Like the questions says, I'm 45, and I haven't had a period in almost 5 years now.

I'll try to give the best history I can, and I know you all can't diagnose, and I don't expect you to, just want to know if anyone has any ideas.

To begin with, I had a miscarriage 10 years ago, the baby had died at 3 months gestation, I bled heavily, almost died, and had to have an emergency D & C because the baby wouldn't leave my body. Since then I've had issue after issue, anemia being the major one. Since that miscarriage my once regular period was off, all the time, then it suddenly stopped altogether when I was 40. I figured it was menopause.

After a year of no periods, at the age of 41, I went to my doctor, told him what was going on. Blood tests, and other tests, and no sign of menopause. So why am I not getting my period?

His thought was that it had something to do with my anemia.

Well, I take daily iron pills (prescription, 3 times a day), and I'm still anemic, and still no period, now for almost 5 years. Every 6 months I get blood work done, and the blood work indicates that I'm not in menopause, or Peri-menopause, or any sort of pause at all, but still no period.

Any thoughts? Not that I want my period back, I'm perfectly fine not having it. But if I'm not in menopause, obviously not pregnant, than what's going on? Is this hazardous to my health? Is there something else I should be getting tested?

Has your doctor tested your FSH and LH? Are they within normal range?

Has your doctor tested your FSH and LH? Are they within normal range?

Honestly not sure J. He ran tests, runs tests every 6 months, but I honestly have no idea what he's checking for. I'll ask next visit.

To make it easy to understand, if your FSH is greater than 30 mIU/ml and you haven't had a period in over a year, you are considered to be in menopause. If your LH is between 14.2 - 52.3 IU or greater, and you haven't had a period in more than a year, you are considered to be in menopause.

These hormones are not tested for routinely. This would not be part of your normal labs the doctor tests for at your visits.

Still anemic despite taking iron suggests to me that your doctor needs to look further.
This might not be it but it's interesting to know: Iron Disorders Institute:: Absorption (http://www.irondisorders.org/absorption/)

In the end Alty, all of us women go through menopause. Some earlier than others. I was in it at the tender age of 42. Some go through it earlier than others.

I think your concern goes back to your familial history of cancer rather than menopause itself.

Regarding your anemia, you might benefit from seeing a hematologist versus your regular primary care physician. As well, with your history of thyroid disorder, you would benefit from seeing an endocrinologist.

Iron pills only work so much, you need an iron balanced diet as well. Vegetarianism would not suit you well.

I do know that my doctor ordered blood work, 6 months ago, to find out if I'm going through menopause. The results said I wasn't. If that helps?

Having said that, my regular doctor is in semi retirement, only works Friday's now. He has a young doctor taking over his practice, and that's who I've been seeing for almost a year now. My old doctor (old as in been with me for a long time, not a comment of his age), has done all manner of tests, MRI's, CT scans, you name it, to find out what's going on. Other than the colonoscopy that showed internal hemorrhoids and IB, which explains the blood loss (I bleed from my rectum, and that's the cause of the anemia), no other anomalies have been found.

In other words, they have no clue what's going on, and every test they can think of has been done. So I'm at a loss here. I have no idea what to do next, what to ask for, what to insist on, what to take, what not to take, etc. etc.

Alty, you would have to be bleeding buckets out of your butt yo stay so anemic. You really should see an internist rather than a general practitioner.

It's a lot of blood J. Not buckets, I think. Never measured it. But every bathroom trip, even just a pee trip, results in a bowl full of blood. Not pink diluted by the water, but bright red. Every time. And it's not coming out of anything but my butt.

Wow, talk about TMI. :(

Internist? How do I go about that? Wouldn't the doctor that did the colonoscopy be an expert? So confuzzled.

You know by now that I'm concerned about your health and my perceived lack of care that you are being given.

I don't know who did your colonoscopy or what his credentials are, so I can't speak as to whether he would know. I just know that this bleeding is not normal and should not be left to continue with only being supplemented with iron pills. IMHO that is not good medicine to allow known bleeding to continue.

How do you find an internist? A simple Google search revealed quite a few in your area.

Alty you know I have zero medical credentials... and even I was shocked to hear what you describe.. any more than some blood on the paper when you wipe (with hemorrhoids) is cause for serious concern.

And in fact the Gastroenterologist I see (regular here due to my age and family history) that is among the FIRST things he asks about. And one of the tings I've been warned to take seriously. Its even asked by my regular doctor during annual physicals.

