I am 43 and just had my first missed period. I took a pregnancy test and it was negative. I don't feel pregnant at all, and my DH had a vascectomy, so pregnancy is ruled out. I had a bit of spotting and cramping one day, then nothing. I am very regular, with 5-7 days of heavy bleeding, so this is very abnormal. Do I need to go to the doctor? Am I in perimenopause? Is there any testing I should do?