Is this Perimenopause or something else?

Hi and thank you for taking the time to read my post.I am a 43 year old woman who has had normal (every 28 days for 5 days) menstural cycles since the age of 14. I have three children (2 pregnancies) and am overweight by about 50 lbs. I also have subserosal(sp?) fibroids. Within the past 12-14 months I have noticed that my periods are coming closer together, sometimes at 23 days instead of 28. Additionally, I have noticed that my breasts are staying tender most of the month. Also Ive been having brown spotting a few days before I actually start my period.

This last cycle I thought I was spotting and then going to start a normal period, instead I sort of spotted dark brown and tan tissue throughout the whole 5 days, these were not "clots" so to speak more like small sheets of tissue (hope this makes sense). Very little red blood. I have scheduled an appointment with my gyn, but cant get in right away. I talked to her on the phone though, and she seems to think that in the abscence of other symptoms like hot flashes this may be attributed to something else..I have no pain in my abdomen, normal menstrual flows (except the lessened one last month). I am finding my short term memory is not what it used to be. Today I introduced two people to eachother who Id already introduced just last week!

Any ideas?

[Elaine Brown, MD]

Hi!
Sorry, probably not menopause.  You are too young!  The tissue discharge is a common complaint, and I am not sure exactly what causes it.  I DO often tell my patients that after 40 "the warranty is up" on their uterus though.  Periods often become irregular and bleeding heavier.  PMS definitely gets worse. This is the peri-menopause and often continues until about age 50 (the average age for menopause in this country is 51).
If I were your doctor, I would be inclined to treat with progesterone for 5 days, and then do a transvaginal ultrasound after the withdrawl (withdrawal) bleed (that I hope would be prompted by the progesterone).  I would want to check the appearance of your uterus after a period.
By the way, I just answered a question about the Mirena IUD -- these can be quite nice during the peri menpause.
Hope this helps!
Dr B