Brief Answer: detailed answer provided Detailed Answer: Hello and welcome to HCM, I am Dr Nilajkumar a consultant gynecologist and I will be helping you in your queries. The symptoms of nausea and gag are vague and may be attributed to various causes from gastrointestinal to hormonal. A few reasons for these are : 1. premenstrual syndrome: This includes a set of symptoms that are variable and include nausea, irritation, temporary weight gain and mood changes. Any combination of symptoms may occur and are usually relieved after periods. 2. Indigestion: As you have already had a gall bladder removed, it is possible that there may be some issues with digestion especially of oils and fats [ cheese etc]. So try a really light diet for a few days like clear soups, no oil and low residue fruits like grapes and orange juice. Also use yogurt daily to improve the gastric bacteria. Addition of B complex group of vitamins twice daily is also very helpful. 3. hormonal imbalances: They may cause irregular periods as well as feeling of nausea and tiredness. If you have not got these tested, get an evaluation for thyroid, estrogen e3 as the initial ones. 4. use of contraceptives like pills implants etc are known to cause nausea and vomiting as well as irregular periods. So please see if you are using any of these. Other causes unrelated to periods include gastroparesis that occurs in diabetics, so please check you blood sugar test result. Kidney disorders and ear dysfunction can also cause nausea. So please see if these have been tested. Now about the periods. Hormonal imbalances and ovarian cysts as well as fibroids are the causes of recurrent periods and pain. So they will need blood tests as well as a pelvic examination and an ultrasound. An ultrasound will also be able to detect renal stones if any. These conditions are common in the perimenopausal period. Most of the time the hormone dysfunction is transient and corrects by itself. So wait and see for the next few cycles. If they continue to be irregular then an evaluation is needed. My suggestion to you as of now are: Try to change your diet and start a low residue diet of clear soups, boiled vegetables and boiled egg whites with yogurt and B complex vitamin tablets for a few days. Exercise religiously every day. A walk in the morning and evening after food are all that is needed. This will help control the hormones as well as correct any digestion issues. See if the symptoms of nausea as well as period persist or go away. If they persist then get a hormonal as well as ultrasound test done [ you will have to repeat this is already done as the pain is a new symptom] after consulting your doctor to determine the cause. Hope this was helpful. Feel free to ask any further queries and I will be happy to help. Thanks for using HCM. Have a good day. Dr Nilajkumar Bagde Consultant Obstetrics and Gynecology

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Brief Answer: I understand the issue. Detailed Answer: Hello and welcome back, The symptoms related to periods and if combined with night sweats may be related to peri menopause. Menopause is influenced by patterns in family but this is not always true. So it is not that every women will experience it at the same time as her mother or sister. There is no specific age for menopause. Most women experience it between 45-55, while some may have it as early as 35 also. Peri menopause is a period of transition from the normal menstrual pattern to stopping of periods and also the lowering down of hormonal function. It may vary from a few months to many years and is different for every female. Menstrual irregularities are common in this period as there are a lot of fluctuations in hormone levels. Sports if very excessive and influence it. Otherwise mostly women active in sports undergo these transitions very well without much issues. Other reasons for frequent periods in addition to hormones are fibroids [ non cancerous uterine tumors, very common], adenomyosis [ enlarged uterus due to increased estrogen, also common] ovarian cysts [ some of them produce hormones and can affect periods] and cervical polyps [ similar to fibroid but found in cervix instead of the uterus]. It is natural for periods to become lighter and the duration to decrease after the age of 40. This is not a matter of concern for us as gynecologists until they are regular. If they become irregular then we are more cautious and try to look for the cause. The most likely cause in your case appears to be hormonal issues. So kindly try to get back into some physical activity [ you are already used to it] if you have stopped it now. If you still exercise and are experiencing problems despite that, then wait for one or two cycles. If the periods continue to come frequently, see a gynecologist with a menstrual chart. An examination and an ultrasound will clear up the matter and a repeat hormonal evaluation may be needed. The doctor will help you with this. Hope that this has provided some insight into the matter. Please feel free to ask if things are not clear and I am here to help. I understand your problem and concern. These are common and can be remedied easily in most cases. So just keep tack of the symptoms and see a doctor if they persist. Regards, Dr Nilajkumar

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