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Perimenopause & scar tissue
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Perimenopause & scar tissue

At age 15, I had a perforated appendix, hence appendectomy.  At 32, I was suspected of an incomplete miscarriage, hence underwent a D &C. A few days later, an ectopic pregnancy was discovered and a tube removed. For  this procedure, laparoscopy was started but abandoned due to excessive scar tissue, and full surgery was performed to 'clean up'.  I am 42 now and have had extremely light 2-day periods since 35!  My 'normal' period' used to be 6 days, with 4 days of heavy flow.  I used to have hotflashes 5 yrs ago but stopped with lighter nightclothes.  I've started dry patches near my nose and mouth. I have no other symptoms. Could I be perimenopausal? Could recurring scar tissue be affecting my ovaries and causing my light periods? How can I find out? I am so afraid my periods may stop altogether. What else could it be? What should I do?      
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A ruptured appendix and an appendectomy and a D&C can both potentially contribute to infertility and an ectopic pregnancy. In theory, scarring could surround the ovary and the blood supply to it and lead to menopause occurring sooner. This would be very uncommon. It is possible that your symptoms of lighter menstrual flow are a sign of perimenopause. The easiest way to find out is to have your doctor draw a blood test for FSH. If elevated, that would indicate you are near or in perimenopause. The problem with this is that most women have a slightly elevated FSH at age 42 or so. Menopause is not considered early or "premature" unless it occurs before age 40. There really isn't a test for finding if there is scar tissue on the ovaries. It does not show up on ultrasound. It would take a surgery which would not be something done for that purpose. The best approach is to have your doctor check your FSH and estrogen levels. Other possible hormone tests could be for prolactin, which is a pituitary hormone, and Thyroid stimulating  hormone or TSH to test for thyroid function which can also affect menses. However, a person's weight can also be a factor, especially if the person is very thin or lost weight.
Machelle M. Seibel, MD
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Thank you so much. A relief to know that I may not have too premature menopause.
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