perimenopause

Hello,  I am an almost 48 year old female that has had consistent 4 week cycles up until January.  I did not ovulate in January and as a result had a scant 2 week late cycle in February.  Then I ovulated normally in March and then ovulated 2 days after my cycle stopped in both April and now again in May.  This causes my cycles to come every three weeks now instead of my typical 4 week cycle.  I also went to the emergency room in April with runs of PVC's.  I had over a thousand that day.  My typical PVC count is less than 10 a day, so this was concerning.  Well, after an echo and thyroid check as well as a holter monitor test that all stated just "PVC's" and no bad arrhythmias I was told to try atenenol if they are still bothersome.  Well, they stopped and I thought I was going to be ok, except I had another bad run of them exactly the same timing the month prior; 6 days before I started my cycle.  So, I was wondering if this might be hormone/perimenopause related?  I have a history of hypoglycemia so am not a candidate for hormone therapy as it raises my blood sugar and I have constant low blood sugar attacks.  So, any thoughts and suggestions are appreciated?  Do you think this might be a symptom of perimenopause?  What are your thoughts on natural progesterone cream (wild yam)?  Should I try this?
Thanks for your thoughts and comments.

[Elaine Brown, MD]

Hi!
To be completely honest, the runs of PVCs are probably coincidental with your cycle changes.  Your cycle changes probably are caused by peri-menopause.  It is not necessary to treat the cycle changes caused by the perimenopause unless you begin to have heavy bleeding or excessive prolonged periods.
Wild yam cream contains progesterone which is a hormone.  I tend to like the natural progesterone creams that are compounded by the pharmacy because the amount of medication in them is much more consistent since they are regulated by the FDA.
I personally prefer to see such preparations used under the care of a physician, because they can cause bleeding and other side effects.
I hope that you have a good cardiologist to evaluate your heart and a good gynecologist to help you through the peri-menopause!
Good luck!
Dr B