If it IS the hemorrhoids bleeding there are surgical and non-surgical ways to deal with them rather than ignoring them. And if it IS something worse..you REALLY need to know.

But never assume when your health is involved.

You are too trusting Alty. You need to have gone for a second or third opinion by now.

I get that the hemorrhoids are internal, but active bleeding is never left to continue. I know you trust your older doctor, but how many times over the years have I said that they aren't doing enough for you.

I do trust him, and he's great, he's sent me for many tests, all came back fine, other than the colonoscopy, which was many years ago.

I did go for banding for some of the hemorrhoids. That doctor did 3 at a time, with students to watch the entire procedure, and frankly, I didn't go back for my next appointment. I was too horrified by the first one.

Since then it's like my doctor knows about it, but unless I mention it, and even if I mention it, it's pretty much, "oh, didn't we already do all the tests for that and found nothing? Well then, it's nothing, so here's your thyroid meds and your iron pills, and have a good day". Ummmmmm...

I asked about surgery for the hemorrhoids, and was met with, "you don't want to go that route, it's painful and horrible". So okay, then what else is there?

It's like they send me to specialists, and never follow up with the specialists they send me to, and they're the go between. All the reports from the specialists go to them! So unless they tell me what's going on, or what to do next, it's pretty much up to me to tell them what to do next, and I'm not a doctor!

The thing is, where I live there aren't a lot of doctors, less that are taking on new patients. Most people go to walk in clinics. I went to one when I fell and got the huge piece of mulch stuck in my leg. While waiting in the clinic waiting room for hours, another patient that was there with his daughter told me that he needs to find a regular doctor, because he doesn't have one he goes to the walk in clinic, and the doctor in this clinic, in his opinion, is an idiot, but what other option does he have?

Once I got in, he took tweezers, jammed them into the open wound where the mulch was stuck, and then spent 5 minutes trying to grab it an pull it out. He didn't even numb it! Syd was there with me, and she almost passed out. So did I! Afterwards he said to Syd, "your mom is a strong lady, because that hurt like hell!" No $hit Sherlock! Ever heard of a local?!

I can't just go to an expert in the field, here you have to be referred by your doctor. So if I want to see a hemorrhoid specialist, my doctor has to refer me. Same with getting a colonoscopy, or blood work, or an MRI, etc. etc. etc.

So really, I don't have a lot of options. I either have to find a new doctor, which is next to impossible, or I have to give my current doctor advice on how to treat me, and what to do next.

Alty. YOU are your own advocate. It is your responsibility to get the results of the tests and make the doctors explain it to you so that you understand.

I worry about you because you go to the doctor, the one you trust, but that doctor doesn't follow up with the results of tests from specialists. Sounds like a quack to me. Sorry, I've told you for years how I feel and I feel even stronger about it now.

Active bleeding of ANY kind is not to be put on a shelf and ignored, only to be treated with supplements. That in and of itself is quackery. It's like, oh you're bleeding to death, here, take some iron. Ridiculous! Iron won't stop the bleeding. It will continue.

How many years ago was the colonoscopy? Probably about time for a repeat.

Get your doctor to refer you to a gastroenterologist. Then YOU follow up for the results.

Not it to sound y, but if I did with my breast cancer you are doing with your bleeding, I would be dead now. Remember, I wasn't a nurse then, just a legal secretary.

Alty, what would you do if this were Syd? You'd fight tooth and nail to get this fixed.

It would have me scared s4itless too! It's like "I know you have a brain tumor, but here, here's a Tylenol."

This doctor is just putting a bandaid on a bigger problem. Most likely it's because this is out of his scope of practice. I do OB, not cardiac. I wouldn't know how to diagnose a myocardial infarction if it slapped me in the face, but I know how to tell if a baby is healthy or sick before it is born. General practitioners are just that, general. They can diagnose the flu, common cold, and most common health issues like thyroid disorder, for example, but there are illnesses that are beyond their scope of practice. If you have congestive heart failure you go to a cardiologist. In Alty's case she is having rectal/colon bleeding, this calls for a different specialty. A gastroenterologist, one who deals with the digestive system, that starts in the mouth and ends at the rectum.

I have to agree with WG. If this were happening to Syd or Jared, you would move heaven and earth to get to the bottom (pun intended) of this. You would never allow them to bleed like you are.

