I Had A Period On 3/27 With Spotting Following Then

Posted on Wed, 22 May 2019

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 22 May 2019 Answered on

Last reviewed on

Question : I had a period on 3/27 with spotting following then a full flow (but no flooding) for 3 days starting 4/16. I continued with spotting off and on. some days nothing. Then had a 3 day period on 5/1 with spotting (but only on tissue) through 5/8. Then nothing through 5/21. Today a bit of spotting on tissue. So far not a full flow. I am almost 50. Had a transvaginal ultrasound on 4/15. Normal. FSH shows not in peri but suspect I have been as there’s been changes and some periods 4 days late.

Can this be stress related coupled with hormonal fluctuations? I had very high stress in April and then yesterday. Also have panic disorder. I tapered from .25 of xanex (starting 4/5) by a 25% reduction. What is the next safe taper amount? Another 25% or 10%? I’ve been on it for two years daily.

Thank you for your time and expertise.

Answered by Dr. Dr. Rakhi Tayal (1 hour later)

Brief Answer:
Can be due to hormonal changes or stress.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.

The irregular bleeding and spotting that you are having can be related to stress, hormonal fluctuations or dysfunctional uterine bleeding. In case the bleeding is more frequent or heavy then you can consider visiting your Gynecologist for hormonal treatment.

As for Xanax, you can taper 25% next time safely.

Please feel free to discuss further. I will be glad to answer the follow-up queries that you may have.

Wishing you good health.

Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Rakhi Tayal (1 hour later)

Does the ultrasound I had rule out more serious problems? She said to visit in 3 months (from 5/2) when I saw her last. Can a women just have irregular bleeding, as long as it%E2%80%99s not severely heavy and have it just be due to perimenopause? I%E2%80%99m afraid of couse of worst case scenarios. Plus with the already existing panic, it makes the fear worse.

When you say next time for lowering by 25%25, is now a safe time to reduce again? The initial reduction was 5/2. On some days I took the full .25 mg with the panic attacks about the bleeding but most days stuck to 25%25 reduction of the .25 mg so .75 of a .25 mg tablet.

Thank you for your expertise, time, and attention.

Answered by Dr. Dr. Rakhi Tayal (14 hours later)

Brief Answer:
Details below.

Detailed Answer:
Hello.
Thanks for writing again.
The ultrasound rules out any fibroid or polyps or any endometrial hyperplasia. The mild irregular bleeding can happen due to perimenopause.
It has been more than 2 weeks since you reduced the dosage. You can reduce it now.

Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Rakhi Tayal (28 minutes later)

Can you site the research or statistically speaking the chances of it being due to perimenopause versus cancer?

Thank you for responses. It is very helpful.

Follow up: Dr. Dr. Rakhi Tayal (23 minutes later)

In addition to the above question, in your experience have you seen many women present with irregular bleeding at the time of menopause or perimenopause? Thanks.

Answered by Dr. Dr. Rakhi Tayal (7 hours later)

Brief Answer:
Cancer can be ruled out only after proper investigations.

Detailed Answer:
Welcome back,

Please note, We cannot rule out cancer based on the statistics alone. This can be ruled out only after thorough investigations.

It is common to have irregular bleeding near menopause. I routinely see many such patients in my OPD.

Regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee