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[Sallyyy]

I have been bleeding for just over 5 weeks after missing two or three periods at the end of last year.

The first theee weeks - awful flooding and soaking through clothes despite 2 pads and super plus Tampax. This has now slowed but still bleeding every day.

My GP ordered bloods and a scan. Still waiting for scan appointment but bloods show anaemia as expected. Thyroid all fine.

I know hormone tests can be unreliable but the FSH and LH have come back as normal (5.4 and 6.8.)

I had assumed this was all down to perimenopause but now concerned that it must be something else as blood tests show I'm not in peri (?)

Would appreciate any thoughts.
Thanks

[Hurdity]

Hi Sallyyy

If you are over 45 and have started missing periods and having very irregular cycles and getting other menopausal symptoms then it is most likely you are peri-menopausal especially if you have had tests which rule out other explanations. As stated on this website diagnosis of menopausal status cannot be made from single blood tests because these hormones vary so much throughout the mesntrual cycle and during peri-menopause. Do read more here: https://www.menopausematters.co.uk/diagnose.php

Hevay bleeding is also common during peri-menopause due to anovulatory cycles and the explanation is given here better than I can explain: https://www.menopausematters.co.uk/magazine/articles-mainly.php#perils

There are some quick links to useful information on the website here:
https://www.menopausematters.co.uk/forum/index.php/topic,38557.0.html

Also conditions like fibroids and polyps can cause heavy bleeding and this sometimes gets worse at peri-menopause. If it is just the bleeding you are concerned about and you don't have other menopausal symptoms like flushes and sweats or severe mood swings etc, then you could have a Mirena coil fitted which would lessen the bleeding considerably. it would be a simple matter then to add in extra oestrogen if/when you need it. if you are under the natural avergae age of menopause of 51/52 then if you are set for an early menopause it is advised to take oestrogen at least from the time of actual menopause (or from the onset of debilitating symptoms) to help protect heart and bones.

Other treatments for heavy bleeding can be found here:
https://www.menopausematters.co.uk/periodtreatments.php

Hope this helps

Hurdity x

[Sallyyy]

Hi Hurdity thanks so much for such a quick helpful reply. I'll read all those links.

I should have said - I'm nearly 48 and do have a number of what I think are peri symptoms. Was just expecting the FSH and LH results to reflect that at least a little bit.

My GP has mentioned the mirena before but I had PND and don't really want to risk the depression/anxiety side effects that can come with it - but I might need to rethink that.

I had a TV scan a year ago for pain that turned out to be gallstones. All was normal but guessing things could have changed in a year so will have to wait for scan.

Thanks again for help.

[dangermouse]

Mine was normal when I was clearly extremely ill with peri.

I think the FSH doesn't start rising until oestrogen falls, nearer the end of perimenopause.

[Sallyyy]

That's interesting to know dangermouse.

[Hurdity]

FSH rises and falls throughout the menstrual cycle even well before peri-menopause. It operates on a negative feedback loop with oestrogen which suppresses FSH. However as the ovaries begin to pack up FSH no longer works to stimulate the follicles sufficiently to produce an egg so more and more is produced, hence the rise - but it is not clear cut and you really cannot tell where you are in menopause from a single FSH reading. Your age and cycle changes combined with menopausal symptoms are a more relaible guide. If under 40 or around that age then at least two blood tests are required to diagnose menopause and then raised FSH levels can be a useful guide.

Here is the ref range:

IU/L

    <1-3 prepubertal
    1-8 males
    1-11 females; follicular and luteal phase
    6-26 at ovulation
    30-118 post-menopausal

Note that reference ranges may vary between laboratories.

You will see that there is no "peri-menopausal" range - which is why many docs may erroneously decide that a woman is post-menopausal based on this ref range. Several women on this forum have been "diagnosed" as post-menopausal based purely on FSH levels, even if they have only been 3 months without a period, and have gone on to have many more periods!

