Period problems

[Lulubelle8485]

Ive not had much help from the drs about this other than to offer antidepressants and hoping someone might have some advice or experience with something similar.
Im 40 and been having issues for a few years, have noticed a lot more pms symptoms as I've got older. Anxiety, palpitations, mood swings in the days leading up to my period, i know this is normal.
Beginning of last year i suddenly developed daily palpitations (skipped beats). Had that checked and they said all was fine.
Around a year ago I had a strange period... normal then when it finished I had quite heavy bleeding with a very large clot for a few hours the next day.
Went to the dr had bloods checked and they said everything was fine and offered antidepressants which I refused. I can deal with anxiety for a few days.
All normal periods again for a few months, then I had a week late period(never had this). Which 2nd day was heavy with gushes and large clots for half the day then back to normal for the rest. Period was on time next month but same thing on 2nd day.
After that I decided to try mini pill, which has helped with my periods, they are now probably every 6 wks and light. But my mood is awful. I feel flat. No libido. I dont like the way I feel, i am unable to lose weight aswell. Im fed up really. Drs just say its an age thing. I just want to feel normal.
Ive developed allergies , one being toothpaste, I have to buy a non foaming one as i developed perioral dermatitis. I suspect I have a food intolerance too. I have random itchy eczema and a really itchy vulva some days (its not thrush its the outer skin).I've also had some uti's in the last few years. Which I've never had bother with before.
Ive done the menopause questionaire and I've got more than half of the symptoms on it. The dr also did a hormone blood test the month after my first heavy period and it was ok then. Im really fed up and not sure what to do. I want to come off the pill but im reluctant to go back to yhe heavy periods as I cant leave the house for that day while they are happening.
Sorry its long, im just looking for any experiences similar to me, they are saying I am too young for peri. What can I do about the heavy periods. They offered the mirena, but as the mini pill has made me feel like this, I can't see why the mirena would be any different?

Hey Lulubelle8485, Sorry to hear about what you are going through. I can relate with a few symptoms, like since a year I used to have period for just 1 -2 days, and just this month I had heavy periods with clots that lasted for 4-5 days. I have not checked myself yet for hormones, however, after speaking to a lot of my friends going through similar symptoms, what you are going through sounds like perimenopause. I do have itchy skin like eczema, however, that has reduced considerably after I started taking collagen powder supplement in my coffee. I also apply pure shea butter everyday, atleast 2-3 times to the affected areas. I have left links in, if you do want to try them.

I had also trouble sleeping, so I am now taking magnesium supplement in the night by Swallow, not daily, but once a week. I have considerably changed my diet, I avoid sugary drinks, and lean more on making fresh fruit smoothies at home. In my weekly grocery shopping, I also order more of organic veggies and fruits, and cut down on salty snacks too. I think it is also good to consult with a female doctor, if not already since they might be able to relate with your symptoms much better. I have been listening to a lot of podcasts where they talk about HRT (hormone replacement therapy), so do talk about this with your doctor if it is an option for you. I really hope you get the right help very soon. All the best.

Definitely think about getting the mirena inserted, it will thin your uterus lining and then reduce the thickness and the bleeding from there. So I'd wait and see across 6-9 months how it works. The mirena is different to the mini pill, as it is synthetic progesterone at a more continuous higher dose. It is a small amount of the progestogen hormone directly into the uterus, leading to localised effects. This can result in fewer and milder systemic side effects, such as weight gain, mood changes, and acne, compared to progestogen taken orally. Mirena is a treatment option for heavy, painful periods as well unlike the mini pill.

You can start on tranexamic acid (if that doesn't work ask about northisterone) it will help with the heavy bleeding, it often reduces them a lot and then wait and see how the mirena coil helps as well. It perhaps use tranexamic acid whilist it settles occasionally on your period, get it from your GP.Make sure for the appointment for the insertion of the mirena coil you take paracetamol and ibuprofen 1h before, get licodaine into the cervix, numbing gel and it correctly positioned.Also ask your GP for mefenamic acid and/or naproxen (NSAIDs which help a lot) and tranexamic acid (helps reduce heavy bleeding) - you need to start taking it days before your period starts so that it can work at best capacity. You must take it with food and omeprazole.I think you could also have PMDD, I would look into starting an antidepressant from once you've ovulated to when your period starts. I'd say for now, I'd focus on using vitamin D and B6 (perhaps some iron due to the bleeding - I'd get it prescribed so you can get a higher dose prescribed) to help with moods. www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/getting-a-pmdd-diagnosiswww.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/treatment-for-pmddwww.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoric-disorder-pmdd

I would go back to this GP practice once more if there is a female doctor. However, if they continue to use the words "fine" or "its an age thing" then I would certainly consider moving GP practice. Something is causing these physical symptoms and it's certainly in your interests to find out what it is. And you are not too young to have peri menopause symptoms even though there does not seem to be any one test proving that.

They need to work out what the cause is in order to treat the symptoms properly.

What blood tests have you had done to date (bearing in mind anything over 6 ,months should be discounted)?. Were your thyroid levels ever checked thoroughly?. I ask as some of the symptoms you describe could also be attributed to problems with the thyroid gland (palpitations, period issues no libido, anxiety, itchiness). It's not normal to feel anxious and in the days leading up to your period either.

For the vaginal/vulva issues, get tested for thrush and BV again, do it via GP, home tests are okay but not as good as an actual lab. Even if you think it may not be thrush test to rule it out, also do it for a UTI.

You could ask GP about trying low dose topical vaginal oestrogen helps a lot with the issues you are having, the dryness, libido, itchiness.

