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Dr. Andrew Rynne
Dr. Andrew Rynne

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Is irregular menstruation common during perimenopausal stage?

Answered by
Dr. Shuba Hariprasad

General & Family Physician

Practicing since :2002

Answered : 1087 Questions

Posted on Fri, 24 Jun 2016 in General Health
Question: Hi, I have recently been given Cerazette by my FP nurse. I took it on day 12 of my cycle. I think I ovulated around day 14/15.
My period is due in 4 days, 28 day cycle. I was given Cerazette to stop periods as in the perimenopause stage, 47 yrs, my periods have become too heavy for me and I basically panic as soon as I observe menstrual blood. I struggle to cope every month. I also suffer from PTSD like symptoms due to a family trauma in 2014. My periods stopped for 6 months and then returned heavier. At times they are normal other times heavy.
I was really hoping to not have a period but to-day, I have noticed some pink spotting and have some discomfort. I can feel myself getting anxious already. I get in a terrible state and make it worse.
Is it okay to take 2 Cerazette at this stage, have taken 12 tablets so far?

Thank you.
Answered by Dr. Shuba Hariprasad 57 minutes later
Brief Answer:
Avoid taking 2 tablets. Stop after consulting your doctor

Detailed Answer:
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

I'm sorry that you are going through this.

Perimenopausal period (the time period in which your hormones and body prepare for menopause) can be rough.
Irregular cycles with irregular bleeding and symptoms similar to those associated with premenstrual syndrome can also create anxiety and stress.

Progesterone is the hormone that is associated with ovulation and normally increases after you ovulate. If no pregnancy occurs, the levels falls and period ensues.
Taking progesterone pills (cerazette) after you ovulate will delay period.
After a certain period of time (variable among women), breakthrough bleeding occurs (due to the sheer weight of the endometrium (uterine lining usually shed in a period)

When taken as a therapy , before ovulation, it prevents ovulation and suppress estrogen. This delays periods for a longer time.

To answer your, I believe your period is on its way. I advice against taking 2 cerazette tablets as it won't help prevent bleeding now.

I suggest that you stop cerazette and allow period to come, after talking to your treating physician.

I understand your anxiety and advice that you practice mind calming activities. Yoga, meditation, a long walk in fresh air. You might have heard this all before and I can only imagine how this must be affecting you with PTSD.
PTSD, in my opinion, is best managed by dealing with the cause.
Medications help to relieve acute or severe symptoms but the cure is to address how a particular event has affected you.
I'm sure that you know what started it, but it is more important to know why and how it has affected you. Do not hesitate to talk about it, even if it sounds irrelevant or unlikely.
Talk to a trusted friend, or a therapist who has experience with PTSD management.
Just know how it affects you can help with your symptoms. Dealing with it comes next.
You are not alone and don't have to do this yourself.

Hope I've helped.
Please let me know if there is anything else I can help you with.

I wish you well.
Dr. Shuba Hariprasad
Above answer was peer-reviewed by : Dr. Naveen Kumar
Follow up: Dr. Shuba Hariprasad 1 hour later
Thank you for your helpful responses, I appreciate them.

I have taken BC in the past Marvelon, after a mis-carriage and have had an IUD fitted prior to having my family other than that I have never used BC as due to anxieties I wanted to but was always concerned about using them.
It has taken me a great deal of courage to actually start them, only 11 days ago after a long conversation with the family planning team, who really recommended them. I presented in floods of tears and informed them I could not cope with periods' and have an actual phobia, which has been exacerbated.
I was told I may have spotting' but after time it should settle, I have to return in 4 months. I also have the option of the IUD, which suited me before.
I am therefore, confused as to why after all of these conversations and courage I would now stop and seriously, if Cerazette does work for me, my anxiety will lessen and I believe I will be happier as at moment and indeed at any time of the month I am constantly checking for blood or strange symptoms. I even admitted to my friend I have inserted a tampon in preparation for my period as I cannot stand the feel of blood emerging or the sight of it. I know this is not normal behaviour and upsets me so much, I never used to be like this, I am obsessive and phobic in relation to periods and get so scared.
Now I am concerned that there are reasons as to why I should stop Cerazette, when I have not given it a chance and the Family Planning team really believed it could help me and eventually stop my periods.

All my blood work and smears have come back normal. I am always up to date with smear checks and overall I am healthy, eat a good diet, take vitamins and mineral supplements, but I struggle with periods at this time of my life and the PTSD symptoms where I will be seeing a psychologist soon.

Thank you
Answered by Dr. Shuba Hariprasad 7 hours later
Brief Answer:
Stop cerazette for this cycle as period seems to be on its way

Detailed Answer:
Thank you for the follow up.

I am sorry for not being clear
I didn't mean that you should go off the pill.

What I meant was that your period seemed like it was on its way and I recommended that you stop it for THISlet it come and then restart it as prescribed the next cycle (between day 2 and 5)
You mentioned your period was due in 4 days. And that you probably ovulated.
My suggestion was to restart it after your period so as to prevent ovulation and delay periods longer.

I am sure your team of doctors arrived at this decision taking everything into consideration and making the best possible treatment plan.

I hope I very clarified your concerns. Sorry, once again.

Please consult your treating doctor before making a decision.

Wish you good health
Please let me know if there is anything else I can help you with.
Dr. Shuba Hariprasad

Above answer was peer-reviewed by : Dr. Prasad

The User accepted the expert's answer

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