Worsening PMS, spotting, heavy periods. Perimenopause

[gatorsmom]

Call my doc office today and scheduled a "problem appointment" in addition to my annual exam. They won't schedule them at the same time (or back to back) because "it gets wonky with billing insurance." That just sounds lazy to me. Mark it down as two appointments, two billing codes, two insurance claims. But whatever. The good news is that I can get in for the problem appointment in 2 weeks and it's with one of the docs who I saw back in my pregnancy days and is of mature age and long-time practicing. Whereas with my annual it's usually an NP, PA, or brand spankin new doc who hasn't even had her own kids yet, much less dealt with menopause (the one they schedule me with graduated 4yr ago!). That will give me this current cycle (due any day now) to try increased dose of ibuprofen and to read the book Latia recommended and go armed with info.

Sounds like a good plan and good luck! This probably goes without saying but make sure you eat a little something when you take the ibuprofen. Don’t take it on an empty stomach. Also, my doc said to start the ibuprofen a day or 2 before I suspected my period was coming.

[gatorsmom]

Yes! I am 39 and positive I'm in PM. No one will believe me or even test. I keep getting told that I'm too young. I just made an appointment with the CNM that delivered my first child. She was by far the most willing person to help figure out problems. I'm hoping she can help because I have all of the symptoms as OP, minus the heavy bleeding (but it's starting to get worse) and the mood shifts are horrible (but all clearly related to hormones).

The mood shifts for me were much worse during perimenopause than anything I experienced previously with PMS. In fact, I would have been willing to take the mini pill without the heavy bleeding just to control my moods. Fortunately, the mini pill helps control both.

[Mom to Brandon and 2 cats]

No advice, just hugs. I'm 47 now, once I turned 46 (almost exactly), I had heavy periods lasting 3+ weeks, sometimes only 3 or 4 days off until starting the next one. For a whole year. Last month, I finally had a normal period of only 5 days. I hope it gets better for you. Mine sucks. I was using overnight pads and changing them every 2-3 hours during the day and washing sheets everynight because I made a huge mess at night. Ugh.

[essnce629]

For using ibuprofen to help decrease heavy bleeding, in the Period Repair Manual she doesn't recommend high doses as that's actually not needed. She says to take 200mg every 6 hours during your first 1 or 2 days of bleeding.

She doesn't normally recommend hormonal birth control as that doesn't get to the root cause of the heavy bleeding. The Mirena IUD is the only type of hormal birth control that she sometimes recommends since it is progesterone only. But even then, says most of the time heavy periods can be fixed with the other non-pharmaceutical options.

I originally joined the heavy periods FB group to look up people's experiences with ablation, which I thought might be an option for myself once I turn 40. I've read too many horror stories about it though that I would no longer consider it. Women who continue to bleed underneath the scarred uterus which leads to horrific pain since the blood cannot escape! Plus I have friends who have had major issues with scar tissue and severe pain during periods after having D & Cs and an ablation could lead to the exact same issues.

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[AngB]

Call my doc office today and scheduled a "problem appointment" in addition to my annual exam. They won't schedule them at the same time (or back to back) because "it gets wonky with billing insurance." That just sounds lazy to me. Mark it down as two appointments, two billing codes, two insurance claims. But whatever. The good news is that I can get in for the problem appointment in 2 weeks and it's with one of the docs who I saw back in my pregnancy days and is of mature age and long-time practicing. Whereas with my annual it's usually an NP, PA, or brand spankin new doc who hasn't even had her own kids yet, much less dealt with menopause (the one they schedule me with graduated 4yr ago!). That will give me this current cycle (due any day now) to try increased dose of ibuprofen and to read the book Latia recommended and go armed with info.

I'm glad you got an appointment, good luck!

[marinkitty]

I totally commiserate with you!

I turned 50 last month, but had a hysterectomy in May 2017. I went in to see my GYN for the same things you are citing - such heavy periods, exhaustion, longer cycles - they were just draining me beyond belief. I'd seen her once before a year earlier but in the intervening time it got so much worse (I was 46/47). I'd been dealing with increasingly bad periods since my late 30s, but they were really starting to impact my life.

