I'm 45 years old with 3 children. My periods have always been regular with about a 35-40 day cycle. Within the last few years my cycle has shortened to about 30-33 days. About every third time I get my period it is a little heavier than the others, but nothing I was ever concerned about. This last period, however got extra heavy on the second day with alot of clotting. I called my gyn and he prescribed 10 mg. of provera for 7 days and ordered a transvaginal ultrasound. I took the provera as perscribed and my period finished out as normal. However, 2 days after stopping the provera I started bleeding again with mild cramping a headache and very emotional.I called my dr. and he said the bleeding could be from the provera. He seems to feel this is a hormonal imbalance and not the start of menopause, but will know more after the results of the ultra sound.Does this sound normal? I am starting to get very worried that this could be something more serious.
A. At 45 years of age, some change in menstrual flow is common. It is most often due to the beginnings of hormonal changes that will likely take 5 to 10 years more to result in menopause. While your extra heavy period might have corrected itself, many doctors would give Provera. Provera is a type of progesterone and it is common to feel some emotional change with that medication. The ultrasound will tell if there is a polyp or other cause of your bleeding that can be seen. If irregular periods or bleeding continue over the next months, your doctor might want to do an office procedure called an endometrial biopsy.
For that procedure, a thin straw is placed into the uterus and a few cells of the lining scraped out and sent to pathology. That will tell if there are any abnormal cells.
It is also a good idea to be taking some iron and a multivitamin. Ask your doctor to check your iron levels and to get a blood count to be sure you aren't anemic.
The most likely cause of all of this is the very early beginnings of menopause, which, as I mentioned above, could be up to a decade off. But the testing suggested should eliminate the slight risk that it is due to something more serious.
Machelle M. Seibel, MD
Hi there, I don't understand why your doctor thinks you couldn't be perimenopausal? I am 51 and have been in peri-menopause the past 5-6 years. At your age, I also had heavy periods with clotting. I think you are wise to get a transvaginal ultrasound but it is my bet, that you are in peri and your change in periods is hormonal.
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