Is This Pre-Menopause?


I am 43 and have five healthy children, my youngest is three years old. I have used the Billings Method through all my marriage and have found it very reliable. My concern is that before my last pregnancy my cycles always were 36 days or even more, sometimes 40 days long, the shortest was problably 32. But after the last pregnancy my cycles began to be 28 days and sometimes less, now in the last three months I began to have brown spotting before my menstruation for about two to four days, then I only have two days of bleeding. I don’t know if this is perimenopouse or something else. I must add that I also have an underactive thyroid and I am taking Syntroid 125mg daily. But I want to know if I should talk to my doctor, and what if they prescribe some hormonal (Contraceptive) treatment, I do not want to take contraceptives at this time in my life. Please help. Monica


Last Updated: December 13, 2014
Dear Monica:

What a wonderful testament to the benefits of natural family planning. You are able to know your body very well and detect changes quite early! I think you are correct that you are in a perimenopausal stage.

However, as you indicated, one needs to be prudent and check for other concurrent factors that may be contributing to your cycle changes. Of course, the thyroid level needs to be checked if it has not been done for a while. Most physicians will check once a year if the patient is doing well. However, your doctor may want to know that your cycles have changed which would prompt me to order a recheck. Perhaps the Synthroid needs to be increased.

Next, make sure that you have gotten your proper exams such as the PAP smear and mammogram. Tell the physician about the changes so they can on the look out for abnormalities. Again, your symptoms are quite in line for perimenopause.

Doctors are quick to advise contraceptives to everybody because unfortunately, that is how we are all trained. The natural family planning methods work throughout a woman’s reproductive life. Just make sure you check with your Billings teacher for an update and review. You and your husband may want to use stricter criteria for fertile and non-fertile days while you undergo these changes. I see no reason to use hormonal (contraceptive) treatment.

I hope that this helps! Please let CANFP know what is found out. We tend to hear a lot from women in their 20’s and 30’s. It would be nice to have much more information from women in their 40’s who are entering menopause. It would be nice to reassure people that NFP works throughout their lives and has added benefits in addition to avoiding or achieving pregnancy.

Sincerely, Gretchen V. Marsh, D.O

Answered By:

Gretchen Marsh, D.O.
Dr. Marsh graduated from Western University of Health Sciences in 1987 in Pomona, CA and is board certified in Family Medicine by the American Osteopathic Board of Family Physicians. She has been certified as a NaProTechnology® Medical Consultant (NaPro) and Creighton model Fertility Care System (CrMS) teacher since 2001. She and her husband, Jon, have 5 sons and live in the Reno region, where she sees patients in person, in addition to her telehealth services offered via

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