September 2, 2008 in Features

50-year-old’s menstrual bleeding won’t stop

Peter H. Gott, M.D.
 

Dear Dr. Gott: I need some advice on a worrisome problem. I am a 50-year-old female in good health. I still menstruate, and until three weeks ago, it was completely regular. I had a normal, on-time period, but two weeks after it stopped, I began another one, which hasn’t stopped. It is like a normal period in appearance, but it has lasted three weeks, and I seem to be bleeding more than usual.

I am not in good financial health so would rather not see a physician unless absolutely necessary. I take vitamins and minerals regularly and continue to feel fine. What should I do?

Dear Reader: You need to see a gynecologist. I urge you to make an appointment as soon as possible. Prolonged bleeding from menstruation can have many causes ranging from blood clots to fibroids to cancer. It is important to find out the cause and have it treated promptly.

Regardless of the cause of your bleeding, you are losing a significant amount of blood and are at-risk for anemia, which can cause weakness, faintness, fatigue and other problems. You should start a daily iron-supplement regimen to reduce symptoms.

I should also mention that at the start of menopause, known as peri-menopause, normal monthly menses become abnormal, often skipping a month or two at a time, but it also can cause heavier or more frequent bleeding. I emphasize again that it is important to see your gynecologist as soon as possible. Only he or she can determine the cause and proper treatment.

Dear Dr. Gott: My doctor told me that I have fibromyalgia. My ribs ache, especially when I lift heavy objects or stretch. I also have insomnia. Can you please explain this condition to me? I am an 80-year-old female.

Dear Reader: Fibromyalgia is a widespread pain condition of the muscles and joints. In order to be diagnosed with fibromyalgia, you have to meet certain criteria. From your brief note, I cannot determine whether you truly have the condition. However, if your only symptoms are insomnia and rib pain, I doubt you have fibromyalgia. Based on the symptoms you listed, it seems that you more likely have a condition known as chest-wall syndrome. It is a benign inflammation of the rib lining. It has no known cause and often resolves on its own, but for some people, it can take many months to heal. I suggest you use over-the-counter anti-inflammatories such as ibuprofen (Advil or Motrin) or naproxen sodium (Aleve). I also suggest you be examined and tested by a rheumatologist, who can determine whether you truly have fibromyalgia or another, similar condition.


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