Separately I'd get an allergy test etc/eczema because that is seperate to your period issues. Get tested for any food intolerance etc and treat your perioral dermatitis - that I'd normally treated by topical creams and antibiotics. Have a separate GP appointment for this, as it's too much to all cover in one so either book a double appointment or just get 2.

Back on why the mirena is more effectice than the mini pill - during a menstrual cycle, progesterone is released later on (luteal phase) - it basically tells the hypothalamus and pituitary glands, stop now you've done your job (which is thinking the uterus lining), let's not go overboard and progesterone maintains the uterus lining (whereas after your period, estrogen stimulates it to grow more). Essentially the hypothalamus, or pituitary glands at that point stop producing FSH, LH - that means that less estrogen is produced (LH and FSH's release triggerss release of estrogen).

So more progesterone means that we can suppress estrogen secretion and thin the uterus lining a lot more than the mini pill - especially because it is localised into the uterus (helpful for periods, as it can thin it so less bleeding and cramps). So mirena mimics the luteal phase, in a more continuous dose. That's why it helps with symptoms.

Yes, sleeping has been another issue for the last couple of years for me too! Has improved since taking magnesium every night, I feel much better.
I probably should take a bit more care of myself, my diet isnt too bad but it could be better.
I take collagen most of the time. That's helped with my hair, but I do need to be more consistent with it 🙂

Thanks for this, thats very informative. I couldn't understand how it worked as I thought it was just the same hormone and would just be the same. When I asked about this they just said it causes less side effects as its in your uterus already.
My periods are not really painful, just heavy on that second day. Ive never experienced heavy periods before so it was a bit of a shock the first time it happened.
I do take a multivitamin which has iron in it, but since I've been on the pill the heavy bleeding has stopped anyway. Its just affecting my mental health so would really like to stop it but the thought of coming off it worries me because the heavy periods will then return.
Before I started the pill the anxiety would be so bad that I would wake up in the morning and I was barely able to function because I felt like something bad was going to happen. For example completely irrational behaviour.. my dh walked the kids to school (5 mins away) he wasn't back when he normally was and I was completely beside myself thinking something had happened to him or the kids on the way to school. 10 mins later he came home and had decided to go to the shop and hadn't seen my missed calls. I can laugh now but its completely irrational and not me! Its maybe 3 days of the month like that. Now that im on the pill i do not feel that anxiety, but I just feel fed up and flat is the only way I can describe it. And add in not wanting to have sex. I dont know whats worse!

Thanks for this.
Im not sure exactly what the last blood tests were when I started having heavy periods. Definitely thyroid and fbc. They wanted to check iron and the thyroid as obviously they were the main culprits of the heavy periods and palpitations. I also had an ecg. Ive had blood tests for thyroid function a few times over the last couple of years and theyve all came back fine and within range. I then had my hormones checked the next month but that month was a normal period and they all came back within range, but from what I have read they are unreliable to diagnose peri. Ive not had any tests done in the last 6 months as I've been on the pill and thats resolved the heavy bleeding, just not the itchy vulva/eczema and now I just feel fed up mood wise and no libido which is why I want to come off it, but am reluctant to as the heavy bleeding will probably start again.
My libido was ok before the pill, so I know thats the reason for the lack of it.
Ive had swabs done for thrush in the past and its not that. They were meant to look into it more but we ended up discussing the other issues at the time.
Its such a nightmare to get an appointment (half an hour of continuous phoning before getting through) that i tend to only go if I really need to. I would struggle to be able to register with another dr surgery as it would be outwith my area they would refuse (im in scotland).
Perioral dermatitis has been treated with antibiotic cream, but it flares if I use different toothpaste, now need to use SLS free. Now I am thinking I might try using an emollient wash instead of using shower gel thia might help with the eczema. I have had a look and am definitely going to get an intolerance test. Im certain im eating something that doesnt agree with me, I just hope I dont have to give up caffeine as I like my morning coffee 😂
Thanks for the info on the mirena, I think this will be my next step. They did try to push it at the last couple of apps before I went on the pill, but I was more worried that if it didnt agree with me I was stuck with it.

For the dermatitis, make sure you keep on using the SLS toothpaste to stop a flare. Have you gotten any treatment or suggestions for the eczema?

Would you be willing to try low dose topical vaginal oestrogen? It helps a lot with the issues you are having, the dryness, libido, and itchiness.

Then, for any extra itchiness, I'd ask to be swabbed again for BV and thrush, just to be extra through. It may be there in small quantities, but especially swab for BV. Ask about an intolerance test as well.

Have you not got an econsult or online form system for your GP?

I'd go for the mirena, use B6 and Vitamin D in the week, at the very least, leading up to your period and during it. Then if the anxiety and mood issues continue persistently for up to 6 months post insertion consider antidepressants from ovulation to your period.

That's good all your hormones, bloods, thyroid etc came back fine. I'm guessing the ecg was also clear? It's likely the palpations are linked to the anxiety etc, rather than a heart issue so good it was ruled out.

You could do with up to date blood test results as any tests done over 6 months ago should be discounted. You need a diagnosis first and foremost.

Use unscented and unperfumed shower gel and the like. Sometimes such intolerances are caused by hormonal changes. And I’d certainly get your thyroid gland blood work redone as normal can indicate towards the bottom of the range of what is ok.

You will need to be persistent in order to get answers.

There is no one specific blood test to diagnose peri menopause. I think the answer to your problems lie elsewhere and that anti depressants will not be needed.