fibroids? perimenopausal?

I am 53 & have always had irregular periods - 15 to 45  days in between periods; 5 to 16 days long. When I turned 49, the periods were shorter in between, but longer in duration.  Since then, I would have a few hrs when the flow would be very heavy, then "normalize". I have 3 fibroids; I go for annual pap smears, and had 2 uterine biopsies ('05 & '06) to rule out cancer for the long lasting periods.  In Nov.'06, I had a 12 day period, then no periods until Apr.- that period was a few days of light spotting.  Then, no periods until Jul 4.  Other than a couple of days "regular" flow, that period was more like very light spotting: It lasted for 16 days. On Aug. 1, I started spotting again - and w/in 3 days had a normal flow.  For 3.5 days, I had very heavy flow that required changing tampons every hour or less - for a few hours.  Then, the period returned to normal or spotting for several hrs, and then returned to heavy flow.  There were several small, dark blood clots during the heavy flow times - and some lower back or front of leg discomfort. As of today, I still have a period that varies from spotting to regular flow. I've begun taking iron pills b/c I don't eat meat & have heard that heavy flow might show low iron.  I am out of the country until Labor Day, so I can't see my gynecologist.  My questions:  Does this pattern seem a result of the fibroids and that I am perimenopausal?

[Machelle Seibel, MD]

Taking iron for this problem is a good idea. If you are low on iron, the iron tablets will correct the problem. If fibroids stay the same from year to year, they are not likely to be the cause of the bleeding. When you return, ask your doctor to get an ultrasound to look for additional fibroids or growth of the ones you have to see if they contribute. At 53, the most likely reason for the change is perimenopause. Talk with your doctor about treatment options. They range from doing a D&C to taking a short course of hormones to using a progesterone containing IUD such as MIRENA. Any of these could help reduce your bleeding but they require a discussion to see which makes the most sense for you.
Machelle M. Seibel, MD

[laprof]

Thank you!  All bleeding stopped by Aug. 16, but I still made an appt w/ my MD for early October.  I appreciate your reply to my question!