Perimenopause: how do ya know???

joanne said:

So sorry you're going through this - wish I could help. Lending you a sympathetic shoulder, and hoping someone else sees the thread has come alive again.

Thanks, Joanne!

There isn't really much treatment for endometriosis other than surgery. The BC pills are one option to stop/ reduce tissue growth and reduce symptoms. Severe cases need surgery. So, what are you hoping they will / would have done?

Sorry that happened to you, Chicagonative. I'm not sure what the symptoms of endometriosis are. I recall pain. Is heavy bleeding also?

You might want to call your internist and enlist his/her help in getting an appointment with another gynecologist quickly.

What testing is usually done to determine whether a person has endometriosis? Can any of the testing be ordered by your internist?

You might take the low dose estrogen just to see what impact it has. That way you'll have more information for the next doctor you see about this. By the way if heavy bleeding is one of your symptoms, then it may be caused by perimenopause. The supplement Oona worked for me, and is available at Whole Foods.

I liked the Avalon practice but am not sure if they are right for this.

I didn't love Klatchko because I found her a bit dismissive of my hot flashes, but over zealous about my heavy bleeding. She even said the 'C' word which freaked me out. I decided to never return, but I think she would do more testing than less and might be good for you. I personally decided to find a female internist who would also do the gynecology stuff. I figured that even if she sent me to a specialist, I could rely on the internist to take the lead and be a calming influence. So I went to Dr. Karen Young, and found her to be perfect for me.

I hope you are able to feel calmer about this. Do you have an internist whom you like?

conandrob240 said:

There isn't really much treatment for endometriosis other than surgery. The BC pills are one option to stop/ reduce tissue growth and reduce symptoms. Severe cases need surgery. So, what are you hoping they will / would have done?

I've had extensive abdominal surgery and GI inflammatory disease that went beyond the colon and effected my reproductive system. She flat out refused to do any investigative work or X-rays. What is the harm in making sure I don't have complications from previous surgeries and actually ruling out endometriosis?

Do you symptoms wax and wane with your cycle? Or are theymore constant? I agree its worth exploring endometriosis because of your family history, but if have had many abdominal surgeries and now are having abdominal pain and cramping, its also possible that its scar tissue and adhesions from past surgeries. I hope you can figure this out and find relief.

lisat said:

Sorry that happened to you, Chicagonative. I'm not sure what the symptoms of endometriosis are. I recall pain. Is heavy bleeding also?

You might want to call your internist and enlist his/her help in getting an appointment with another gynecologist quickly.

What testing is usually done to determine whether a person has endometriosis? Can any of the testing be ordered by your internist?

You might take the low dose estrogen just to see what impact it has. That way you'll have more information for the next doctor you see about this. By the way if heavy bleeding is one of your symptoms, then it may be caused by perimenopause. The supplement Oona worked for me, and is available at Whole Foods.

I liked the Avalon practice but am not sure if they are right for this.

I didn't love Klatchko because I found her a bit dismissive of my hot flashes, but over zealous about my heavy bleeding. She even said the 'C' word which freaked me out. I decided to never return, but I think she would do more testing than less and might be good for you. I personally decided to find a female internist who would also do the gynecology stuff. I figured that even if she sent me to a specialist, I could rely on the internist to take the lead and be a calming influence. So I went to Dr. Karen Young, and found her to be perfect for me.

I hope you are able to feel calmer about this. Do you have an internist whom you like?

Thanks, lisat. I've been slow to set-up a team of doctors in NJ and was in the process finding an internist. Dr. Karen Young sounds like the type of Dr. I'm looking for. My previous internist was like this and it was such a positive experience.

Find a new doctor ASAP, @Chicagonative. A few years ago I was explaining my complicated medical history to a physician, who told me "That is historically interesting, but has no bearing on what you are dealing with now" HUH??? That sort of dismissive, LAZY@$$ attitude has no place in any medical community, I don't care how much alphabet soup appears after his/her name,and how expensive the medical education is, it is all for naught if there is no respect for the patient.

I wish I had a recommendation for you--- I truly do. I hate most of my doctors.

carolanne said:

Do you symptoms wax and wane with your cycle? Or are theymore constant? I agree its worth exploring endometriosis because of your family history, but if have had many abdominal surgeries and now are having abdominal pain and cramping, its also possible that its scar tissue and adhesions from past surgeries. I hope you can figure this out and find relief.

