Question perimenapause

[asscherisme]

I am in my early 50's and stuck in never ending perimenopause. I have been having cramps from hell for the past year before and during my period. I never had cramps when younger. My doctor did a sonogram to make sure there was nothing wrong and when it came back normal just told me to take 3 advil to deal with it.

Anyone else experience this? Horrible cramps associated with perimenopause? Any suggestions other than advil? The cramps are horrible and make it difficult to function some days. They affect my sleep too. I woke up at 4 a.m. this morning and even with advil was in so much pain I could not fall back asleep.

 

[Elizabeth35]

Have they done a full hormonal work up to determine where you are in perimenopause?
Any other testing other than sonogram?
Debilitating pain should NOT be dismissed, clearly something is different in your body. Fluctuating hormones could cause more cramping, although I don't know anyone who had this issue in perimenopause.

Can you see a different Gyne or ask your PCP for a referral to someone who specializes in perimenopause issues?

 

[asscherisme]

Elizabeth, I asked for bloodwork and she said it was not necessary. I am seeing my PCP in March so I will ask her for bloodwork and a referral to a different gyn (the other doctor was a gyn who I didn't like). She ordered the sonogram because of the pain and the extreme bleeding some months. I am sitting here in pain right now and it is horrible.

 

[Elizabeth35]

Hmm. Sadly, sometimes docs make decisions based on what health insurance will cover.
But checking hormone levels during perimenopause is fairly common.
The sonogram would have checked for polyps/fibroids/growths or endometrial thickening so it's good that those are off the table as causes.
I hope you get a solution soon---you shouldn't have to be in so much pain that Advil doesn't help.

 

[Gabbycat]

Can you define normal for your sonogram? As in nothing at all was seen? I ask because I had severe cramping a few years ago. My first GYN saw what they thought was a fibroid but basically dismissed it as the source of pain as periods had otherwise not changed. I even ended up in the ER with male doctors telling me it was my gallbladder. . I finally ended up seeing a different GYN who went in to take out the "fibroid", and it turned out that I had actually a fibroma the size of a baby's head twisting my fallopian tube and cutting off the blood supply to my ovary so that it had started to necrose. So, the point being that sometimes when doctors say things are normal they see something but just assume it can't be responsible for your issue because it doesn't fall into a category that they think should be causing issues, not because it actually can't be causing issues.

 

[missy]

@asscherisme I am sorry you are experiencing so much pain. As you know perimenopause is generally a process and there is no one test per se to say yes you are in perimenopause. Though hormonal testing (FSH and estrogen specifically) might be helpful.

Unfortunately perimenopause can last a decade. I was fortunate in that mine only lasted a few years and I had zero symptoms. But not lucky in that because I had zero symptoms I didn't go on HRT and I developed osteoporosis from the lack of estrogen.

The pain you are in is not normal however and I think further testing needs to be done to evaluate why you are in such pain. It could be related to your prostaglandin levels. The higher your prostaglandin levels the worse the cramps could be as they direct the uterus to contract during one's period.

But it could be many other reasons and I agree you should find a better gyn to help you get diagnosed properly.

 

[asscherisme]

Can you define normal for your sonogram? As in nothing at all was seen? I ask because I had severe cramping a few years ago. My first GYN saw what they thought was a fibroid but basically dismissed it as the source of pain as periods had otherwise not changed. I even ended up in the ER with male doctors telling me it was my gallbladder. . I finally ended up seeing a different GYN who went in to take out the "fibroid", and it turned out that I had actually a fibroma the size of a baby's head twisting my fallopian tube and cutting off the blood supply to my ovary so that it had started to necrose. So, the point being that sometimes when doctors say things are normal they see something but just assume it can't be responsible for your issue because it doesn't fall into a category that they think should be causing issues, not because it actually can't be causing issues.

I am sorry you went through that. My gyn specifically said there were no fibroids or cancer visible.

 

[asscherisme]

@asscherisme I am sorry you are experiencing so much pain. As you know perimenopause is generally a process and there is no one test per se to say yes you are in perimenopause. Though hormonal testing (FSH and estrogen specifically) might be helpful.

Unfortunately perimenopause can last a decade. I was fortunate in that mine only lasted a few years and I had zero symptoms. But not lucky in that because I had zero symptoms I didn't go on HRT and I developed osteoporosis from the lack of estrogen.

The pain you are in is not normal however and I think further testing needs to be done to evaluate why you are in such pain. It could be related to your prostaglandin levels. The higher your prostaglandin levels the worse the cramps could be as they direct the uterus to contract during one's period.

