Q: I am a 47 year old married woman, having two daughters aged 19 and 15. After the birth of my second daughter 15 years ago, I have been having irregular menses with increased bleeding intermittently, which gets regulated with medicine. During all these years I have also been suffering from acute pain (cramps like) in lower abdomen and cervix and in between throbbing pains in vagina, extending upto anal region, especially during early morning hours for about 25-30 minutes. Here,I would also like to tell you that I had a pregnancy terminated 2 years after this began (3.5 months old, after operation like normal delivery). My recent problem is that my last periods nearly 2 months ago, and I have not had it after that. Due to this I have been experiencing heaviness and bulkiness in lower abdomen accompanied by hot flushes and uneasiness. My gynaecologist, after examination and ultrasound scan, has informed that there is multiple fibroid uterus and it has to be removed by operation. Pregnancy test result is negative. Heaviness is gradually increasing. Currently I am taking only Homoeopathic medicine for helping starting of periods again. Being anxious to know the reason for menses stoppage, I would seek your advice on further course of action.

A:At 47 years, menses generally stops due to menopause, however rarely large fibroids could also be responsible for stopping of menses. Get a serum FSH level done and a good ultrasound of the lower abdomen and consult a gynaecologist with the reports. If you have fibroids causing all the pain you have had all these years, removal of uterus will help and then you can safely start HRT to take care of your hot flushes.