Hormonal Changes: Is It Perimenopause or Something Else?

Q: Hormonal Changes: Is It Perimenopause or Something Else?

Hello： A blood test can be performed to check if menopause has occurred. <br>If menopause is confirmed, hormone replacement therapy can be initiated. <br>If abnormal bleeding persists, a follow-up appointment for further evaluation is necessary.

Contraceptive film-coated tablets

Hello, I am currently 48 years old.
My menstrual cycle used to be very regular.
I have two uterine fibroids measuring 2 to 3 centimeters that are being monitored regularly.
My menstrual flow has not been heavy, and I occasionally experience menstrual cramps.
However, in the past couple of years, my periods have started to come about 5 days early.
Additionally, I have been experiencing night sweats, hair loss, and symptoms of anemia.
After my last period on September 18, 2023, I did not have a period in October, and I am not pregnant.
The doctor performed an ultrasound, and my ovaries appeared normal.
Based on the thickness of the endometrium, I should still be having periods, but since I did not have one, in November, the doctor prescribed hormone replacement therapy with Conjugated Estrogens, which I started taking on November 7.
By November 11, I began to notice some spotting, and by November 13, my period officially started, although the flow has been light.
Should I continue taking this medication? Given my situation, could this be an indication of perimenopausal symptoms? Do I need any additional treatments? Thank you.

Xiao Zhu, 40~49 year old female. Ask Date: 2023/11/15

Dr. Lin Xinwang reply Obstetrics and Gynecology

Hello: A blood test can be performed to check if menopause has occurred.
If menopause is confirmed, hormone replacement therapy can be initiated.
If abnormal bleeding persists, a follow-up appointment for further evaluation is necessary.

Reply Date: 2023/11/15

More Info

Understanding hormonal changes during the transition to menopause can be complex, especially when symptoms vary widely among individuals. Based on your description, it seems you are experiencing several common signs associated with perimenopause, which is the transitional phase leading up to menopause.

At 48 years old, you are within the typical age range for perimenopause, which usually occurs in women in their 40s and can last several years. The irregularities in your menstrual cycle, such as your periods coming earlier than usual, are characteristic of this phase. Additionally, symptoms like night sweats, hair loss, and anemia can also be linked to hormonal fluctuations during perimenopause. These changes are primarily due to the declining levels of estrogen and progesterone, which can affect various bodily functions.

The presence of uterine fibroids, which you mentioned, can also complicate your menstrual cycle. While fibroids are often benign, they can contribute to changes in bleeding patterns and menstrual symptoms. Regular monitoring of fibroids is essential, especially as you approach menopause, as their behavior can change with hormonal shifts.

Regarding the medication you were prescribed, Contraceptive Hormone Therapy (likely a form of hormonal birth control), it is often used to help manage irregular menstrual cycles and alleviate symptoms associated with perimenopause. The fact that you experienced some spotting and then a light period after starting the medication suggests that your body is responding to the hormonal treatment. However, whether you should continue taking it depends on several factors, including your overall health, the severity of your symptoms, and your personal preferences.

It is essential to have a thorough discussion with your healthcare provider about your symptoms and treatment options. They can assess whether the benefits of continuing hormone therapy outweigh any potential risks, especially considering your history of fibroids and anemia. If your symptoms are manageable and not significantly affecting your quality of life, you may not need to continue the medication. However, if you find that your symptoms are disruptive, further treatment options may be necessary.

In addition to hormonal therapy, lifestyle modifications can also play a crucial role in managing perimenopausal symptoms. Regular exercise, a balanced diet rich in fruits, vegetables, and whole grains, and stress management techniques such as yoga or meditation can help alleviate some symptoms. Staying hydrated and ensuring adequate sleep can also be beneficial.

If your symptoms persist or worsen, or if you experience new symptoms such as heavy bleeding, severe pain, or significant changes in your health, it is crucial to seek further evaluation. Additional tests, such as blood tests to check hormone levels or imaging studies to monitor the fibroids, may be warranted.

In summary, based on your symptoms and age, it is plausible that you are experiencing perimenopause. Continuing hormone therapy may be beneficial, but this decision should be made in consultation with your healthcare provider, who can tailor the approach to your specific situation and health needs. Regular follow-ups and open communication with your doctor will help ensure that you receive the most appropriate care during this transitional phase.

Similar Q&A

Menopause at 42: Hormone Therapy Concerns and Weight Management

Dear Doctor: I am 42 years old, 150 cm tall, and weigh 44 kg. After a blood test, it has been confirmed that I have been menopausal for six months, and I occasionally experience night sweats. I am feeling very depressed about my situation. Do I need to take hormones? I am very co...

Dr. Mao Yikun reply Obstetrics and Gynecology
Hello: Menopause is a phase in life, similar to childhood and adolescence. However, during this period, due to a deficiency in hormones, individuals often experience some uncomfortable symptoms. It is important to recognize that this is not a disease and to adapt accordingly. In ...

Understanding Perimenopause: Irregular Periods and Ovulation Issues

Hello, Director Zhang: I would like to ask if experiencing menstrual cycles every two to three months during the perimenopausal stage, with a basal body temperature not exceeding 36.6 degrees Celsius but showing irregular low temperatures, indicates anovulatory menstruation? Is...

Dr. Zhang Kunmin reply Obstetrics and Gynecology
Hello Nenny: Before menopause, menstrual cycles and flow can be irregular, and basal body temperature may not reliably indicate ovulation. It is recommended to continue using contraception and monitor the menstrual cycle and flow; if there are significant abnormalities, a clinica...

Managing Hyperthyroidism Symptoms During Menopause: A Patient's Dilemma

I officially reached menopause last month and have been experiencing palpitations, dry and rough skin, and hair loss. Blood tests indicate that my hormone levels are low, but I have mild hyperthyroidism. The doctor prescribed medication for hyperthyroidism and for palpitations, b...

Dr. Zhou Jiazhen reply Breast and Thyroid
Dear Koko, Hello. The thyroid and ovaries are both endocrine organs and may have mutual influences. During menopause, hormonal changes are significant and can have a wide-ranging impact. Given the prevalence of similar conditions, I recommend maintaining a regular lifestyle and ...

Understanding Hot Flashes: Signs of Menopause in Women

Dear Director Wang, I have been experiencing sudden episodes of heat and sweating between the back of my head and the nape of my neck for the past month, lasting for one to two minutes. This occurs about ten times a day. Does this indicate that I am entering menopause, consideri...

Dr. Wang Jionglang reply Obstetrics and Gynecology
Hello: In response to your question, menopause is a natural phase that every woman goes through, typically occurring around the age of 45 to 50. In addition to changes in menstruation, common symptoms include hot flashes, night sweats, chest tightness, palpitations, mood swings, ...