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    Losing my grip
    An_246914 posted:
    I am out of my mind with worry. I'm 54, perimenopausal, and lite bleeding with a random clot here and there for 1 month today. I do not believe I ovulated in quite a long time, my periods have been very irregular for the last 3 years.

    During very long cycles, there was intermittant spotting. Seeems like when I did ovulate, I had a normal period in amount and duration. I have not had a real period in many months, just episodes of spotting that came and went, this time it's not going away.

    I am not sure if scouring the internet is helping me or making me more fearful.

    I have a drs apt on the 27th, I feel like I will be out of my mind by then.

    Mary Jane Minkin, MD responded:
    Dear An_246914,
    Please read some of the other questions and answers from today; this type of bleeding is very common in the perimenopause-so I think you are doing exactly the right thing in seeing a health care provider, just to make sure there isn't anything unhealthy in your uterus; statistically, the odds are that this bleeding is indeed related to perimenopause. So bottom line: do keep your appointment for this coming week, but try to relax, as the most likely explanation will be hormonal-
    Good luck,
    Mary Jane
    An_246914 replied to Mary Jane Minkin, MD's response:
    Thank you so much Dr Minkin, I truly apprecate your reply. I keep reading and reading it, trying to relax even a little bit. It's so hard when my body which has been so very regular and dependable my whole life now, is anything but.

    All of this is foreign to me, and feels very, very wrong.
    janet44 responded:
    Hi there I have the exact same thing freaking out !!!! Dread going to the bathroom in case it's there again. It comes and goes have spotted brown mucous here and there all month especially around ovulation . I even did a ovulation test to see if I was ovulating and yes I did this month. I am seeing my family planning consultant on Friday and hope they can scan me. Hate this stress and constantly searching the net thinking the worst . Hope you get on ok today keep in touch x
    An_246914 replied to janet44's response:
    I had a pap test, endometrial biopsy and blookword today (cbc, fsh and thyroid). Going for an ultrasound on Friday morning. Dr said my uterus is a little enlarged and since my mother and sister had firbroids, it's a possibility that I have one.

    Dr Minkin what are your thoughts?
    An_246914 replied to An_246914's response:
    I had the ultrasound today, the tech told me I have a few fibroids that are a good size.

    I don't have all the other test results yet.

    I'm not sure what to think now.
    Mary Jane Minkin, MD replied to An_246914's response:
    Dear An_246914,
    Fibroids are indeed very common; and once you are fully menopausal, they do rate to shrink. If they are impinging on the lining of the uterus, they can also cause some bleeding/spotting. It's great that you already had an endometrial biopsy; the results of that should be available early next week- and presuming they are all benign, the likeliest explanation of your bleeding is a combo of perimenopause and the fibroids-hope you'll get the good news soon,
    Good luck,
    Mary Jane
    An_246914 replied to Mary Jane Minkin, MD's response:
    Dr Minkin, I wanted to update you. My endometrial biopsy was negative, no cancer or pre-cancer. thank god. my ultrasound showed a couple fibroids. Blookwork: thyroid normal, cbc normal, FSH 58.3.

    My dr said if bleeding doesn't stop or it gets worse, hysterectomy is a possibility. I can not take hormones.

    I am still spotting. Yesterday I had an episode of a few clots and bright red bleeding, today it's just a brown wipe on the tp. how do I deal with this ongoing pest? Is it ok to wait it out to see if it will go away on it's own ?

    Dr wants me to repeat ultrasound in 6 months.

    What are your thoughts?

    Also, it is 8 days past my biopsy, is it safe or ok to have sex now? Will I be hurting anything with the fibroids?

    what are my chances of accidental pregnancy at this point? When am I safe to go without birth control ?

    I will also go over these questions with my dr but yesterday when the nirse called, I was so relieved I didn't thin to ask.
    Mary Jane Minkin, MD replied to An_246914's response:
    Dear An_246914,
    I am delighted for you that the biopsy was negative; that's terrific. Highly unlikely you would get pregnant with an FSH of 58.3; you are truly perimenopausal, and those ovaries aren't doing a ton of work! (premenopausally the FSH is less than 25)
    As long as your CBC is ok, you really don't have to do anything, as long as the bleeding isn't driving you nuts. A couple of options do exist: you mentioned you couldn't take hormones. I presume you were referring to estrogen. Progesterone (progestin) therapy often times can help; you could take it by mouth to help control the bleeding. Another option is to insert a progestin coated (Mirena) IUD; that often times will significantly help to control bleeding. I'd hate for you to have to undergo a hysterectomy, being as close as you are to menopause, at which time all these problems should get better.
    So good luck,
    Mary Jane
    choclategirl responded:
    be careful your iron level does not drop.. mine did and I needed two emergency transfusions... have you had the hormone blood test to tell if you are close to the end of periods?
    Mary Jane Minkin, MD replied to choclategirl's response:
    Dear Choclategirt,
    That's a very good point to all of our community: if you are having significant bleeding, ask your health care provider to order a CBC, or hematocrit; you want to make sure you''re not becoming anemic. And if you are, do take some iron-because you will need it.
    Mary Jane

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