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Periods not stopping, light flow, cramping, losing weight, tests normal. Not pregnant. Taking Lamotrigine. Any advice

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Posted on Sun, 8 Jul 2012
Question: Hi,
I'm 42 and my periods have been pretty regular in the past, but this last one hasn't completely stopped, and I'm going on 19 days. This has never happened before. The blood is mostly obvious after using the restroom, and isn't heavy enough to use tampons. I use pads, but they're not really needed either. The bleeding is pretty light, but definitely there, and I am having some cramping. I've been losing weight due to a stomach issue. The weight loss is actually a good thing since I'm overweight, but losing it due to pain kinda sucks. I think I dropped 15lbs or so this last month.. (Doctor's still don't know what is causing the stomach pain, even after a huge barrage of tests, including a colonoscapy and a gastroscopy.) I've been told by various friends that my extended period is due to the weight loss, and is nothing to panic over and to just take some extra iron, but now I'm not so sure. (Also, I haven't had sex in a couple months, and the stomach doctor just did a pregnancy test, so I know I'm not pregnant.) As a bonus, I'm horribly bi-polar, and take lamotrigine, provigil, bupropion, and quetiapine. I don't have decent health insurance right now, so going to the doctor is a luxury, and due to the stomach and psych issues I'm already in over my head financially. Any advice will be greatly appreciated.
Thank you. ~E.
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Answered by Dr. Sree Gouri SR (1 hour later)
Hi,
Thanks for writing in.
Your symptoms can be due to the following conditions:
1.Perimenopausal phase: it is transition period between normal menstrual periods and menopause.
Normal age of perimenopause is around 47 but it can start earlier also. There will be hormonal fluctuation during this period which will lead to symptoms like irregular periods, heavy bleeding, insomnia, decreased libido, abdominal cramps, nausea, anxiety etc.
Stress, dietary modifications, exercise etc can also lead to perimenopausal symptoms.
For this, hormonal levels need to be tested. Depending upon the reports, appropriate treatment in terms of hormonal replacement can be given.
2. One more condition is metropathia hemorrhagica in which abnormal, continuous bleeding can be due to persistence and exaggeration of follicular phase which can also be seen in perimenopausal age. We would need to treat the cause here.
3. Fibroids, which can lead to extended periods and excessive bleeding. Treatment will be medical or surgical depending on symptoms and number of fibroids.
4. Drugs you are using for bipolar disorder also can lead to menstrual irregularities.
An ultrasound of the abdomen will put us in a much better position to comment on the possible causes of menstrual bleeding and weight loss. This would be rather required at this stage.

Hope this helps. I will be available for follow ups.
Take care.

Above answer was peer-reviewed by : Dr. Aparna Kohli
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Dr. Sree Gouri SR

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Practicing since :2006

Answered : 5839 Questions

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Periods not stopping, light flow, cramping, losing weight, tests normal. Not pregnant. Taking Lamotrigine. Any advice

Hi,
Thanks for writing in.
Your symptoms can be due to the following conditions:
1.Perimenopausal phase: it is transition period between normal menstrual periods and menopause.
Normal age of perimenopause is around 47 but it can start earlier also. There will be hormonal fluctuation during this period which will lead to symptoms like irregular periods, heavy bleeding, insomnia, decreased libido, abdominal cramps, nausea, anxiety etc.
Stress, dietary modifications, exercise etc can also lead to perimenopausal symptoms.
For this, hormonal levels need to be tested. Depending upon the reports, appropriate treatment in terms of hormonal replacement can be given.
2. One more condition is metropathia hemorrhagica in which abnormal, continuous bleeding can be due to persistence and exaggeration of follicular phase which can also be seen in perimenopausal age. We would need to treat the cause here.
3. Fibroids, which can lead to extended periods and excessive bleeding. Treatment will be medical or surgical depending on symptoms and number of fibroids.
4. Drugs you are using for bipolar disorder also can lead to menstrual irregularities.
An ultrasound of the abdomen will put us in a much better position to comment on the possible causes of menstrual bleeding and weight loss. This would be rather required at this stage.

Hope this helps. I will be available for follow ups.
Take care.