Family, Internal Medicine, General Medical Questions/Menopause or something else?


I am 45 years old and have always had a menstrual cycle anywhere from 27 to 30 days. I can remember on one occasion where my cycle was 35 days. I am on Levothyroxine for hypothyroidism. My last period was January 27. On February 14 I noticed a brown tinge when I wiped after going to the bathroom. It happened two more times that weekend, but it wasn't obvious--I had to look for it. I haven't had my period yet and I have never spotted in between periods. I'm not on birth control currently, but I was when I was younger for about 10 years. Other than my thryoid issue, I've never had any health issues and I do keep on top of mammograms, pap smears, etc. Could this be perimenopause? I've had many changes in the past 6 months: My mom died, new job, sold her home, etc., but I never missed a period or been this late until now. I'm extremely worried as I don't know my family history (adopted). Any research I do it comes up as a possible cancer. I guess my question is, should I wait another month and see what happens or is this urgent? I'd appreciate any guidance.

Dear Lisa,

I do not think this is anything to be concerned about. I recommend you make an appointment with your gynecologist for bloodwork to measure your hormone levels to identify how close you are to menopause. My only other thought is to ask if you may be pregnant?

Family, Internal Medicine, General Medical Questions

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Dr. Pamela M. Cipriano, DNP, APRN


My name is Dr. Cipriano. I have a private practice specializing in adult health and wellness. I can answer questions associated with thyroid disease, cardiac disease, pulmonary disease, high blood pressure, muscular aches and pains, cholesterol levels, male/female sexual questions or questions on the sexual organs, gastrointestinal problems, healthy ways to lose weight and maintain a healthy lifestyle, and nearly anything else that pertains to medicine.


I am on the Medical Staff at a local hospital where I work as a medical/surgical hospitalist as well as in the emergency department. I am certified in critical care and advanced cardiac life support. Prior to becoming a Nurse Practitioner, I was a certified critical care nurse (CCRN).

Society of Hospital Medicine American Association of Critical Care Nurses American Association of Nurse Practitioners Connecticut Advance Nurse Practitioner Society

Maryville University 2014-2016 Doctor of Nursing Practice University of Connecticut 2007-2011 MSN, Acute Care Track Nurse Practitioner. Board Certified September 2011 Critical Care Certified 2014 Central Connecticut State University 2002-2006 BA Psychology St. Mary's Hospital School of Nursing 1991-1993 Diploma Nursing Registered Nurse

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Named as a World Wide Leader in Healthcare and was included in the 2013-2014 edition by the International Nurses Association.

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