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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 58677
Experience:  GP in the United States
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Hi dr Phil My wife would like some help She has perimenopausal

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Hi dr Phil
My wife would like some help
She has perimenopausal symptoms which is concerning her
Can they include nausea joint and muscle pain while being on a period ?
She is fit slim and a yoga teacher eats correctly.
She is having bouts of mood swings clotting a little on period and the periods are heavier and close together ?
I'm going to get relevant bloods done with her this week can you help here and suggest the relevant tests ?
Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.
Hi mark. Happy to help
That is possible but be sure not to ignore other causes. Muscle and joint pain can be a sign of autoimmune disease like lupus.
Also, frequent bleeding could be uterine fibroids.
I would consider a pelvic exam and vaginal ultrasound as well
Customer: replied 3 years ago.
She has had all of the above tests all negative.
Would it now be worth getting relevant bloods for perimenapaue and what would you advise. ?
No, the blood work won't really show perimenopause
They are not reliable
If all those tests are negative I would say likely that it is perimenopause
Customer: replied 3 years ago.
Would the nausea and joint pain only on period equal that ? Ie perimenapause
yes it probably is.
given those negative tests I would say that is very likely.
I wouldn't say that without a negative workup but with that, yes
Customer: replied 3 years ago.
She us a celiac Related???
celiac common causes muscle and joint pain
Customer: replied 3 years ago.
Ok can that alter her periods I e menopause ?? The fact she is a heavy celiac ?? And has been for years.
yes, it can.
celiac causes body wide inflammation which can affect everything
Customer: replied 3 years ago.
So I'm guessing she would have a worse menapause with more symptoms ?
that is fair to say if that is the trend she is going in. However, not necessarily. I mean sometimes these things fluctuate over time
Customer: replied 3 years ago.
What advice and cure would you suggest Dr Phil she is struggling with this at mo
Well, seems like diet/exercise are not an issue. I would focus on that.
Low dose anti depressants like effexor or zoloft can help.
Customer: replied 3 years ago.
She is anti drugs ! Lol
So it's just one of those things ?
Yes sir :)
Customer: replied 3 years ago.
But my bladder is ok ! Lol. Scans were only done in July psa low and urine tested perfect 10 times !!!
Yes, the bladder looks okay on all tests in IC
It just spasms and causes these symptoms
Customer: replied 3 years ago.
Nerves cause the spasm. But nothing serious ?
Thanks again see you in the usa. !! Next year if I'm still alive !! Lol not connected to wbc by any chance ?? Not over 18 years surely ?
that is correct. Nothing serious Mark.
You will be alive sir. I would bet on it
No, not connected at all
Dr. Phil, MD and 3 other Medical Specialists are ready to help you
Customer: replied 3 years ago.
Life saver bonus paid sir
welcome as always my friend.
Have a great Sunday :)
Customer: replied 3 years ago.
Just to finish a tube tumour or bladder cancer wouldn't present like that ??

No those would generally present with bloody urine and for a tube tumor the scan would be abnormal

