“Irregular menstrual bleeding?”
I'm a 47 year old female. I had a bilateral mastectomy in 2016. There was no chemo or radiation. I had a daily dose of 10mg Tamoxifen for 5 yrs ending in early October. A missed period that month, but had brownish discharge. I resumed a normal period in November. I had at least two periods in December and then multiple periods since, usually 7-10 days of bleeding and then 7 days no period. Last periods: 12/26-12/30, 1/6-1/13, 1/19 and counting. I'm possibly pre-menopausal, but not exhibiting symptoms except insomnia. I’m also stressed. My last pap was six months ago and normal. I'm not experiencing any physical abnormalities. I've taken Adderall and Lexapro for several years. I understand it can take three months for tamoxifen to leave your system is my body still readjusting? If not, what type of testing should I seek?
Female | 47 years old
Complaint duration: 3 months
Medications: Tamoxifen
1 Answer
Hello,
You are a 47 year old woman with a three month history of irregular menses. In 2016 you had bilateral mastectomies but no postoperative chemotherapy or radiation. You were placed on tamoxifen for five years which was recently stopped. Now you are having irregular menstrual cycles.
There are several reasons for the onset of irregular periods. I am assuming that the mastectomies were performed for breast cancer which was hormone receptor positive You were started on tamoxifen for this.
Often when a woman develops irregular periods, an endocrinological evaluation needs to be performed. The irregularity of the periods implies that there is a disconnect between your bodies endocrine system and the uterus. Sometimes a trial of hormones can help regulate the systems. However, in the case of a patient who has had breast cancer the risks of hormone therapy may be significant from a cancer point of view.
Tamoxifen has also been reported to interfere with normal menstruation. It is not possible to predict the effects of the discontinuation of tamoxifen.
A third possibility is that you are undergoing menopause. Abnormal periods may result from age related changes.
For further evaluation you need to be evaluated by an experienced gynecologist for a complete examination and to obtain the necessary endocrinological tests.
Good luck.
You are a 47 year old woman with a three month history of irregular menses. In 2016 you had bilateral mastectomies but no postoperative chemotherapy or radiation. You were placed on tamoxifen for five years which was recently stopped. Now you are having irregular menstrual cycles.
There are several reasons for the onset of irregular periods. I am assuming that the mastectomies were performed for breast cancer which was hormone receptor positive You were started on tamoxifen for this.
Often when a woman develops irregular periods, an endocrinological evaluation needs to be performed. The irregularity of the periods implies that there is a disconnect between your bodies endocrine system and the uterus. Sometimes a trial of hormones can help regulate the systems. However, in the case of a patient who has had breast cancer the risks of hormone therapy may be significant from a cancer point of view.
Tamoxifen has also been reported to interfere with normal menstruation. It is not possible to predict the effects of the discontinuation of tamoxifen.
A third possibility is that you are undergoing menopause. Abnormal periods may result from age related changes.
For further evaluation you need to be evaluated by an experienced gynecologist for a complete examination and to obtain the necessary endocrinological tests.
Good luck.
