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Premenstrual bleeding



40yo with recent miscarriage (8wks) req misoprostol. First menses thereafter preceded by spotting 7d in advance and short menses overall. Heading into 2nd cycle post miscarriage and spotting again (albeit light) 7d in advance. Likely related to poor ovarian function? Certainly have had my share of US with IVF and no other problems unearthed. No pain noted either.


At this point, your age would be a significant factor (i.e. decreased pregnancy rates, increased risk of pregnancy loss after age 40).  I would suggest ovarian reserve testing (a baseline FSH - a blood test- is a good place to start).  I would also talk to your physician about a "time-frame" before considering fertility treatment to accelerate your time to pregnancy.

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Response by:

Daniel B Williams, MD Daniel B Williams, MD
College of Medicine
University of Cincinnati