Bingo...this is exactly what I want to confirm. I have an extensive history with adhesions and scar tissue in my colon. I was completely speechless when this Dr. told me off the bat she didn't want to do any testing. I felt she had no desire to see complex patients and preferred to deal with 'run of the mill' issues. I'm not discounting the low estrogen BC, but I don't feel this is the right route...

calliope said:

Find a new doctor ASAP, @Chicagonative. A few years ago I was explaining my complicated medical history to a physician, who told me "That is historically interesting, but has no bearing on what you are dealing with now" HUH??? That sort of dismissive, LAZY@$$ attitude has no place in any medical community, I don't care how much alphabet soup appears after his/her name,and how expensive the medical education is, it is all for naught if there is no respect for the patient.

I wish I had a recommendation for you--- I truly do. I hate most of my doctors.

Sounds like we saw the same person. This dr. wasn't willing to connect the dots...it was frustrating. I hate doctors as well and I dragged my feet before making an appt.

This dr was also inept. She had to leave in the middle of the exam to go find a smaller tool, which she struggled with and mumbled that she needed someone helping her. Then she complained she had five other patients waiting to see her. I've dealt with arrogant doctors before, in fact my GI surgeon is as arrogant as they come, but she is competent and knowledgeable and I respect her. This was such a cluster.

But there really aren't conclusive tests for endiometriosis. The only true test is surgery and finding it when they go in.X-rays and standard tests like sonograms are of absolutely no use in finding endiometriosis. It can only really be seen invasively through surgery. What did you suggest she do?

If there is endiometriosis and the symptoms of heavy bleeding and cramping, the BC pills may give some relief without having to put you through another surgery. So, it sounds like her approach may be the right one.

Now, her not listening to your complicated history and being dismissive aren't acceptable. And certainly there are doctors out there who may be more compassionate. Just do your homework, ask the right questions and know what your options are.

My goodness- inept indeed. Who was she?

Aw Chicagonative, I'm sorry that happened to you. I do like my ob gyn nurse practioner at Summit Medical Mary Alice Saporito. She may not be quite right considering your diagnosis but I've found her to be great at being normal in this weird world of perimeni-whatever. She also has a terrific haircut that I admire every time I see her. Hope all works out for you.

So glad I stumbled onto this long standing conversation. Thanks for sharing all this from the bottom of my moody, recently irregular mid-40s heart that now worries about an unexpected pregnancy like a college sophomore. Happy to report that my hair stopped falling out in unusually large amounts in the shower a few months ago. Not sure why it started and not sure why it stopped.

Looks like there is more fun waiting around the next bend.

conandrob240 said:

But there really aren't conclusive tests for endiometriosis. The only true test is surgery and finding it when they go in.X-rays and standard tests like sonograms are of absolutely no use in finding endiometriosis. It can only really be seen invasively through surgery. What did you suggest she do?

If there is endiometriosis and the symptoms of heavy bleeding and cramping, the BC pills may give some relief without having to put you through another surgery. So, it sounds like her approach may be the right one.

Now, her not listening to your complicated history and being dismissive aren't acceptable. And certainly there are doctors out there who may be more compassionate. Just do your homework, ask the right questions and know what your options are.

I have horrible cramping and in the last year my periods went from 3-4 days to 7-9 days and the secretion is extremely irritating. I'm having a lot of abdominal tenderness, not related to my GI issues.

giner, soooo happy about your hair!!

Chicagonative, sounds like someone good is just around the corner and at the very least you have lots of people here who understand. (Now, if only I could get rid of this month's cramps... All of a sudden my body decided to act like it's 15 years younger)

Yes, I understand, I had similar ( maybe not as severe). The BC pills helped a little. Try them. That last thing I want is surgery especially when they can't even be sure endiometriosis is the cause. Terrible that there is so little that can be done for a very common problem.

giner said:

Aw Chicagonative, I'm sorry that happened to you. I do like my ob gyn nurse practioner at Summit Medical Mary Alice Saporito. She may not be quite right considering your diagnosis but I've found her to be great at being normal in this weird world of perimeni-whatever. She also has a terrific haircut that I admire every time I see her. Hope all works out for you.

