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ask: Perimenopause, Pregnancy, or Something else

By ebe July 12, 2010 - 2:43pm
 
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About a week before my period was to start, I had a discharge and some spotting - it didn't last long. I had had sex with my boyfriend a week earlier, and he withdrew. I am 44 years-old and I should know better, but he has done it so many times. Anyway, now my period is 4 days late, and I have no symptoms that it is coming - no breast pain, puffy abdomen, headache, etc. However, I am SO tired that I can hardly move. I am also having some clear, watery discharge in the mornings mostly. My last period I did have was very light so I am wondering if maybe I am just in the early stages of periomenopause. If my period doesn't come in a few days, I will buy a pregnancy test, but I was just seeking advice. It is strange for me to not have my period or not even feel like it is coming. If I was pregnant, I figure that there would be other syptoms. What else could make someone my age skip a period? I don't have an eating disorder nor do I over-exercise.

 
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Cary Cook BSN RN

Hi Ebe

It could be perimenopause, or it could be pregnancy, and there is really no way to tell without time or testing. I don't know about the watery discharge, though.

You can have a blood test to measure your hormone levels and tell you whether you are in perimenopause. That can be helpful just to know so when you have symptoms they aren't as worrisome. But it is also possible to become pregnant at your age, and if you don't want to raise a child you really should use a different method of birth control. I know you are nodding right now or rolling your eyes, but I had to say it.

The watery discharge thing makes me wonder if you have something going on, though. In your position I would see my health care provider just to rule out any kind of infection, since that doesn't seem to be the norm for you.

I'm sorry I can't give you a definitive answer, but I hope you get one soon. Good luck and please let us know if we can help further.

July 14, 2010 - 8:26am
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Anonymous (reply to Cary Cook BSN RN)

Thanks for your response. My boyfriend and I have a long distance relationship, and don't see each other as often as most couples. We have been doing the pull-out method for over 14 years and never have had a scare. However, you are right - there are safer ways. I cannot fathom that I am pregnant, and I can't seem to buy a test yet. In my research, alot of my symptoms matched those for pregnancy and perimenopause. I was surprised how similar they were.
Anyway, still no period and I feel good. No cramps, breast soreness, bloatiness, etc. The fatigue has lessened. If I were pregnant, wouldn't I be feeling some of the signs? I also mislead you on the discharge. It is more clear than watery. It is like excess egg whites. I have experienced this slightly before in my cycle, but not as much as now. I was wondering if it was a sign for something.
I need to do a pregnancy test, but I would like my boyfriend here when I do it. He can't come for two weeks, and I don't know if I should wait that long. I do feel fine and have no signs of pregnancy except a missed period. I feel ridiculous because I am too old and should have been smarter. I am still hopeful it is just perimenopause or something else not serious.

I don't want to take too much of your time, but my last period was very light, and my boyfriend and I didn't even have sex that month. Then I got the stomach flu which led to a yeast infection. I was treated with diflucan. For over a year I have been using a bioidentical hormone cream that I get from my doctor, but for some reason I quit using about a week before my period. I didn't feel like I needed it. Could any of this explain a very late period? I am sort of grasping at straws, but my period has never been late in my life.
Actually the thought that my periods could be ceasing due to early menopause seems okay to me because I really dislike my period. On the other hand, I always wanted a child, but sort of gave up on the dream awhile ago - although I never gave it up completely. I guess that is why I am so scared to find out my answer. Life is scary sometimes.

July 14, 2010 - 9:48am
Cary Cook BSN RN (reply to Anonymous)

Okay. If your doctor gave you hormones, you are probably in perimenopause, unless there was some other less common reason for it? What tends to happen in your cycles get a little longer or sometimes shorter and for some people the bleeding gets much heavier and that's why so many women in their 40s end up with a D&C or ablation. But eventually the cycles kind of lengthen and the periods get a little more erratic. You might start your period, it goes away for a day or two, comes back for a day or two and you're done. That sort of thing.

Other symptoms are hot flashes, some people have trouble sleeping, some get kind of emotional sort of like a PMS thing and that is also from the change in hormones. Perimenopause can go on for years before you finally stop having periods altogether.

Since you are on hormones my guess is you are perimenopausal and that would make it less likely for you to have become pregnant easily but not impossible. If you want to go to the doctor they can check for pregnancy with a blood test earlier and with better accuracy than the over the counter urine test. So that's an option.

Good luck and don't worry about writing again if you have more to discuss. That's what we're here for.

