Do I need a bx.

I am 52 y/o post menopausal x 5 years,  no pregnancies, had pelvic/ transvaginal  US and to r/o ovarian ca, recently developed severe constipation with no cause identified. Ovaries normal on US, 9m endometrial thichening and trace fluid seen  in the endometrium. I am asymptomatic, no pain, no bleeding. My gynecologist is recommending saline sonogram and endometrial biopsy . Could this be a polyp? Is is necessary to do the saline sonogram and biopsy?

[Elaine Brown, MD]

Hi!
Yes, I would agree with your doctor that a saline ultrasound and biopsy should be done.  An alternative would be a D&C hysteroscopy.  This has the advantage of being done under anesthesia, but the disadvantage or being considerably more expensive.
A polyp is definitely a possibility.  These are benign about 90% of the time, but not 100%.  The most likely result is proliferative endometrium which can be treated with progesterone, but you need to rule out endometrial cancer.  I am glad your ovaries were fine.  I hope you are also having/have had a colonoscopy too.
Good luck!
Dr B