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[arc73]

Hi all 

Been browsing for a little while and finally decided to join. I'm 45, and up until last summer my cycle was a regular 23-27 days, my period lasted a week and I often got a slight spotting at ovulation. I'd been using the Paraguard for over 20 years without any issue.

Then last summer, when work got very stressful and we were also getting poisoned by solvent fumes from an art studio next door, I suddenly started getting spotting before my period (anything from 4-9 days) with increased cramping. I saw my GP in November and have been tested for infection (none bar a bit of occasional BV) and had an ultrasound. I have a very slightly enlarged uterus but they just diagnosed possible early fibroids/adenomyosis. My GP suggested having the Paraguard removed might reduce the bleeding - it's made my periods slightly slighter and the awful cramping has pretty much gone, but had no effect at all on the spotting. She suggested the Mirena might help but I wasn't keen, especially if it might stop my periods entirely. I like to know where I am with things.

About 6 months ago I started back on Agnus Castus tincture which has helped with all my PMS sore boobs and bloating, but no use with the spotting. I also cut down on caffeine, sugar, wheat etc and take iron supplements. I am assuming from google research that my progesterone levels might be low, hence the agnus castus. I haven't experienced much in the way of hot flushes, night sweats etc beyond the odd moment I have always had. My libido has taken a pounding as I'm stressing about the spotting, although my partner is being an absolute star.

Also feeling quite drained most of the month, especially from when the spotting starts to when my period ends. Just had some bloods done today for iron, thyroid and blood count, results at end of week. GP suggested it might be oestrogen levels taking a dip after ovulation and that a patch such as Evorel Sequi could help. I was put off straight away by spotting being a possible side effect.

Has anyone experienced anything like this, and did anything help? I kind of assumed perimenopause would be a bit more stop starty. My cycle length hasn't changed at all, I'm just spotting for a good week before and nothing I have done seems to help

[Dancinggirl]

Hi and welcome to MM arc73 - welcome to the pre peri menopause phase.  What you are experiencing is all pretty normal but if bleeding does become an issue then the Mirena would be good idea.  If you have the Mirena in place, then if flushes and night sweats emerge, you can then simply add in some oestrogen.
Here is an article that may help you to understand what is going on:
https://www.menopausematters.co.uk/magazine/articles-mainly.php#perils

DG x

[arc73]

Thanks for the welcome and the reply Dancinggirl

I'm uncomfortable at the moment taking hormones, it's been nearly 25 years since I was even on the Pill. If I can ride some of this out naturally like my mother did I will do (have checked with her already and she had no spotting like this). I'm more trying to understand what my hormones are doing - I thought it was low progesterone and oestrogen dominance but GP is offering more oestrogen. She suggested the patches because the doses are lower than the mirena and I will still get a period. Even though from reading it will be an artificially managed one.

I'll play the watch and wait game for now and keep reading the forums

[Dancinggirl]

The oesrrigen dominance theory is something the alternative therapists tend to push - menopause symptoms are about the hormones fluctuating and it's the drop in oestrogen that causes the most symptoms.
Your GP is wrong about the Mirena - it delivers a lower dose of progesterone gradually and more locally and as part of HRT together with oestegn can be really easy and effective.
However a low dose of an HRT e.g. Femoston 1/10 might help things to settle and this would be sequential and give you a regular, predictable monthly bleed. Again your GP is wrong to offer the combined HRT patches as these are medium dose so probably too high a dose for early per meno. Sadly go are not that clued up on HRT!!!
Do look under TREATMENTS on this site to get clued up and it's worth printing these off to show the GP if and when you decide to try HRT.
You are right not to jump into HRT - try to relax and not worry about the erratic cycle and spotting ( this is normal) but if things do become problematic then HRT is worth trying. DG x