Perimenopause. Help. When should I call my doctor?

Updated: Dec 4, 2020

Welcome to part 3 of this 4-part topic.  If you haven’t read the first post on the subject, here is the link:   Click here: Perimenopause vs Menopause. Confused? Let’s Hack That.


Too many women suffer in silence.  Not seeking help or advice from a doctor.  Maybe you are afraid of side effects of the HRT.  You may not believe anything will relieve the symptoms.  You may feel comfortable with having a conversation with your doctor on the subject.   Maybe your doctor is one that doesn’t seem understanding when it comes to perimenopause.  (Which was my original experience, but not all doctors fall into this category).


Perimenopause, I’m told, is not as clear or tangible to doctors as Menopause is.  Some feel “helpless” in helping their patients.  But many now understand perimenopause and are able to guide and help you along this stage of your life.


Yes you should talk to your doctor.  Let’s talk of the reasons why.


Early onset of Menopause

When a woman has a surgical removal of both ovaries, or has cancer treatments like chemotherapy or pelvic radiation, she will experience what is called “induced menopause”.  She will experience the end of her periods due to a medical procedure / intervention.

Other factors that can influence the timing of your natural menopausal stage are genetics and smoking.  It has been shown that smokers tend to reach menopause around 2 years earlier than non-smokers.


When should I be concerned about perimenopausal symptoms?

You don’t necessarily have to call your doctor to get diagnosed with perimenopause or menopause.  You now know that irregular periods are common and normal during perimenopause.  But other conditions can cause changes in menstrual bleeding.


When should I call my doctor?

Call your doctor if you experience the following symptoms:

  1. spotting after your period

  2. blood clots during your period

  3. bleeding after sex

  4. periods that are much longer or much shorter than normal

Abnormal bleeding can be caused by hormonal imbalances, birth control pills, pregnancy, fibroid, or rarely, cancer.  However, talk to your doctor so that you can be clear on the cause.

Also talk to your doctor if :

  1. Your period is extremely heavy (you are changing pads or tampons every couple of hours)

  2. your bleeding lasts longer than seven days

  3. you bleed between periods

  4. you are getting your periods less than 21 days apart.

Note:  You should also call your doctor if the symptoms of either perimenopause or menopause become severe enough to interfere with your daily life.

How is perimenopause diagnosed?

In a the first post of this series I suggested keeping a journal of your perimenopausal experience.  Tracking your symptoms and how you are experiencing them.  Also keeping track of your last period, any irregularities, etc.


Your doctor will ask you the date of your last period, what symptoms you are having, and how often you are having them.  Be honest.  Don’t be afraid to discuss everything from trouble sleeping to symptoms regarding sexual problems.   It is very important to openly communicate with your doctor so he/she can help.


Your doctor may also do a vaginal swab to test pH levels.  During your reproductive years, your vaginal pH is about 4.5.  During menopause, your vaginal pH rises to about 6.  This simple vaginal swab can confirm menopause.


Remember that perimenopause and menopause are both natural stages in a woman’s life.  All women go through it even though we may have different experiences.


Here are other things your doctor may do as tests.  These tests can help confirm menopause and rule out other possible conditions like ovarian failure or thyroid condition.

  1. Blood test t check levels of follicle stimulating hormone (FSH) and estrogen

  2. Tests for liver and kidney function

  3. a complete cholesterol test

  4. a thyroid function test (blood test for TSH, T4, T3)

During your visit with your doctor, he/she will also consider your age, family history, and menstrual cycle to determine if you are experiencing perimenopause.  A blood test can check your hormone levels.  However, your doctor may not order one done unless your symptoms are occurring at an unusually young age.  (This was my experience.)

Next week, post 4 of this 4 part series.  We will talk about possible treatment options.


Yours in health, happiness and success,

Nancy Shimmy

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