33yrs old and peri menopause symptoms?

Dear Doctor,

Lately, since Sept 2007, 2 or 3 (consecutively) times a months (especially near towards my periods) i would wake up in the night with wetness between my breasts. I didnt have sweatness elsewhere, except one time where my upper lip was very moist.
Q1. Are these pre-menopausal night sweats?

Also, i have experienced twice at different times what feels like a hot flush, i.e. very warm heat on my face/head..
Q2. Is this called a hot flash?

My last 2 periods went onto 7 days. Normally my periods last for 3 days and then have brown discharge until day 5 or 6. But this time i noticed that very slight brown discharge continued until day 7 and on day 7 i even had very small fresh blood.
Q3. Is this called irregular periods?

I also noticed that this month i have not ovulated. My cycle is has always been regular, occuring every 24 days (give or take a day) and i always experience abundant cervical mucus mid cycle. This time i have not seen any cervical mucus.

Q4. My main query is that am i experiencing premature ovarian failure or even perimenopause? I have been under a lot of stress and anxiety and worry for the 2 months. Because i have been worried relentlessly, I havent eaten much and cannot sleep properly. However, the 'very mild night sweats' started before this.



Q5.What tests can i do to determine my fertility status ( I am based in the UK).
My doctor will perform a 21 day cycle test. What will this test for?

I had my thyroid checked and that was normal.

PLease advise...Im scared of being infertile as i am only 33 yrs old and childless.

Thank you.

[Machelle Seibel, MD]

The symptoms you are having could be due to menopause. The sweating could be a night sweat. The warmth could be a hot flash, and the menstrual changes you are having could be due to hormone changes that occur as menopause approaches. An elevated blood test for FSH and a low level of estrogen will be very helpful in telling if menopause is near. However, anxiety and stress can also cause these same problems in some women. You had your thyroid checked and that is good to know it is normal and not the cause. If the FSH is elevated, it will suggest that getting pregnant will be more difficult. The day 21 test must be an endometrial biopsy to test the uterine lining and see if ovulation occurs. That test (I assume that is what is being done) tells more about the quality of ovulation. He/she may also be getting a blood test for progesterone which tells if you ovulate or not but usually does not explain the quality of the ovulation or answer the questions you mentioned above. If fertility is an issue as you suggest, see a fertility doctor soon and get all the facts and decide if it makes sense to have an aggressive go at childbearing at this time. Understanding what is going on will be very helpful to you and there should be a clear answer after the tests come back.
Machelle M. Seibel, MD

[ayg67]

Please have your doctor check your FSH levels, this is hormone is very indicative if you're having premature ovarian failure.  I was menopausal at 31 yrs old.  My FSH was in the 90's.  
Good luck