Brief Answer:
perienopausal irregularities

Detailed Answer:
Dear XXXX,

I can understand your concern.

Prima facae, considering your age, irregularity of menstrual cycle can be attributed to the perimenopausal changes in the body.

How long do you have irregularity in the menses?
How heavy or scanty is the pattern of bleeding?
Do you get any emotional disturbances? Or mood changes?
Do you have bone pains?

This information may help me clinching the diagnosis and giving you further advice.

Before menopause, usually the menstrual periodicity does become irregular. Many a times women do not understand when should they decide that they have achieved the menopause. So it has been depicted that if a woman does not get menstrual bleeding for six months at a stretch, then she has entered menopause. Any bleeding after a gap of six months is considered as post menopausal bleeding and calls for investigations.

Now it is 3 months since you had your last menses. If you do not get menses for next three months, you have reached menopause. If you get menses before that, you are in a perimenopausal irregularity of the menses.

You need not be worried about this irregularity. Just be prepared for the retirement from the reproductory life. Have your own group for entertainment and family members tied with you.

By this age, you should have got your blood examined for Calcium levels. Women usually land into calcium deficiencies resulting into pathological fractures of the bones. So start regular use of calcium and get your blood examined for calcium levels.

I hope I have provided you relevant important information and guidance. If you also feel so, please post a good review and grade me with 5 stars.

For any more information, I am always available for you, XXXX.

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Brief Answer:
Investigate for heavy prolonged bleeding. Calcium needed.

Detailed Answer:
Dear XXXXX,

Thanks for the information I had asked for.

Fortunately you do not have any emotional changes or bone pains. However, you should take daily calcium tablets. In this age, due to Oestrogen hormone deficiency, bones start loosing calcium in them. Body does require calcium supplementation. Also include milk, cheese, figs, paneer in your daily diet.

Secondly, I am not quite happy about the last heavy period lasting for 10-12 days. During premenopausal period irregularity in menses is understood and acceptable but not the heavy and prolonged bleeding during menstruation.

I would advise you please to get the following work up done:
1, Clinical examination to assess whether you have any tumour in the uterus. Did you have any pain during the phase of bleeding?
2. Ultrasonography to find out any specific findings, particularly in the uterus and ovaries. Also it will assess the thickness of the uterine lining (endometrium)
3. If required and indicated, laparoscopy, hysteroscopy and hysteromicroscopy.

I would appreciate if you upload the results and images of these investigations. Then we can figure out whether you need any further work up or no further investigations are indicated.

Please report to your Gynaecologist and get thorough work up done.

I hope you are satisfied with is information and Guidance. If you want any more information or if you have any doubts or queries, I am always available for you XXXX.

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