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Menopause  (Expert Forum)
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Spotting - Perimenopause or Other?
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.

Spotting - Perimenopause or Other?

by nycjane, May 28, 2006 12:00AM
I am 47 years old and have always had fairly regular, uneventful periods.  6 months ago, I spotted for 14 days straight.  I went to the MD and he examined me and gave me a pelvic ultrasound and said he saw nothing unusual.  He also said my uterus lining was thin.  He told me to come back if it happened again.  

My last period was April 20.  But I spotted for 5 days starting May 5.  As of today, still no period.  I visited MD last week and he examined me and said he saw no polyps or anything else.  He said it could be peri/hormonal fluctuations.  He gave me a prescription for 10 mg of Provera for 10 days and told me I should get a period after that.  He said if I spot again within a few weeks afterwards, I will have to have an endometrial biopsy.  I've had no ther spotting besides those 2 instances.  

Does it sound like peri or something more serious?  I've never had anything like this so I am a little concerned.  Thank you in advance.

Jane

by Machelle Seibel, MD, May 29, 2006 12:00AM
A. It is hard to know what the answer is from your history because we have too little information.  But as a guess, it sounds like perimenopause.  Your doctor might want to get a blood test for FSH, a hormone that rises as menopause approaches.  Irregular cycles are very common and typically there is no cause for concern.  If your doctor does do an endometrial biopsy, it will cause some mild cramping, but the tissue can be sent to be looked at under a microscope and it should tell if everything is OK.  If the biopsy if fine, it is likely there is little to worry about.  But expect your cycles to get more irregular over the next months. If your doctor has made sure there is no serious problem and only perimenopause, it isn’t necessary to do any treatment, though hormones can help to regulate the bleeding.  It is also a good idea at this time in life to start taking a multivitamin and calcium supplement if you aren’t already, get a mammogram and bone density, and in a year or two, get a colonoscopy.
Machelle M. Seibel, MD
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