I had planned to pursue the ablation, but an u/s is required first and they found a large benign tumor attached to the top wall of my uterus (maybe partially to blame but not entirely, according to my GYN). Once that was found, and it would have taken 2-3 in office surgical procedures to remove and then I'd have the ablation, and then still a 50% chance of a later hysterectomy (that's the statistic my GYN quoted me for people who have ablations and later need hysterectomy), I went ahead and had a robotic (less invasive - only an incision at the belly button and that's it) hysterectomy (removed uterus, tubes and cervix, left the ovaries intact).

Best decision I ever made. I was nervous since I'd never had surgery with a general anesthesia before and people told me how awful the gas pain and abdominal pain would be post-op, but it was really not bad. Pain until they "unpacked" the dressing they'd used vaginally (because with robotic surgery, everything they detach via incision comes out that way) a few hours post-op and then discomfort at the surgical site for a week after surgery if I moved around too much or laughed or sneezed. But I was off narcotics after 24 hours and up and around completely in a week with a belly binder to hold things firmly around the incision. It was 6-8 weeks before I could exercise strenuously and another month or so before I could return to pilates or surfing (anything prone or with focus on core), but so worth it.

I did a hyperbaric chamber "dive" the day before my surgery that I think made my recovery a breeze - had no swelling, no bruising - my surgeon honestly couldn't believe it when she saw me for my post-op visit a week post-surgery.

While I wouldn't rush to hysterectomy, I also wouldn't shy away if nothing else is working. I refused to try hormonal birth control as I'd never done well with it and hadn't been on BCP since before my first child in 2002. No desire to go back to migraines, bloating etc. I also didn't want to insert an IUD. So for me surgery was a permanent solution. No adverse impacts at all - sex is the same, I'm still not in menopause except that now I have ZERO pre-menopausal symptoms at all. My GYN thought I'd hit menopause between 52-54 so I figure I'll start having some signs soon but without a uterus etc it is maybe harder to tell? I sleep well and don't have any hot flashes, mood swings etc.

[StantonHyde]

I just hit menopause in the last year. The thing that saved me all this time was my Mirena IUD--loved that thing. I had to go on BCP when I was 18 because my periods were so heavy and painful. I have been on hormones or pregnant from 18-55!! I had some weird memory/anxiety issues with perimenopause but nothing for an extended time. I have 2-4 hot flashes a day but just where I take off my jacket and maybe get a little sweaty. I am not sopping wet. The other thing is that apparently SSRIs help with menopause symptoms and I have taken those for 20+ years so I had that going for me.

[Kindra178]

Heavy doses of ibuprofen for regular use is subjectively "safe". It can and does cause stomach ulcers and other issues so it personally isn't something I would ever consider as a solution longterm. (When I bled last year from Oct-Feb off and on, my obgyn did have me try that while I waited for my appointment,etc.) I would absolutely try an ablation or even a hysterectomy if it failed over years of heavy ibuprofen use.
ANY obgyn can order bloodwork to tell if someone is in perimenopause/menopause. It's just the basic fertility bloodwork that all obgyns should be able to order and understand, not anything that's super specialized or difficult. I guess it's more of a matter of having a good doctor who cares to try.

Hormones fluctuate though, so testing estrogen etc is worthless. My family practice doctor, my gyn and various articles confirm this.

Op, I don’t have low iron but do have all the other symptoms you mention. I’m commiserating.


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[MMMommy]

I feel your pain. I've had horrid, heavy periods (specifically on the second day of my period) the past three years or so now. Day 2 is absolutely the worst, and I might as well just sit at home on the toilet and stay there all day. It's like my entire period is coming out that one day. I actually wear a Depend on that day (and the next day) to save me the hassle of having to rinse underwear after underwear. The Depends have been a lifesaver on those heavy days. Obviously not ideal if you are out and about and need to change them. But they are great for at home and when sleeping. I did a pelvic ultrasound recently and it turns out I have fibroids. So I will be having surgery to remove them next month. I am hoping that the surgery will curb my raging periods. Good luck to you, and I hope things get better!

[jgenie]

ANY obgyn can order bloodwork to tell if someone is in perimenopause/menopause. It's just the basic fertility bloodwork that all obgyns should be able to order and understand, not anything that's super specialized or difficult. I guess it's more of a matter of having a good doctor who cares to try.

I had my primary care physician order the tests when they drew my regular yearly bloodwork.She was happy to add it to the list of tests.