I agree with both of you. I know I don't take good care of myself, and yes, if this were one of the kids, or one of the dogs, I'd be fighting tooth an nail to find out what's going on. But for some reason when it's me I don't fight that hard. I do go to the doctor, I do get the tests done, but once they say all is fine, I just live with it, even though it's not fine.

I agree with both of you. I know I don't take good care of myself, and yes, if this were one of the kids, or one of the dogs, I'd be fighting tooth an nail to find out what's going on. But for some reason when it's me I don't fight that hard. I do go to the doctor, I do get the tests done, but once they say all is fine, I just live with it, even though it's not fine.

So so what are you going to do to fix this? Your kids need their moM, the dogs need you, heck even Rod needs you.

Does your doctor know about the frequency and the amount?

So so what are you going to do to fix this? Your kids need their mon, the dogs need you, heck even Rod needs you.

Rod needs me the most. The kids can fend for themselves. He'd die without me. ;)

I'm going to demand answers. I have an appointment next week, and I'm going to demand more than pills, but an actual solution! Surgery, more banding, whatever it takes, and I want to know why I haven't gotten a period in 5 years if the blood tests show that I'm not in menopause!

Because you're right, the kids do need me, and the dogs, and especially Rod. :)

Okay Alty, I have a list of what you should ask the doctor...

1) What are my hematocrit and hemoglobin levels? He should give you 2 numbers. One number for the hematocrit and one for the hemoglobin. Write those down and let me know what they are. Don't accept "normal." You want the actual numbers.

2) What are my FSH and LH levels. Again they should be 2 numbers. Again, don't accept normal, you want actual numbers. This will give you your menopause answer.

3) Is it common practice to treat rectal bleeding with iron rather than finding the actual cause of the bleeding and correcting that problem? What is the solution to this problem? You can't keep putting a bandaid on it, so to speak, you want an actual solution. Taking iron supplements is not a solution.

4) I would like to have a referral to a gastroenterologist. Don't take no for an answer. Your children need you. Rod needs you.

Lastly, you need a better diet. I know you hate cooking. Make it fun for the family. Plan menus for the week, you cook, they clean up. They cook, you clean up. Do you have a crock pot/slow cooker? These recipes are easy peasy and can be very healthy.

Have you considered a second opinion?

Five hundred greenies to J_9!!!!!!

Alty, an added benefit with the cooking part is that your kids AND Rod will not only learn more about healthy eating with family meal planning, but will do the actual cooking. One of the best things my mom did for me was allow me in her kitchen even as a little kid and had me making meals for the family (and cleaning up, "wash as you go") before I was a teen. Your kids will be going off to college or into their own home before too long. They need to know how to do stuff.

WG, my kids cook meals all the time, and bake, from scratch. Not worried about that at all. :)

WG, my kids cook meals all the time, and bake, from scratch. Not worried about that at all. :)
Yaaaaaaaaayyyyy!!!!!

Not sure if this matters, but I had a D&C about 6 years ago and haven't bled either. My doctor runs blood and says I'm not menopausal either.

TJ, that matters a lot, because all the issues started when I had to have to emergency D&C. My body hasn't been the same since then. That's when the anemia started, that's when the issues with my period started (not all at once, I still got periods for many years after, but they were never the same as before the D&C, and then suddenly stopped 5 years ago. Before the D&C I would have periods so regular that I could tell you the day and time I'd get it. After it would sometimes be months between getting it, sometimes a year and then when I did it would either be very light, or so heavy that it felt like I was miscarrying again).

I was trying to remember when they stopped. I know it tapered from slight periods to every few months. My Dr. said I had a lot of scar tissue, but bloodwork says I'm not in menopause. I'll be going in the next couple of months for my annual checkup and I'll let you know what he says about me. By the way, he is a specialist dealing with infertility and other female issues, not a regular Ob/GYN. I know you don't have the same kind of insurance as the U.S. but be pushy and demanding. Your health is important and when I had terrible insurance, I made tons of phone calls to bypass the system. I wasn't going to wait for 6 months to see a specialist. Demand help immediately.

Not sure what tests were done, but you might want to ask your gynecologist about the possibility of Asherman's Syndrome. That may be a possibility, especially since it started after a D & C.

Not sure what tests were done, but you might want to ask your gynecologist about the possibility of Asherman's Syndrome. That may be a possibility, especially since it started after a D & C.

Thank you Doula. I will definitely mention it during my next visit. :)