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Forum Name: Gynecology

Question: Do my hormone levels show I am pre-menopausal?

 SandieK - Sat Mar 22, 2008 11:54 am

I have had 3 different blood tests for my hormone levels in the last two years, here are the results...




My doctors says I am fine and has not yet prescribed anything for me. MY periods have become irregular, I bleed so bad it is unreal, I have clots that come out of me and I have to change maxi pads in the middle of the night (I wear two super plus overnight ones, I have to wear them during the day as well). I have horrible cramps now (I never really suffered when I was younger), I swell up like a blow fish, I have been having trouble sleeping, I get dizzy all of the time, I have hot and cold flashes all day and night. I am so mean that I think I will end up divorced within the next month or two. I have told my doctor all of this and she told me to take morre prozac. It does not work. I am at my wits end...I do not know what to do, I know that right before my periods I become this irrational person I do not even know, I just want to die. I could use some help interpreting these test results, I have been all over the internet and I cannot find any answers.

Thank you.

ps. I am 38, my mother started going through menopause at 36.
 Debbie Miller, RN - Mon Mar 24, 2008 3:48 pm

User avatar Hello,
This is a very challenging time for you and I'm sorry you are having such stress as a result.

First, you should understand that it can be very difficult to diagnose perimenopause. The labs do not tell it all but are helpful as part of the whole picture if interpreted based on when during the cycle they were tested. Sometimes the labs are deceptive. Estrogen levels are very unpredictable during perimenopause - even throughout the day. Another common occurrence is when the woman has just enough estrogen to sustain menstruation but not normal levels for pregnancy. The decline in estrogen results in limited egg production, resulting in anovulation and diminished progesterone production. This can bring on the emotional symptoms you describe which are similar to PMS. Irregular cycles are common during this time.

If you feel your symptoms are not getting proper attention, you may wish to pursue a second opinion, perhaps with someone who specializes in gynecology and women's hormone issues (this may or may not be an OB/GYN). Sometimes a doctor who once delivered babies decides to concentrate on the perimenopausal period and they can be especially knowledgeable about this condition. Many doctors decide to treat women based on symptoms even when labs appear normal. It makes no sense to treat her based on lab values alone.

The best time to check blood levels of estradiol and progesterone would be 6 - 8 days prior to the next menses. It takes a doctor skilled at interpreting the results as opposed to just comparing lab values because of the fluctuation and resulting wide ranges reported by the lab. Seeing the levels alone without the controls a(s provided in your post is not very meaningful). Your doctor could better evaluate these (with the complete lab information) than we can.

There are treatment options and you may have more than one concern gong on at once. Menorrhagia (long, heavy periods) can be a part of the perimenopause but can also lead to anemia so you should have it evaluated. Sometimes the endometrium builds up too much during the cycle. Hormones, D&C, uterine ablation are all treatments sometimes used when this is the case.

You might also consider seeing a therapist to talk about some of the emotional issues you are experiencing, especially as they relate to your marriage relationship. While the perimenopause period is limited, it still can last a few years so getting help dealing with it is important. They antidepressants can also be very helpful so don't be too quick to write this off.

Good luck.

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