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Menopause (Expert Forum)
Endometrial Lining
Answered by
Machelle Seibel, MD - Women's Health, menopause, ReproductiveMedicine
University of Massachusetts Medical School
MA
Questions in the Menopause forum are answered by Dr. Machelle Seibel. Topics covered include menopause issues, depression, hormone replacement therapy, hot flashes, joint or muscle problems, memory problems, mood swings, osteoporosis, sexual problems, skin changes, sleeping problems, vaginal problems, and weight problems.
Endometrial Lining
by Gin285, Oct 06, 2006 12:00AM
I am 72 years of age. Eight months ago I had a pap test done. During the internal my gynecologist told me she could not feel my ovaries and scheduled a sonogram and vaginal ultrasound. The technichian told me the reason the doctor could not feel my ovaries was because my uterus was tipped. I thought that was the end of the problem. The Doctor then told me I had a thickening in the uterus and she scheduled a sonography (quite a painful procedure) There have been no signs of polyps or other growths. I have never had any bleeding, discharge or abdominal pain since menopause. The next test was an endometrial biopsy and I was put on provera for six months. I am due for yet another biopsy in two weeks. I had a D&C four years ago when I lived in another state. Now, the thickening is back. My question is: Is there ever going to be any end to these biopsies? I asked my gyn. that and her answer was "I could refer you to a cancer specialist but the results will be the same. We both read from the same book". Why would I want to see a cancer specialist when none of the tests show any cancer cells? Would provera cure what a D&C did not? Having this problem hovering over my head for the last eight months is really beginning to get on my nerves. What do you think?
Thank you for taking the time to give me your opionion.
Gin285
Thank you for taking the time to give me your opionion.
Gin285
Doctor's Answer
by Machelle Seibel, MD, Oct 17, 2006 12:00AM
, Oct 17, 2006 12:00AM
A. Not being able to feel your ovaries in menopause is a good thing. It usually means that they are small enough not to be able to be felt and therefore do not have disease. Sonography, also called ultrasounds or ultrasonography, can be uncomfortable, especially if the vagina is dry or if a person isn’t sexually active. If they are too painful, the exam can be done from above the abdomen, though the vaginal route is sometimes clearer to see.
You didn’t mention what the endometrial biopsy showed, but provera for six months implies that there might have been something in the lining the doctor was concerned about. Early, premalignant changes are often treated with provera and six months of treatment should take care of the problem in many instances. A D&C often isn't a cure; it's makes a diagnosis.
I would consider seeing a cancer specialist. They will likely be less concerned about the thickening and simply watch the changes by ultrasound or put you on provera for some of the time. Given what you have explained, the problem is likely to be less serious than it is to be worrisome. It just might need a distant eye on it to be sure things don’t change.
Machelle M. Seibel, MD
You didn’t mention what the endometrial biopsy showed, but provera for six months implies that there might have been something in the lining the doctor was concerned about. Early, premalignant changes are often treated with provera and six months of treatment should take care of the problem in many instances. A D&C often isn't a cure; it's makes a diagnosis.
I would consider seeing a cancer specialist. They will likely be less concerned about the thickening and simply watch the changes by ultrasound or put you on provera for some of the time. Given what you have explained, the problem is likely to be less serious than it is to be worrisome. It just might need a distant eye on it to be sure things don’t change.
Machelle M. Seibel, MD
When they did your first endometrial biopsy, did the results come back normal, or was there hyperplasia?
I completely understand your frustration, as I am 51 and have had quite a year with an ovarian cyst, surgery to remove the ovary and cyst and then some irregular bleeding for which they did an endometrial biopsy.
I am not sure why they would put you on provera, which is a progesterone, if you had no bleeding. I am not a doctor, but I would suggest seeking another opinion if you aren't comfortable with what they are telling you.
Hope the doctor here answers your question soon. It seems like she gives wonderfully, logical answers.
Hudson
I'll let you know how I make out. I really was pleased to hear from you. Thank you!!
You might want to ask for a copy of your pathology reports from the biopsies. That way you can read and research the terminologies for yourself.
Please post again and let us know how you are doing. I'm sending good thoughts your way :-)
Hudson
She stated that everything she is doing is not to hunt until she finds cancer but to check out all the indicators that there could possibly be any and then rule it out. She is giving me prozac before the next visit along with stronger pain med. and something new that I will insert in the vagina that will cause the uterus to expand thereby making it easier to do the biopsy and also to insert pain meds if I need them. When I finally hear that this is over I intend to spend a few hours in church and thank the good Lord that he has led me through it.
I'll keep in touch and let you know how things go the next time. If this site is still active.
Gin
Good luck and keep us posted.
Hudson