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[lemonbar]

As I posted in the "all things uterine" thread, I just found out that I am most likely in menopause. This is according to my gynecologist, who did an FSH test and discovered that my levels are 110. I went to get a check-up because my cycle has not returned, even though I am six months postpartum and not breastfeeding.

I am so confused and upset. How could this be? I am in my mid-40s. I've had two children, probably, if the doctor is right, while in late periomenopause or even early menopause. Could it be possible that my arthritis, which developed right when I turned 40 was a sign that I was approaching menopause? And I do remember having night sweats at about that time.... My cycles were definitely messed up, too, although they came regularly and I never skipped cycles (this made getting pregnant very difficult). My FSH was about 11 before I got pregnant with my first child at age 42. It was at least 30 (but probably much higher) before I got pregnant last year. In hindsight, these issues look now like signs that I was approaching menopause. I just never put it all together.

Could it be that I am now postmenopausal? Someone help me with the terminology: when is a person perimenopausal, menopausal and postmenopausal? Should I expect to have anymore symptoms of menopause, or is the time where I would have to worry about this now past? I just can't believe I would go through menopause and not even know it. It just seems too bizarre. 

I hope I have not offended anyone with this post. I know this is probably no big deal to women who have severe problems with "the change"; and I am sure no one who is trying to conceive wants to hear that I got pregnant twice while perimenopausal or even menopausal. I just feel so stupid and confused. I don't know how this could happen to me without me realizing something was going on!

Thanks for any info./advice.....

[llanfair]

I've been told that "menopause" is a point in time, whereas "perimenopause" is the time both before and after that point.  I think that menopause is usually defined as one year after the last menstrual period, and the symptoms start several years ahead of the last period, tapering off gradually after it.  That's why the term "pre-menopause" isn't used so much now.

Perimenopause can go on for years, unfortunately (as I'm now discovering).

[collegekidsmom]

What you describe can all be symptoms of perimenopause, which can go on for years. If you've had irregular cycles, night sweats, joint pain-those can all be symptoms of perimenopause. Women can and do get pregnant  throughout this time. Menopause would be the point in time when you have gone 12 months without a period, and perimenopause can go on after that. "Postmenopausal" would include anyone in the group after the point in time described as menopausal. Many women go through menopause naturally without a whole lot of issues. For women who don't want to be pregnant, many think they are menopausal but in fact they turn out to be pregnant.
You say you didn't even know you went through menopause, but for many women with skipping of periods, and the final end to them does mean menopause. Maybe some mild hot flashes for a long time or a short time, but no other symptoms-very common. Your other very common symptom is your age. 51 is the average age I believe to hit menopause but mid-forties would be very common. You describe many symptoms of menopause, but unfortunately, things can change, levels can fluctuate and things may start up again for a while. It's a gradual process for most, easy for some, difficult for others. Whatever it will be, it will be.

[msparticularity]

As it turned out, I started into perimenopause at 33 when I had an ovary removed. That was an in-and-out kind of a thing, mostly featuring worse PMS and some hot flashes for awhile. I also gained almost 50 pounds for no very good reason. By my late 30s and into my early 40s I was having the hideously heavy bleeding and terrible cramping and so on that so many others here have described. In my early 40s I developed RA and started on large doses of fish oil to see if that would manage it. I also learned that both my dad and my cousin had recently been diagnosed with Type II diabetes and figured out that a part of what was going on with my body was likely pre-diabetes, so I radically changed my eating habits. From about 42-46 I had easier--though still significant--regular periods. I think the easier nature of my cycles was ALL about the fish oil, and also the fact that I had lost the 50 pounds I'd picked up, which probably helped with the estrogen levels. Then, at 46 I began skipping cycles and they were sometime very light and/or very short. Sometimes I would have a fairly normal cycle for as much as 6 months in a row, then I would skip for a couple of months or a little longer, before having another couple...and so on. Finally, I had my last period just after our big cross-country move two years ago, and have never had another.

I guess I would designate myself as having been menopausal in that 46-48 range when I was having really irregular--and much lighter and shorter--periods, and then menopausal since then. I am still having some hot flashes, although they've tapered off steadily in terms of frequency and intensity. These last few years have actually felt okay to me--really more like I was completing a natural process, and MUCH better than things were in my 30s with all of the crazy perimenopausal stuff.