So glad I stumbled onto this long standing conversation. Thanks for sharing all this from the bottom of my moody, recently irregular mid-40s heart that now worries about an unexpected pregnancy like a college sophomore. Happy to report that my hair stopped falling out in unusually large amounts in the shower a few months ago. Not sure why it started and not sure why it stopped.

Looks like there is more fun waiting around the next bend.

My husband has to regularly declog our shower drain due to my massive shedding...my mood is so bad, I don't even like hanging out with myself anymore.

:-(

Chicagonative, I believe you told me that you've had uc for years when I was asking for advice about my daughter who was recently diagnosed with it. She was sent to a new gyno last month after a colonoscopy didn't explain the scope of her pain. She does have uc, but her pain was also in areas of her abdomen where there wasn't ulceration seen. Her new gyno suspects she has endometriosis as well and wants to start her on hormonal bc to see if it helps. He says that the common thinking is that if the symptoms improve while on hormonal bc, then it is endometriosis. It's that....or exploratory laparoscopic surgery.
In doing some research, my daughter came across a statistic that said that 80% of women with uc also have endometriosis.
Best of luck finding a doctor who will listen!!

Yes, many of us have similar. The hair loss is scary especially for a person like me that always had super- thin hair. Is this why all th grey- haired old ladies have super- short hair?!?! No!

conandrob240 said:

Yes, I understand, I had similar ( maybe not as severe). The BC pills helped a little. Try them. That last thing I want is surgery especially when they can't even be sure endiometriosis is the cause. Terrible that there is so little that can be done for a very common problem.

I'll give them a try. Just curious, how bad are the side effects. I'm already not my usual happy self and I worry about becoming more moody and water retention (which is an issue for me). I wasn't given any time to ask any questions...so I truly appreciate everyone's insight.

Not bad. Not like the ones from 20 yrs ago. Give them a try. Good luck. I think maybe you ( we) were hoping for a cute that doesn't exist with endiometriosis. Surgery or the pills is really all we've got bet if men got it, it would have all kinds of treatments.

leighan said:

Chicagonative, I believe you told me that you've had uc for years when I was asking for advice about my daughter who was recently diagnosed with it. She was sent to a new gyno last month after a colonoscopy didn't explain the scope of her pain. She does have uc, but her pain was also in areas of her abdomen where there wasn't ulceration seen. Her new gyno suspects she has endometriosis as well and wants to start her on hormonal bc to see if it helps. He says that the common thinking is that if the symptoms improve while on hormonal bc, then it is endometriosis. It's that....or exploratory laparoscopic surgery.
In doing some research, my daughter came across a statistic that said that 80% of women with uc also have endometriosis.
Best of luck finding a doctor who will listen!!

Yes, I have Crohn's disease. I was a mess with fistulas, in and out of my colon, my surgeons at the Mayo clinic spent 12 hours cleaning up the extensive mess. Before I ended up at the Mayo clinic I had a battle with an internist who refused to listen to me and was adamant I was anorexic...even though my GI dr diagnosed me with Crohn's. The internist want to admit me to a psych ward. That pretty much left me with a very unhealthy outlook on doctors.

ETA: I hope your daughter is doing well.

conandrob240 said:

Not bad. Not like the ones from 20 yrs ago. Give them a try. Good luck. I think maybe you ( we) were hoping for a cute that doesn't exist with endiometriosis. Surgery or the pills is really all we've got bet if men got it, it would have all kinds of treatments.

So true!

I so appreciate this thread, keep it going. I will be 45 in a few months and have been feeling recently like I've morphed into a helpless old lady who looks like complete crap and can't handle anything competently anymore. I've gained about 30 pounds over the last 5-6 years, my hair is thinning (except on my face and chin, where it's flourishing), I never have any energy, have to pee constantly, and have trouble focusing/concentrating on anything for any period of time, which is starting to impact my performance at work. I don't really have panic attacks but I do have periods of high anxiety accompanied by shortness of breath. I feel like my frustration levels are lower than they've ever been and even find myself frequently grumbling at God for failing to help me when I need help, which is pretty much all the time... I've been on the pill for many years and my periods are almost nonexistent -- I wear a regular absorbency tampon for a day, at most two, and I'm done. I do however always get a headache the week of my period that lasts at least 3 or 4 days. I tried to consult with my doctor about much of this and she basically brushed it all off and told me that if I just lost some weight I would feel much better. Thanks, doc.

Any or all of this sound like perimenopause?