July 15, 2010 - 6:45am
ebe

Hi Cary,
Thanks for all your help. I still have not started and I don't feel like I am going to. I did saliva tests to get my hormone cream which was lessened to a very light dose.(Only 2 "clicks" versus the 4 that I was originally perscribed.) I went on the cream mainly to treat fatigue and anxiety attacks - very few hot flashes.
I am curious about something called endrometrial hyperplasia. My last period was mostly a brown discharge versus a normal menstrual flow. The article I was reading made it seem that my hormone cream could have upset a balance and caused a thickening of my uterine lining which might stop my period. Is that correct? I am unhappy with my current doctor and need to find someone who is close to where I live. I appreciate your help because right now I can't just rush to the doctor. The strangest thing to me is my lack of any period symptoms - no cramps, acne, anxiety, anger, etc. I am not complaining - having no period has been great, but it is not normal. My boyfriend is going to try to get here sooner so I can take a pregnancy test - I guess he doesn't have to be here, but it would be nice. Neither one of us think that a pregnancy is likely, but technically it is possible. I guess we need to eliminate that possiblity first. I will keep you posted.

July 15, 2010 - 2:57pm
Cary Cook BSN RN (reply to ebe)

It will help if you can tell me what hormone you are taking.

July 16, 2010 - 5:40pm
ebe

Hi,
It is a bioidentical compound made for me. It is a progesterone cream which says 20mg/1ml. I did only 2 clicks of the cream, but for a year I did 3-4. Towards the last month I got lazy and forgot sometimes. THANKS for your help.

July 17, 2010 - 3:43am
Cary Cook BSN RN (reply to ebe)

Hi Ebe

I suggest you read this article about the function of progesterone in your body. I think it will explain your symptoms for you. http://www.empowher.com/menstrual-cycle/content/progesterone-hormone-hea....

Basically, if you have plenty of progesterone and not enough estrogen, it can delay your periods. Your body has a hormonal feedback system, and they all work together, so if you are higher in one than another it has an effect on everything.

Let me know if this helps.

July 18, 2010 - 8:41am
ebe

Dear Cary,
Thanks for the article. It had alot of good information, but it mostly talked about if progesterone is too low - I am probably too high. I did take a pregnancy test, and it was negative so that is ruled out. The strange thing is that I feel good - no hot flashes(I never had that many, but a few.) I don't have any cramping, bloating, or breast soreness. I am not edgy or angry or weepy - all the normal hormonal things. My skin is clearer and smoother than it has been around my period time. My period is 12 days late. I don't know what is wrong - well, actually things are right. Isn't it funny that women expect to feel terrible for a week every month? I guess that I will just wait it out and see what happens. In the meantime I need to find a new doctor. Thanks again for your help.
Angie

July 19, 2010 - 3:26am
Cary Cook BSN RN (reply to ebe)

I understand that. But the opposite symptoms would apply to high progesterone, and that's what you seem to have. Too much progesterone would prevent a period and all of those other things. So it seems you need to have your hormones tested again and decide whether you need to be on progesterone or not.

Sometimes I think we're better off if we just go the way of natural menopause instead of hormone treatment. I know not everyone can do that, but to me it seems simpler and the symptoms of menopause are often less than the symptoms of getting your hormones all out of whack by supplementing them.

Please let us know what happens, because it really will help others. Thank you.

July 19, 2010 - 6:17am
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Anonymous (reply to Cary Cook BSN RN)

Dear Nurse Cook,
Your advice to Ebe seemed very helpful and informative. I'm hoping you can provide me some advice as well. I'm trying to figure out if I could pregnant or just late due to perimenopause which I may be going through. I am 48 years old. Up until this year my period usually came every 26 days. Not every month but usually. Sometimes it came the 24th or 25th day, sometimes 27th day. The early part of this year my period came early like 20 -22 days for the first few months. Then in the summer months it was coming very late, one month 40 days, the next 41 then the next 42. In September it came 31 days. That last period although lighter also seemed to last longer. Usually my period would last 5-6 days and be gone. This last time it seemed there was light spotting or a brownish discharge for a few extra days. Earlier this month while having sex with my boyfriend the condom slid off but we didn't realize it till afterwards. I am now in the 35th day of my cycle and no period yet. I've read a lot about pregnancy symptoms and don't have any symptoms yet, no nausia, tender breasts, or anything. As for period symptoms I do not get cramps, tender breasts or feel fat like some one before or during my period. The only way I know it's coming is because the week before I am extremely hungry and feel like eating all day and a few days before I belch a lot, which I was doing earlier this week. I'm of slender build 5'4" 107lbs and I don't think i get bloated either before my period. I've been a little hungrier this week but not ravinous. Since the periods were coming 40-42 the month before last should I wait till the 43rd day to take a pregnancy test or could I take it now since my last period came on the 31st day and now it's been 35 days since the last one? Not knowing if I could be pregnant or not is driving me crazy but I don't want to take the test too early and get a false negative. As a rule I think I am usually an a-symptomatic type of person as I don't suffer during my periods. I have been pregnant once before back when I was 28. I had no symptoms back then either. It had occurred to me that I hadn't gotten my period for a while so I got a pregnancy test which was positive. Back then I had no nausia, tender breasts, cravings or any other signs. I tried to provide as much detail as possible. If you need more information please let me know. Can I take the pregnancy test now or do I have to wait another week which at this point seems like an eternity.

Thank you,
Wondering in LA

October 22, 2010 - 1:05pm
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