Customer: replied 3 years ago.
So chill ?
For lack of a better term, yes
Customer: replied 3 years ago.
Relax and esr assured sound better lol
Customer: replied 3 years ago.
That means yes ??
And the esr would be up with a tumour ??? Lol
Yes, that means yes.
I would expect the ESR to be up in many conditions including cancer
Customer: replied 3 years ago.
It was 1. A week ago. Thanks again sir see you next year dinner on me !
Deal :)
Customer: replied 3 years ago.
Where in us are you. ?
Customer: replied 3 years ago.
See you there.
alright! looking forward to it Mark!
Customer: replied 3 years ago.
I won't mention my anxiety ! Over dinner lol
I'm normal in life run a business and everything then I get a pain I have to completely analyse it ! And run down for blood work etc
Apart from that I'm a good functioning person !
It's easier for me to use yourself and just answer. Than Google. Myself stupid !!!!!!
I was a pro at soccer years ago and was always fit I gained a little weight in my late 40s then I got the liver prob. Since then it's got worse and worse guess it's because I see all the blood work now days. ?
Anyway your a life saver
you're welcome Mark
And this obsessive part of your personality probably makes you successful. But it is a blessing and a curse.
Customer: replied 3 years ago.
Michigan looks great love the lakes in February send me some good hotels then il book up will bring my son Harry 18 he wants to go university in the states .
But you will get an invite back to Cambridge. And London lol
It's still REALLY cold here in February. The lakes are frozen.
If you want to see beautiful scenery come in late spring/summer
Customer: replied 3 years ago.
Spring it is.
sounds good Mark. good luck to your son too!
Customer: replied 3 years ago.
Will book it in jan. Harry is great pro footballer and doing a degree. !
Shame he has celiac just found out last week we did the genome test.
At least he knows Mandy is a heavy celiac but also fit as a fiddle.
I'd better pay you I'm chatting on your time sorry !
No worries! That is awesome that he can make a living playing football. Good for him Mark! That is impressive
Customer: replied 3 years ago.
Hi Dr Phil
Guess you were right !
Please check the following but the wbc stays the same even with my molar healing so fast that must be reassuring ?
White cell count 3.60
Lymphosites 1.1
Neutrophils 1.90
Mono .35
Eosinophils 0.2
Mcv 90.80 mch 32.5 mchc 358 says slight high? Rdw 13.7 platelets 180 mpv 12.2
Basophils 0.04
Red cells 5.01
Sodium 139
Potassium 4.7
Bicarbonate 27 urea6.4 creatinine 87 est gfr 85. Chloride 97.2 says slight low
Billibubin 9
Alp 71
Ast 19
Alt 20
Ldh 150
Ck 100
Gamma gt 10
Protein 76
Alumnin 50
Globulin 26
Calcium 2.42
Phosphate 0.9
Uris acid 376
Triglycides 0.6
Cholesterol 4.7
Iron 24.90
T I b c 71
Prostrate profile
Spec ag total 0.4
Spec ag free 0.2
Ratio 0.5 can you give me your thoughts of my overal health sir ?
Just got these back for 50 years old medical from my insurance they seem good to me ?? Oh esr 1
Those look good Mark!
Customer: replied 3 years ago.
They have just come back !
So the wbc in context now you have them all is fine ??
And the ones that are minuscule outside range are ok ? Overal good ?
Yes overall very good
A couple slightly out of range in the overall picture is insignificant
Customer: replied 3 years ago.
Can I please forget the WBC now !!! And rest assured for. 6 months. And again the alp is good !
Customer: replied 3 years ago.
Guess I owe you a drink as well as good meal. But seriously in good health for 50 ?
Liver is very good I think ?
Liver is good. Good health for 50. no question
I don't drink but you can buy me a steak :)
Customer: replied 3 years ago.
Done. ! So seriously all jokes aside WBC is fine with all the other results so good around it ?
And it hasn't chsnged for 2.8 years now sits around 3.6 all the time. !
Yes, that is correct
and this wouldn't have even been flagged in my lab.
You would "see" it as normal
Customer: replied 3 years ago.
Ok great my lab is 3 to 10 just the lymphosites marked just under but there ok at over 1.0 says my doc and they go up and down.
So even the lowest it got ie 3.48 isn't a prob at all. ?
yes, that is correct. they go up and down
the lowest of 3.48 is still okay Mark
Customer: replied 3 years ago.
I'm going to re test in 6 months as long as over 3 all good ?
Last one your a heart expert.
My blood pressure is 90 over 60 pulse 51 with the bloods I'm guessing I've been lucky there?
Yes, sir!
that is very lucky!
good blood pressure
6 months recheck on the CBC
Customer: replied 3 years ago.
But nothing to worry about no cancer ?
I appreciate the excellent rating.
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I greatly appreciate a positive rating in the customer satisfaction survey that you will receive via email. It is important for me to get your feedback. Thank you. :)
Customer: replied 3 years ago.
Il call you if I get panicky ! But you have had all my bloods !! Lol so that's me I guess I'm healthy ?
Yes you are healthy except for anxiety Mark
Customer: replied 3 years ago.
Well I'm taking my flying licence had 3 lessons love it no stress up there how odd ?
Love it. Just health that gets me.
That's great Mark!