Lemonbar, I'm wondering if you might expand a bit on your feelings about your own situation. I was really incredibly happy to get through menopause, so maybe I'm just not getting why you're feeling sad, confused and upset. Were you hoping to have more children? Or is this about the aging process generally?

[infopri]

Lemonbar, if it makes you feel any better, I woke up one day to find out I'd missed the main event, as well.

I started taking birth-control pills when I was 19.  As the years went by and new, lower-dose pills came out, my GYN changed my prescription from time to time.  After one of those changes, when I was in my early 40s, my cycle seemed to get completely out of whack--heavier bleeding, skipped periods, breakthrough bleeding, etc.  We changed prescriptions again.  And again.  I went on a quarterly cycle: no week off at the end of the month, only at the end of each three-month cycle.  (Yes, that means four periods a year.)  Except that, most of the time, I didn't bleed even during these quarterly intervals.

So one day, I asked my GYN whether I could be in menopause.  After all, I was in my 40s, and, because no woman in my immediate family had gone through natural menopause (my mother, her sister, and both of my grandmothers had had hysterectomies in their early 40s), I had no idea of what to expect or when to expect it.  My GYN asked whether I was experiencing hot flashes, night sweats, or irritability.  No, no, and no.  The GYN insisted that the irregular periods were a result of the pills.  I asked him again the following year.  Same conversation.  Rinse and repeat, several years in a row.  No hot flashes, no menopause--so he said.

Finally, I convinced the GYN to give me the FSH test.  I went off the pill (for the first time in almost 30 years), waited an appropriate amount of time before taking the test, and scored something in the 80s.  Bingo. 

Then I started having hot flashes.  Duh: What's the (former) treatment for hot flashes?  Hormones.  What's the active ingredient in the birth-control pill?  The same damn hormones--at about four times the dosage.  No wonder I hadn't been experiencing symptoms!  Now that the (ingested) hormones were out of my system, I had a mild case of hot flashes for about a year or two, and a fairly big dose of irritability (I'm told) that still hasn't evaporated.  Happily, I never did get the night sweats.  (Interestingly, though, my internal thermostat has been on the blitz since all this started.  In addition to getting the hot flashes, I also got easily chilled.  And these days, I'm much more tolerant of heat and even humidity than I used to be, and much less tolerant of cold.)

So, I guess I'm one of the women that collegekidsmom was talking about who didn't have a lot of issues (other than surprise).  Based on the "12-months-after-the-last-period" criterion, I was 47 when I entered menopause, and in my early mid-40s when I began perimenopause.  I never had kids, so there's an element of "Well, that's it, that train is gone," but I'm okay with that.  I'm very glad I didn't inadvertently get pregnant during perimenopause, as my grandmother did--leaving me with an aunt nearly 20 years younger than my father and only a few years older than my sister.

[collegekidsmom]

I think it is also somewhat common for women who have not been taking BC pills to start taking them at perimenopause-both for prevention of unwanted pregnancy and for evening out the process. Then at an appropriate time hormone levels are tested and menopausal status is determined. It is also possible for many to go through the whole process without any medication-but I'm sure there is a lot of anxiety around getting pregnant when cycles are getting very irregular.

[llanfair]

I'm 47.  I won't know when I hit menopause - I had a hysterectomy at 35 but kept the ovaries.  I've been having night sweats for several years now, and hot flashes hit last year for real.  That wasn't so bad, but when the exhaustion and mental fog hit this past spring, I snapped and asked my GP about HRT.  She started me on estrogen-only Premarin this June, and I'm feeling much better.  I plan to go off it in a couple of years, and hopefully the worst will be over by then.

[lemonbar]

Thanks for all of the responses. Some of what people are describing here seems to match what is going on with me.

I know it sounds weird to hear that I might be upset about being in menopause. It's not because I want more children. I think it has to do more with wanting to feel like I know my body and thus myself. I have always tried to educate myself on health issues so it was a bit disconcerting to hear the doctor say I was most likely in menopause. Seems like I should have been able to put two and two together and figure this out for myself. Especially with the night sweats...seems a classic sign that things were progressing. They were happening right when I was trying to get pregnant for the first time, so maybe I was just in denial. And, I did not connect the night sweats with the arthritis at all. They seemed to me to be two disconnected events. 

Part of my response also has to do with aging and feeling old (I know that sounds vain). I don't want more children, but somehow, not being able have them anymore makes me feel old (rather than relieved!).

