Q. My husband and I had a wonderful weekend January 24-25. My last period started Jan. 9. I have always been regular, 28 days or less to my cycle. I am 43 years old. My period is now 10 days late, and I have used three pregnancy tests of different brands, all of which were negative. I still have sore nipples, backache, and tiredness. At what point should I make a doctor's appointment to see if something is wrong, or should I still suspect pregnancy? We were not sexually active for a while, and it just seems so coincidental that when we were, my period is missing. (We have three children, 15, 8, & 7) I would really appreciate any advice! Thanks so much.
A. If your period is 10 days late and the HPTs (home pregnancy tests) are negative, you are probably not pregnant. They would be showing some signs of hormonal change by now.
It is possible that you are experiencing some form of perimenopause, which can happen as early as your thirties. One of the first symptoms can be missed or irregular periods.
Perimenopause, or pre-menopause, is a transitional stage of two to ten years before complete cessation of your period. Its average duration is six years, and typically appears in women from 35 to 50 years of age. Woman can find themselves experiencing puzzling changes, and not know why. What is actually going on is a gradual decrease of estrogen. The manifestations of perimenopause can vary. Here are some of the most common symptoms: Menstrual cycles become shorter, longer or unpredictable; flow becomes heavier or lighter; low blood sugar; fatigue several days before menstruation; weight gain; decreased sex drive (You, obviously, are not experiencing this one!); headaches - from mild to migraines; dry and/or itchy vulva or clitoris; and increased incidence of yeast infections.
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Q. Is it possible to get pregnant during a pre-menopausal state? I am 38 and we are working on our third child. I think I may be pre-menopausal with the symptoms you have listed on your site.
A. It's possible to get pregnant during pre-menopause and even early menopause, but it can be difficult because it's very hard to predict just when ovulation is occurring. If you're having irregular periods and/or other signs of pre-menopause, you should consult your OB/GYN to make sure your symptoms are not a sign of another problem. I think it's a good idea to have a clean bill of health before attempting pregnancy. After all, it's hard work and it can wreak havoc on a woman's body, especially if you are not healthy.
Q. During pre-menopause a women's estrogen level decreases. When you are extremely overweight, women are thought to have more estrogen and this is why it is difficult to get pregnant and it almost works as a form of birth control. Does this mean that if I am obese, as I get older I will become more fertile? I am 38 and we would like a third child but are having some difficulty getting pregnant.
A. That's an interesting theory, but I don't think you should play the waiting game if you want to become pregnant. There's a possibility that one day your estrogen levels may even out, but who knows for how long. It may be a year, maybe a month, maybe a day. And, who knows when that will happen. Maybe not until you're fifty. If you really want to have another child, I think you should take action now: Go on a diet and start an exercise regimen while you are still relatively young. Not only is it more difficult to become pregnant while being obese, but there are a lot more risks associated with pregnancy for obese women.