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What Causes Delayed Menstruation And Unusual Brown Spotting?

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Posted on Mon, 19 Oct 2015
Question: Hello,
I am 15 days late for my period but started brown and light bloody spotting two days ago. ‎However no period, and I am usually regular every 26-29 days and never missed a period in ‎my life. I am 42. Can I be pregnant?"‎
doctor
Answered by Dr. Manisha Jain (56 minutes later)
Brief Answer:
Urine pregnancy test advised

Detailed Answer:
Hello mam, thanks for trusting health care magic.
In case you have history of unprotected intercourse then yes there are chances that you are pregnant so get a urine pregnancy test done and see the result.
In case negative then nothing to worry as this can be the start of perimenopausal transition state.
All the best.
Regards
Dr Manisha
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (2 hours later)
Thank you doctor.
I had an urine pregnancy test last week, and it was negative. Could it have been too soon to test?
Also regarding the start of perimenopausal transition state - does that mean that I can no longer get pregnant?
doctor
Answered by Dr. Manisha Jain (13 hours later)
Brief Answer:
Tests advised

Detailed Answer:
In case the test is negative a week back then no risk of pregnancy at such a late date after that act so nothing to worry from that angle.
In case you are desirous of pregnancy then I think you need to speed up your efforts as this is a high time or you may totally lose your fertility potential.
In my opinion get certain hormone levels tested viz - TSH, prolactin and AMH.
These tests will give us a lot of information regarding your fertility issues.
In case you have any questions about it, please feel free to ask as I basically practice infertility so will be glad to help you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (3 hours later)
Thank you doctor. Yes I am desirous of pregnancy and it will be my first. I took some tests in May 2015 on the third day of period and the results were: FSH-5.8, LH-2.4, E2-32.12, PRG 0.60, PRL 24.1, AMH 0.82, FT4 1.11, FT3 3.32, TSH 1.61. Both me and my husband did a karyotype testing and they were normal.
Could these results have changed now after 4 months, after this episode of delayed period?
What are my chances of getting pregnant with my own eggs? What can I do to improve chances of success?
doctor
Answered by Dr. Manisha Jain (1 hour later)
Brief Answer:
IVF with your eggs at least one attempt

Detailed Answer:
Good thing is your tests are more or less normal only except AMH which is quite low so it needs early intervention now and it implies poor ovarian reserve.
In my opinion you should opt for IVF (test tube baby) and take induction drugs and let the gynecologist see the response in the form of number of eggs which start maturing.
Chances of pregnancy are on lower side with your eggs only because -
- lesser number of eggs will be retrieved due to low ovarian reserve
- poorer quality of egg because of advanced age.
Still since you haven't tried even once, one try is worth the effort.
Other donor egg IVF is always an option.
Wish you luck.
Whenever you need any opinion, remember I'm always there to help you out.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (4 hours later)
In October 2014 my AMH level was 2.05 while in May 2015 they were 0.82. Is such a change in only 7 months normal? Could some external factor be the cause of this change? Or could it be a mistake in testing results? I have heard that low vitamin D levels may affect this.
Many thanks again.
doctor
Answered by Dr. Manisha Jain (8 minutes later)
Brief Answer:
Repeat testing advised

Detailed Answer:
Yes you are right that low vitamin D can adversely affect it but this drastic change is not possible in 7 months so most likely seeing your age your first report seems abnormal.
So better get it repeated after a month.
Till then take dehydroepiandrostenedione (DHEAS) tablets after discussion with your gynecologist as these are known to increase AMH Levels if take thrice a day for 3 months.
Discuss this with your doctor and let me know in case you have any query.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (20 hours later)
Thank you doctor. Yes, it makes sense to repeat AMH testing.
As regards taking DHEA, I have been concerned about its possible side effects. In case I take it for 3 months, what could be the expected results? Is there a specific type of DHEA that I will need to take, or any drugstore kind will do?
I have also heard about vitex/chasteberry and the positive effects taking it may have in regulating hormones and the female cycle. I have not considered taking it until now because my cycles have been very regular. However, now that I had this delayed period, is it a good idea to I start taking it as well? What about progesterone creme? Could it be beneficial as well?
Many thanks!
doctor
Answered by Dr. Manisha Jain (7 hours later)
Brief Answer:
DHEAS intake is very helpful

Detailed Answer:
Sorry for the delay in response.
You can try these things as well as there is a definite documented evidence of their use.
As regards DHEAS intake, discuss with your gynecologist as she is the best source because she can evaluate your ovarian reserve via ultrasound and repeat AMH levels and co relate all of them.
But in my opinion you must take it in case you plan your treatment a little later than 3-4 months as it has been seen to increase the AMH significantly in some patients.
Progesterone support in later part of the cycle is a good option but that should be taken along with follicular study only so that you take it only after ovulation and thus will aid in delivering nutrition to the baby.
All the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (1 hour later)
Thank you again doctor. I really appreciate your advice. One last question about uterine fibroids. I was diagnosed with three of them last year each measuring less than 3 cm. In the meantime I introduced some changes to my diet (more greens and legumes, less meat, less dairy and wheat products), and have lost weight, around 7 kgs. Still have to see wherher fibroids have shrunk though. Do you think dietary changes and the weight loss may have helped? Do you have any other advice on how to treat fibroids?
doctor
Answered by Dr. Manisha Jain (18 hours later)
Brief Answer:
Size of fibroids not related to weight loss

Detailed Answer:
No dear, weight loss has practically no effect on fibroids as they are composed of muscles and not fat and thus will not shrink in size.
To decrease the size there are drugs like ulipristil and GnRH analoges but these are not recommended in patients who are desirous of pregnancy.
Since they are small in size so can be left as it is and just try for pregnancy now and don't delay it any further.
In case you need any advice in future you can contact me directly on this forum.
All the best.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Manisha Jain

OBGYN

Practicing since :2007

Answered : 5136 Questions

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What Causes Delayed Menstruation And Unusual Brown Spotting?

Brief Answer: Urine pregnancy test advised Detailed Answer: Hello mam, thanks for trusting health care magic. In case you have history of unprotected intercourse then yes there are chances that you are pregnant so get a urine pregnancy test done and see the result. In case negative then nothing to worry as this can be the start of perimenopausal transition state. All the best. Regards Dr Manisha