Not sure, but sounds like my life. Other than the periods-I get the headache, what feels like a bladder infection AND have massive flow for 3 days and light flow for another 4 or 5 days. And, periods are closer together. Such fun.

@bluepool,

Have you had your hormone levels checked? And, incidentally, that is how the MDeities can tell if you are actually in peri-menopause. Some of your symptoms sound like thyroid problems, to me (and I was recently reminded by one of my doctors, I went to law school, not medical school, so don't mind me). I would also advise you to start looking for another physician. Seems to me a lot of these doctors are only useful if you are in an uncomplicated pregnancy. Being a woman doesn't stop if you have never had, or are finished having babies. As the population ages, we need more GYNs who specialize solely gynecology.

I've started a new just-before the bleeding starts symptom: chest pain. Luckily it feels only a teeny bit worse that the arthritic pain I get in my higher ribs and sternum, so I'm not totally panicking yet, but it's coinciding with the complete bone-wrenching exhaustion and brain-numbing energy drain that rounds out my life. I asked my sister, and my clients how they managed, and they all gave me such sympathetic looks then said 'no-one ever died of menopause alone, even though she wanted it'.

But I understand completely how bluepool's self-esteem has been shot.

The new theory on pain management is that if we can all lose a bit of weight, not only are we healthier and happier, we are also stressing all our muscles and nerves less so there is a reduced risk of straining to the pain level. That means we won't be flooding our pain-receptors with pain signals, thereby training ourselves to respond to every sensation as if it's a major pain/trauma. (It's also thought that the diversion of focusing on another activity takes mental energy away from the awareness of the constant pain, as well) I'm not sure I buy the theory, but being more fit and more flexible means that I can cope with pain better.

joanne, the weight and pain connection sounds logical. I need to lose 30 pounds at least and I have thought about the toll it takes on the body especially as one gets older to have lug the weight around. I remember what that 10 lb. baby did to my back years ago so now I have the equivalent of three attached to body. Hope you feel better, and maybe get the chest pain looked into?

LisaT, you must have gained all of those 30 pounds over the past nine months, then, because when I saw you last June you looked pretty good to me!

Bluepool, a lot of that does sound like fairly typical stuff, except for the headaches. I have personally experienced most of the rest of it. The sad truth is when we get into middle age, our bodies and how they react to everything change noticeably, so gaining weight becomes really, really easy, and losing it correspondingly more difficult. Just one of many reasons why I think aging is so gosh-darned UNFAIR. That and dentistry are my biggest complaints about being 55.

I think in one way your doctor is sort of right... if you lose some weight you probably will feel better, and if you start exercising as part of a plan to do just that, you will probably feel better right away, or at least soon. I noticed that when I started working to lose weight and cut down my cholesterol numbers a couple of years ago. I also made some major dietary changes to reduce inflammation in my body.

If you are already on the pill, that ought to be working to level out your hormones, which would most likely make your doctor thinks she's already doing all she can on that front, but it could be that you need a different dose. If your body's hormonal make-up is shifting naturally on its own as you get closer to menopause, it could respond differently to the hormones in the particular pill you've been taking for awhile. There are different levels of dosages for the hormones that make up birth-control pills, and you might benefit from trying a different combination there.

I wonder what would happen if you tried the same system I took up two years ago after I saw a cardiologist? It was essentially a plan of combined nutritional approaches and exercise designed to reduce systemic inflammation and lose a little weight, and I felt so much better for about a year. I lost 15 pounds, and my cholesterol went down pretty dramatically, and I felt and looked great. Unfortunately, more recently I fell off that wagon totally for the past year, and now I'm trying to get back on. Gotta get back to the elliptical trainer and the yoga videos. Forget the sugars and carbs, ramp up the proteins and fiber.

That could be something you could try on your own, and if it doesn't help, maybe ask your doctor about the pill dosage? Or connect with a new doctor?

Oh, and Joanne, that approach to weight and pain management makes total sense to me. I feel so crappy since I gained back the weight I had lost that I am altogether down in the dumps, physically aching and cranky all the time. Of course, that could be due to situational stuff, too, but a lot of the sheer discomfort is because of the extra weight I've gone back to carrying, I'm fairly certain.

@bluepool, that all sounds exactly like what I experience, including the headaches. I even had bouts with vertigo in the beginning of my "transition".

[Damn, I guess it really is God's version of a gender reassignment or revocation at least!]