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