own eggs. At our age, even without problems there is a 5% chance of getting pregnant. That number drops to about a 2% for an actual sustainable pregnancy.

Bee

by missers, Jan 04, 2007 12:00AM

To: Billeen

Thanks for your comments. My husband and I decided not to go through fertility treatments years ago when I was first told my chances were next to nil to conceive. It was a tough personal decision to make. We were blessed with a natural conception (probably since the stress of it all was off because we had already made our decision) and I delivered a healthy child. I was already 38 when I had him and thought we would try again right away to have another when he was a year old. But my cycle started going haywire and the focus became making sure there was no clinical reason. Do you know if a RE would be able to help me in that regard even if we stay true to our decision not to go the fertility treatment route? My GYN doesn't seem too concerned but really isn't offering any tests or ideas and my main concern is that my body is healthy. I'd switch to a new GYN but my insurance limits me on who I can see.

by billeen, Jan 05, 2007 12:00AM

Hi Missers

My RE sees people from 16 years old+, so I don't think that it will be a problem. I think that you should make an appt! Good Luck.

B

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