Hello, I would be happy to help you with your question.

Given your family history, it is likely that you too will go through menopause at an earlier age. As you likely know, menopause is defined as no period for 12 months. In terms of the workup of a 40 year old with abnormal bleeding, estrogen levels are relatively useless in terms of figuring out a cause. Here is what should have been done (perhaps it was - let me know)

1. You need an exam and an ultrasound of the uterus
2. You need labs that would include tests of thyroid function and an FSH (a better indicator of early menopause)
3. You need a biopsy of the lining of the uters - to evaluate for pre-cancerous changes (this is indicated in any woman at 40 or older with abnormal bleeding)

Estrogen levels vary dramatically during your cycle. The levels might seem "high" during the early part of your cycle. And given your abnormal bleeding, I find that this number really does not tell you much.

In terms of treatment of irregular bleeding:
1. You can do nothing if the above workup is normal
2. You can consider hormonal therapy to regulate your cycle
3. If indicated, you can consider surgery to stop the bleeding.

I hope this helps. Let me know if you have followup questions. You did not mention what exactly it is they wanted to "prescribe".

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Thank you for the followup clarification.

First of all, don't get fixated on the "high estrogen level" issue. This is simply a reflection of cycles where you do not ovulate. This occurs more often as you transition to menopause. The lack of ovulation leads to a buildup of the lining that then sheds in an unpredictable manner. This is exactly what you are experiencing, and it can possibly go on for years or months. The lining NEEDS to be cycled in some regular fashion, or you are going to be driven crazy by the unpredictability of your bleeding!

Qlaira is simply another form of birth control that claims to be more "natural". It too contains estrogen and progesterone. It is worth a try in terms of regulation of your cycles. Here are some other options to discuss with your doctor regarding abnormal bleeding and mood related problems:

1. Consider a progesterone only form of cycle regulation (depo-provera injection every 12 weeks OR Provera taken two weeks out of every month)
2. Nuvaring - a low dose form of birth control inserted vaginally (for 3 weeks, then one week off for a cycle)
3. A Mirena IUD - your cycles will lighten up and go away (this is a popular option with minimal to no hormonal side effects)
4. A low dose of antidepressant such as Lexapro 10 mg per day

I hope these options help. Good luck!! Discuss this with your doctor and be patient!

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