I am a 48-year-old female; age of menarche was 12y, 11m., multiparous (7 children, 2miscarriages, 1ectopic pregnancy). I have always had normal 29-day cycles. In less than two months I have had 4 extremely heavy menstrual periods (one of which was quite painful and I had not had any cramps since before I had my first child at 23) with large clots that lasted 5-7 days of which the first 3-4 included very heavy flow. My BMI is 29. My lipid profile is good as is my blood pressure. I feel healthy. I have mild DM 2. In researching perimenopause I have not found a description of menstrual irregularities similar to what i have been experiencing and so as my children's sole surviving parent, I am worried. I am a widow and have not been sexually active for years. My last pelvic exam was two years ago and it was grossly normal, as have been my mammograms.

Meds:

metformin 1000mg bid
amphetamine/dexamphetamine 30 mg bid
Saphris 10 mg sl qd hs
pramipexole 1 mg qd hs
alprazolam 0.5-1.0 mg tid prn (infrequently)