Hotflash! - Goldstein5 - Menstrual Calendar



	Meet the author: Steven R. Goldstein, MD Menstrual Calendar Join our health discussion groups - click here

	Sue: Perimenopause seems to be very difficult to diagnose. It seems that it can only be found while ruling out other disease and health conditions. How are women to know if they are not perimenopausal through blood tests like FSH (follicle stimulating hormone) levels? How effective is this testing and during which part of their cycle should it be done? How do you treat a woman who has a “normal” FSH in the face of classic perimenopausal symptoms as irregular menses, hot flashes and mood swings? Dr. Goldstein The very best way to diagnose perimenopause is a good and accurate menstrual calendar (get your copy - click here). Often a woman who is ovulatory will have regular cyclic menses. As she becomes oligoovulatory ½ her cycle may change from every 27–28 days to a pattern of, for instance, 27 days, 34 days, 23 days, 36 days, 27 days, 21 days. This woman has probably ovulated two of the last six months. Keep track of even subtle changes Keeping an accurate menstrual calendar can help me ascertain if even subtle changes in the cycle regularity my indicate oligoovulation which is the first sign of this perimenopausal transition. Furthermore if there is evidence of the subtle menstrual changes and any of the psychosocial changes we have mentioned (mood swings, inability to concentrate, free floating anxiety, memory lapses, sleep disturbances) then it is not inappropriate to consider a two month trial of ultra low dose birth control pills. You ask in the question about treatment. The most important treament is knowledge I would offer the following: the most important treatment is knowledge. Many of these patients think that their lives are getting away from them and that there is something the matter with them, and it has been implied that it is all in their head. Knowledge that there is something physical causing their problems is a crucial first step into insight and feeling better. In the second place healthy lifestyle choices are a must. This is not only true for perimenopausal patients but for all of us. Not smoking, moderate alcohol intake, adequate exercise (aerobic, strength, and flexibility), good nutritional choices, vitamins (the antioxidants A, C, & E as well as timed release B6 are an important element of good health. Finally however as I have previously mentioned a two month trial of ultra low dose birth control pills as long as the patient is a non smoker and has no other contraindications will enable me to evaluate how much of the patient symptom complex is hormonally mediated. I am confident that if a woman will allow me to "take control" of her cycle with low dose birth control pills (I'm at a point where I call them cycle regulators) that I can "take off the table" whatever portion of her symptom complex is in fact hormonal. back \| next		click here to join HotFlash & ask a question HotFlash News Interview 1 Estrogen Dominance Estrogen vs. Progesterone Replacement vs. Substitution Perimenopause Diagnosis Menstrual Calendar What are SERM's Future of Ultrasonography go to interview 2 Ask Dr. Goldstein newly revised for 2000! Could It Be...Perimenopause? by Steven R. Goldstein, Laurie Ashner see the interview with Dr Goldstein In clear, supportive prose, Goldstein offers no-baloney advice. "Today's perimenopausal women has neither the time nor the patience to go through four to fifteen years of symptoms without relief," he says. He fully delineates the roles of various hormones, how to determine if you're in perimenopause or not, as well as how to treat the various symptoms to gain control over your life.

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