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I Am A 42 Year Old Woman, 5’6’’ 200 Lbs,

Posted on Sun, 7 Oct 2018

Question: I am a 42 year old woman, 5’6’’ 200 lbs, just diagnosed six months ago with celiac disease. My cycle has been sporadic, only about 4 times a year, for the past two years. It is sometimes heavy, sometimes light, usually around 8-10 days in total. I recently started having mild hot flashes and have just noticed a bald spot in my pubic hair. It is not just hair loss randomly spaced, it is right in the middle and smooth with no growth for about an inch and a half. I googled this and was so confused. Could I be in menopause already? I read some hair loss is normal but is a pronounced bald spot normal? Any info would be appreciated. Thank you!

Answered by Dr. Purushottam Neurgaonkar (1 hour later)

Brief Answer:
Feedback, USG FSH

Detailed Answer:
Hi there
I welcome you to HCM virtual clinic.
I have understood your concern and
I will suggest you the best possible treatment options.

Please do not panic.

You are right in thinking about menopause.
You can be in perimenopausal age.
Hot flashes, irritability, mood changes, vaginal dryness, palpitations are few of the symptoms that point towards menopause.
Also delayed periods are indicative of perimenopausal period.

I would like to know about few things in detail.
1) Have you done USG report within last 6 months?
2) Have you got your FSH blood levels done?
3) Are you on any other medications for any medical conditions?
4) Are you following any exercise regime?
5) Since how long you have noticed the hair loss and is there any itching or rash?

Your feedback will be of help to suggest you better treatment options.
Please feel free to communicate with me again.
I hope this answer helps you
Thanks.
Dr. Purushottam Neurgaonkar

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Purushottam Neurgaonkar (1 hour later)

Thank you for replying! I have not had an ultrasound (I assume that’s what you mean by USG?) in over a year. The last time I did have one I had a small cyst. I have not had FSH hormone checked in the past year but have had progesterone checked and it is low.

I take Prozac 60mg for anxiety and alprazolam as needed for anxiety (on average about once a month, not on a regular basis) but have been on those for almost twenty years.

I have recently been under a lot of stress and have not kept up with my exercise regime but was exercising four times a week up to about three months ago.

I have been on a gluten free diet for almost six months due to the celiac diagnosis. And I know I am at risk for more autoimmune disorders. My mother has Addison’s disease, she did mention loss of pubic hair as one of her symptoms. I do have some dark spots on my face but assumed they were age/sun related. When she was diagnosed her whole body was hyperpigmebted. I also don’t have any of the other symptoms of that disorder but thought I should mention it to you.

I have only noticed the bald spot just in the past week. I’m not sure how long it has been there or been growing. No rash, no itching. Skin is normal.

Answered by Dr. Purushottam Neurgaonkar (8 hours later)

Brief Answer:
Phyto SERMs. Exercise, diet, soy milk, tofu.

Detailed Answer:
Hi there
Thanks for appreciating the answer and reverting back to me.

I have gone through your reply.
It's great to know about your health consciousness.
Opt for a healthy diet and regular exercise regime.
Include more portions of fruits, vegetables and salads in the diet.
Regular weight bearing exercise is essential in this period of time

Please get USG done along with FSH levels. This will let you know about the structural normalcy of the uterus and ovaries,and ovarian reserve.

Please seek prescription support from your treating doctor for Phyto SERMs.
Use of soy milk, tofu is advisable.

Indulge in regular recreational activities.

I hope this answer helps you.
Thanks.
Dr.
Purushottam Neurgaonkar

Above answer was peer-reviewed by : Dr. Vaishalee Punj