But it could be many other reasons and I agree you should find a better gyn to help you get diagnosed properly.

Missy, I agree, I need a different doctor! You are very lucky you have had no symptoms. I think I have been in perimenopause for at least 6 or 7 years. I will definitely discuss with my PCP next month. The gyn did prescribe HRT after the songram but my PCP told me NOT to take it because I have hypertension and she was not happy the gyn prescribed it. She said it could raise my bp to dangerous levels and put me at high risk for stroke. I had already decided that I was not going to go back to that gyn. She honestly was really insensitive and weight shamed me and pretty much made me feel like my heavy bleeding and painful periods were my fault because of my weight. I actually sat in my car and cried after I left her office. Ironically, I have lost weight during the pandemic and am healthier than I have been in years and my PCP has praised me for it.

 

[AprilBaby]

No cramps but very heavy bleeding for months. One day I fainted at work and found out I was anemic. The next month I had an ablation. That helped for 1 month. The following month I had a hysterectomy. Best thing I ever did.

 

[wildcat03]

I'd probably ask for a Mirena IUD. Not sure if they'd do it because it would be off label but it will help heavy bleeding. I had no cramping at all for the 2.5 years I had one.

 

[whitewave]

I'd probably ask for a Mirena IUD. Not sure if they'd do it because it would be off label but it will help heavy bleeding. I had no cramping at all for the 2.5 years I had one.

I was going to say this or an ablation. I had a mirena (well, two) for a total of about 9 years and it was fabulous. I went through peri and then menopause with no periods! Now I’m in menopause and no issues— soon to be post menopausal in a few months. Early 50s.

 

[FL_runner]

Mirena is a good idea or taking a Monophasic birth control pill so you don’t have periods.

but extreme pain and cramping may be fibroids/etc as above which would show on ultrasound but heavy bleeding and pain around menopause also makes me wonder if there is endometriosis or potentially abnormal endometrial growth- did they consider an endometrial biopsy or CT scan? Talk about surgical options like an endometrial ablation or hysterectomy? You need to see a different doctor.

as an aside I work in medicine and the amount of prejudice and judgement that overweight patients get is disgusting. My husband is a big guy but has lost significant weight with diet and exercise and is very careful with what he eats and doesn’t drink alcohol at all- he has an autoimmune condition and it’s easy for him to put on weight, and the things some doctors and nurses have said to him are ridiculous- I want to send hugs because your pain should absolutely not be dismissed.

 

[Tekate]

I'm sorry you are having this, it's those dang prostaglandins, you are probably producing more estrogen to build up the lining of the uterus and as the estrogen increases so does the prostaglandins, once you hit the point where no matter how much FSH your body produces no more estrogen is produced because you are outta eggs sorry you are experiencing this, i had terrible terrible cramps until I was about 25, then it slowed down.. I feel for you. Did you talk to the gyn about taking the pill?

 

[asscherisme]

Thanks so much for the input and suggestions. I will definitely discuss with my PCP and also get a recommendation for a new gyn.

 

[m51galaxy]

My last year of having periods I suffered from much heavier bleeding and sometimes more painful cramping than normal. Finally it all stopped. No physical problems. Hopefully yours will just stop soon and there is no underlying issue.

 

[RunningwithScissors]

Sorry you are experiencing this. I agree with the others, you need to go get a second opinion!

I'm 47 and these last two years I've been in and out of actual menopause (not peri-menapaus.) The menopausal stretches are really bad with horrendous hot flashes. Anyway, I routinely get my hormone levels checked because my body is fluctuating. So getting one's hormones checked is not unusual. I'm not saying it will get to the bottom of what is ailing you, but it is nice to know exactly where your levels stand.

Up until my early menopause hit, I had severe menstrual cramps my whole adult life. So I can tell you what worked for me to alleviate them and perhaps it will help you.

My obgyn had me take 500 mg of Naproxin (which is prescription strength) or 2 Alleve (which works just as well at 440 mg) every 8 hours for the duration of my period. It made me sleepy but kept the cramps to a minimum. Obviously, ask your doctor before taking any medication. And be careful with naproxen and make sure you take it with food and you don't have any ulcers because it can make them bad.

Also, caffeine made my cramps much, much worse. I had to avoid it altogether when on my period. And stay hydrated and fed (low blood sugar made mine flare up badly.) And stress makes them bad too.

Alcohol (like a glass of wine) greatly relaxed my cramps.

Hope you get to the bottom of what is causing you such pain.

 

[Made in London]

I can not offer you any advice on your cramps but I just want to offer my sympathy.I had the menopause from hell & I wouldn't wish it on anyone!