Here is the range for LH:

     IU/L

    <0.15 pre-pubertal
    0.5-9 males
    0.5-14.5 females follicular and luteal phase

    16-84 at ovulation
    17-75 postmenopausal

The day of the cycle on which the tests are done is also crucial as you can see.


Hurdity x

[Taz2]

Mine was normal when I was clearly extremely ill with peri.

I think the FSH doesn't start rising until oestrogen falls, nearer the end of perimenopause.

Yes FSH stands for Follicle Stimulating Hormone which is what the body produces to try to get the ovaries to release an egg when one hasn't ripened as normal which is what happens as the ovaries begin to fail. My FSH was well over a hundred and I was still having fairly regular periods so blood tests can be unreliable in terms of what symptoms we should be expecting.

Taz x

[Sallyyy]

Thank you again for all the replies. I have now been bleeding for 7 weeks :-(

My GP gave me prescription for Norethisterone at 3 weeks to help stop flooding / clots but theses eased naturally so I didn't take it.

The bleeding continued every day though and yesterday and today got heavier again so I have started the tablets. Since starting them the flooding and clots has increased again which I wasn't expecting but hoping this will settle.

I've got scan date through now for 20th March.

[Sallyyy]

I should have mentioned that my scan just over a year ago showed :

'Bulky endometrium is heterogenuous and may represent either adenomyosis or early fibroid changes. No focal fibroids seen.
Endometrium is thin and normal for day 6. No polyps seen.
Both ovaries appear normal.
No adnexal masses or free fluid seen.'

In my intro post on the site I also said that my husbabd has incurable cancer :-( which I think is why I'm so anxious about this as I need to be ok x

[Hurdity]

Hopefully your scan will show all is still Ok and this is just normal peri-menopausal symptoms due to anovulatory cycles  - when the womb lining builds up as the egg follicles start to develop and produce oestrogen but is not shed because ovulation does not take place. When ovulation does occur bleeding can be much heavier. Other reasons seem to cause the heavy bleeding too.....In your case I do hope it eases off soon.

Also - sorry to hear about your husband.

Hurdity x

[Sallyyy]

Hi I had my scan today all ok with ovaries etc (2 small fibroids) but womb lining is 'thick' at 15 mm which Im now very anxious about because of the links with endometrial cancer.
So the timeline is:

No period for 84 days

22nd Jan started period - light for couple of days then v v heavy inc clots and flooding. Heaviness then fluctuated but continued bleeding until started prescription from GP ...

10th March started Norethisterone - bleeding stopped two days later

17th March finished Norethisterone

Today : Scan and womb lining 15mm (about 8 days after bleeding finally finished)


Would appreciate any thoughts.

Thanks x

[Claireylou]

Hi Sally. I went through the same this time last year. My womb was very “bulky” and my lining was 18 mm. I'd had weeks/months of extreme bleeding.

Consultant radiographer who did my scan picked up adenomyosis, a few small fibroids and the thickened lining. She explained to me that a “bulky” uterus was typical with adenomyosis. There are a number of treatments offered. You could have an ablation followed by a Mirena coil. Treatment with a progesterone or a hysterectomy. I opted for the latter because I was dangerously anaemic and in a lot of pain but this option really is the very last resort. It was explained to me that adenomyosis would only worsen but it might slow down/disappear after menopause.

Histology after surgery confirmed exactly what was suspected. I know it's hard but try not to panic. A very thick lining doesn't necessarily mean something sinister is lurking. Oh and my FSH and LH were completely normal on all blood tests.

I hope that my rambling post has helped, take care xxx

[Sallyyy]

Thanks so much for taking the time to post Claireylou I really appreciate it x

[Claireylou]

That's ok! I know how scary it is when you're constantly bleeding heavily. Have you got a follow up appointment with a gynaecologist to discuss your options ?

[Sallyyy]

I've booked a phone appointment with my gp for next week when they'll have seen the scan report.