Question: Hi, I am British and have lived in China for 11years. The past two years I have experienced awful sweating with no sensation of heat, and no exertion during the season changes from Spring to Summer, and Summer to Autumn. The climate is a challenge here, but I thought I had aclimatised. Also, I have had myoma problems for 5 years, which have decreased in size, but continue to give me a lot of pain at night, before, during and after my period. My periods have become very irregular this year, as I am now 49. The last period was nearly 4 months after the previous one. This is the longest gap ever - although the gaps have been quite regular with two month gaps instead of the usual. At one point I thought I was pregnant, because I felt very nauseous and my breasts had really swelled. Then I had an extremely heavy period, after which my stomach area went back to normal size and my breasts decreased again. I did wonder if I had miscarried. Against all odds, my husband and I have been trying for a baby since last year, and we are keeping a very open mind on it. It is frustrating that many other symptoms I have belong both to perimenopause and pregnancy, and myoma so I find it very confusing and just have to be patient! I don't have night sweats, except naturally when the climate is hot. I have no sensation of heat when I sweat during the day, but I feel quickly chilled, especially around my kidneys and lower back. My back is often wet. I wonder if all these things are interrelated? I will see a traditional doctor tomorrow, but I wondered if you could shed any light?? Other symptoms include; dizziness, waking up very hungry, irregular bowels, general feeling of weakness but still motivated and enjoying life, sometimes a burning tongue tip which I know is menopause, swelling legs, varicose veins, swelling abdomen and breasts more full and sometimes tender. A vague feeling of nausea throughout the day, or no nausea at all, blocked nose on and off, some moodiness and dreaminess. Appetite generally ok, but sometimes really don't know what to eat, and lately don't like fried food. I am guessing the inevitable is it's all the menopause, but I would just like to know your opinion. Thank you

Dear Dr XXXXXXX

Thank you for your reply. In fact, I did follow up yesterday with more queries, but it seems it wasn't received. We have already made enquiries for ART, and the result was we decided to keep trying naturally. It is very expensive, our chances are slim, even though my husband's count was good and he is 31. You mention that menopause explains all my symptoms, but I am a little mystified as to why I have more myoma pain now, with aching legs, than I had when the myoma were much bigger. I realise some aches and cramps can be attributed to menopause, but I have learnt to recognize the difference between cramps and myoma pain. Myoma pain is relieved by a hot water bottle over the kidneys. Cramps are relieved by pressure of a pillow against the groin. The only thing I can guess at is that myoma cause more pain as they shrink slowly in size. The other thing I would like some clarification on is ; is feeling sick, or a general feeling of nausea which comes and goes, all typical menopausal symptoms? Because I definitely feel this sensation at times, and this also goes hand in hand with a heightened sense of smell. Perhaps you could clarify this for me. My final query is that it seems to me the chances of getting pregnant are naturally very low indeed, which I accept - but given my conditions, will they make testing particularly unreliable? I am referring to urine testing and blood testing. Even an ultrasound in an early pregnancy would be pretty useless, because of the myoma. As we will continue to try, I would like you to clarify these for me. I am a realistic person, and we have placed it all in the lap of the gods, and the belief of what will be will be. Miracles can sometimes happen. I started drinking my homemade soybean milk today again, and have had no sweats and more energy. This suggests to me that my hormone levels are most definitely fluctuating, but have not yet plundered into the depths of no-return. I look forward to your replies, and hope you get this message.