Brief Answer:
Seems to be heading for menopause

Detailed Answer:
Hi

I would explain as follows:

At the age of 44 years, woman's menstrual life is at the terminal part.
In these days, her womanhood hormone called as oestrogen is at low levels. This hormone is responsible for giving her wetness and libido during sex. So if you are experiencing dryness during sex, please use a good lubricant. Oil-based lubricants like Vaseline, etc. are harmful to woman's genital organs. So use only water-based lubricants. You may use vaginal jellies that are available over the counter.

She had short phase lapse in the menses and again she got her menses after a couple of months which are irregular, more frequent and scanty. This is suggesting that she is approaching her menopause now. At this phase of reproductive life, the pregnancy is very remote possibility, and moreover if at all the pregnancy occurs, the chances of abnormal baby are very high.
Her hairiness is also suggesting that proportion of male hormones in her body is increasing now, which is common at menopausal age.

Also please make her understand that stress is a nasty thing which comes in way of pregnancy and regular menses. Please manage her stress professionally, if required with the help of a counselor or psychiatrist.

I would advice you to think on following lines:

1. Are you really very keen on having her own baby? If so, you may have to get her hormonal levels estimated. Initially I would advice you to get her blood examined for Oestrogen, Progesterone, FSH, LH and Prolactin. This will really give you fairly clear idea whether she is forming her eggs normally or not or whether she is reaching her menopausal milestone. Also these investigations will reflect whether her uterine lining would be adequate to get the pregnancy implanted and then nurture it to the term.

2. If she can become pregnant, are you willing to accept abnormal child if it comes to that? Of course, now a days in modern obstetrics, we have got many tests to find out about the normalcy of the child. If diagnosed well in time as an abnormal child, would you be courageous enough to get the pregnancy terminated?

3. If she is beyond becoming pregnant, would both of you be willing and happy to adopt a child? This may serve all your purposes.

Please take your decision after discussing the matter with your wife and let me know it. I shall be more than happy to guide you further. In that case, I would like you to get the above mentioned investigations and upload them so that I can review them before I give you any advice.

Take care

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Brief Answer:
She needs calcium supplementation

Detailed Answer:
My dear XXXX,

I am indeed impressed by your approach towards the problem. You are taking a decision after understanding the scientific information. I am sure your obstetrician will guide you properly and you will take your final decision. I will be keen on knowing what you have opted for.

Lower back pain, waist bone pain are definitely major concerns. These symptom are suggesting that due to her perimenopausal period of life, she may be having calcium depletion from her bones. This is dependant upon the hormone oestrogen, which at this age is low in her. Please get her bone density test performed. I am sure she is going to need calcium supplementation. In fact we always advise all the females to supplement themselves with calcium from the age of 30 years.

Regarding her irregular and scanty menses I am not much concerned and you also need not be.

Dear XXXX, please avoid any sort of intra-vaginal interventions like douche, flush, etc. She does not need any such external cleaning methods. Follow such methods only if the Gynaecologist advises her for any pathology.

I would appreciate if you keep me updated regarding your option of child.

Please take care of your dear wife nicely and follow only medical advice. If you feel to contact me anytime, I am always available for you.

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