[collegekidsmom]

I think that the idea of being "too old" to have children does take some getting used to. That's maybe why natural menopause takes a period of time, and when you go through those years you get used to the idea over time. When menopause hits you all at once due to surgery or other medical reasons, it must come as a shock. You really need some time to get used to the idea if you weren't expecting it. There are also some connotations of being "menopausal" with being old in general. However, once you get used to it, you might take it in stride and look at it as a liberation of sorts. I can certainly see how it could blindside you if you have not even given it much thought. Perimenopause, if going through it naturally, prepares you pretty well for the end of the whole process, and I'm sure can get so annoying -in terms of symptoms -that menopause looks better all the time!

[llanfair]

Yes, Lemonbar, if you're already well into this process, you may have skipped a lot of the physical discomfort by now.  That part, at least, is a big plus.

[monarda]

Thanks for all of the responses. Some of what people are describing here seems to match what is going on with me.

I know it sounds weird to hear that I might be upset about being in menopause. It's not because I want more children. I think it has to do more with wanting to feel like I know my body and thus myself. I have always tried to educate myself on health issues so it was a bit disconcerting to hear the doctor say I was most likely in menopause. Seems like I should have been able to put two and two together and figure this out for myself. Especially with the night sweats...seems a classic sign that things were progressing. They were happening right when I was trying to get pregnant for the first time, so maybe I was just in denial. And, I did not connect the night sweats with the arthritis at all. They seemed to me to be two disconnected events. 

Part of my response also has to do with aging and feeling old (I know that sounds vain). I don't want more children, but somehow, not being able have them anymore makes me feel old (rather than relieved!).

I feel this way too. Haven't had children, haven't been on BC pills since 2003, mostly because I didn't like what the BC was doing to me (B12 deficiency).  If we'd had children since then it would have been okay.  I didn't want to go through fertility treatments or anything. But all the same, now in perimenopause, I'm feeling old.  I just turned 50, too.  Mostly my body is confused and I'd like to respond to it. Somehow.

[lemonbar]

As is my normal response to these sorts of things, I went out and bought a book so I can read up on menopause. But from all that has been said here and on similar threads, it seems like I have been in perimenopause since my late 30s; and that, if I don't get a period by next July or so (the last time I saw any blood at all was this past July), I will have been in menopause. But, I won't know for sure until next year.

I am keeping my fingers crossed that this is it, and that, by next July, I won't have to worry anymore about symptoms (or birth control).

It is nice to know that a community of women exists here who are in the same phase of life as am I. I went to a conference last year, and the room was stifling. I happened to be sitting next to a group of women who were sweating it out and laughing about being the menopausal group in the room. It was kind of endearing to see that.

[llanfair]

It really is good to have others slogging along too.  Some of my friends at my old workplace used to joke that they had their own little tropical paradise :)

[biomancer]

My mom has a refrigerator magnet that says "I'm not having hot flashes - I'm having short private vacations in the tropics!"

I suspect that part of why you're still feeling anxiety and not relief is that you are probably still in the post-partum range - the hormones can go completely bonkers for up to a year (6 to 9 months is typical).  I suspect you're also right that you were already perimenopausal before you got pregnant with LemonDrop.

<I edited out a huge bit in which I rambled about LH and FSH and how those tests are *supposed* to be done, the physiology of menopause, and some anecdata.>

 I think what I'm trying to say is that it will all be OK.  I think right now that it's just going to take time, as your body is still recovering from having LemonDrop.    Once your body gets everything figured out, you'll probably be in the "relief" camp with many of us.

[patchouli]

Lemonbar,

 I totally get how you feel about this.  I was forced into menopause early due to surgery and felt, well, violated--a bit angry, too.  The women in my family had menopause in their 50s, but I was pushed into it  much earlier.  There is a loss there, that for me (and it sounds like you), needed some mourning, really.  It's about moving from one part of life into another, and especially when you're not ready or think that will be later, that can be jarring.

I didn't have "big" symptoms either, but still, the loss of the reproductive years is an end to the largest part of your life as a woman so far.  I also found menopause liberating, too, though, in terms of no fear of pregnancy and in overall being more able to be focused on what I want.  

I didn't really suffer much with symptoms but I would advise you right now to research how you will deal with this hormone-or-not, as your skin and hair and other parts might be affected, might not.  It will also make you feel more empowered.  A place that has forums on hormone therapy and menopause is www.hystersisters.com

By the way, my own mother was diagnosed with RA right after my birth (she was 40) and didn't go through menopause for 11 years.