Spotting - Perimenopause or Other?

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

[Machelle Seibel, MD]

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