Question: Hello
Question about peri meno bleeding and cramping.
51 yr old woman. Aware that I am in perimenopause. Gyn check up in January with ultrasound. Exam normal, PAP normal, ultrasound showing thin lining, normal and appropriate. Blood tests indicated I was not yet in menopause, but moving toward it. Low normal levels.

I am on mild HRT. Estrodial 0.05mg patch 2x/wk. Progesterone 200mg day. I started this 5 years ago due to a severe period of hormonal fluctuation—I was literally bouncing from pre to post menopausal levels by the week and it was causing huge emotional issues. This was done under the guidance of a doctor and an oncologist It helped immensely to stabilize things. (Note- I do have a history of breast cancer. 2000 and 2008. Hormone negative and double mastectomies. It is felt in my case that risk is mitigated in taking the HRT. ) That said, the plan is to wean off this year as at some point, I am going to need to go into full menopause.

After nearly 8 months without a period, I started spotting 2 weeks ago. Not a full period. Barely staining a light pad. This continued for two weeks. Stopped and then started with a little spotting two days later. It has lasted another 2 days and appears to be stopping again. I have also noticed mild cramping. When I was younger, I used to experience severe cramping with periods. That seemed to stop after I had children-12 years ago. And as my periods have slowed/stopped, I have not noticed it in while.

I am trying to get into see my gyn next week. This kind of spotting has occurred before and tests have only revealed an uneven but normal endometrial lining that was likely sloughing off unevenly due to hormonal craziness.
The question is this—I’m worried as this has now occurred after 8 months of literally nothing. And I am confused by the accompanying cramping. Is there cause for concern of something like- uterine cramping? Or is this more likely a reflection of my hormone levels continuing to drop as I move closer to true menopause. The mild HRT I am on no longer keeping things in the temporary balance they were in?

Otherwise no other health issues. Not overweight, non smoker. Generally decent health.
Thank you for your time
Julie

Thank you for your reply.
Just so I am understanding correctly-- could the cramping be related to the endometrium shedding then? I don't think I have a urine infection-- no accompanying symptoms. I will ask to have it checked, however.
thank you
XXXX