Endometrial prolifration

Hi...just got word from gynocologist that I have endometrial proliferation.  This was found after doing a hysteroscopy of my uterus, due to some light post-menopausal bleeding.  I am just 49 and only one year of no periods up to this.  He said that I am not ovulating, but this condition is present.  Can you explain to me what this is, and what options I have, if I continue bleeding.  Can this lead to cancer?  He suggested doing aggressive treatment if I have problems in the future.  I am a smoker (trying to quit now) and have a family history of breast cancer so not sure hormones will be a good choice.  Thanks for your help.

[Elaine Brown, MD]

Hi!
If you are interested, in how the cycle works, take a look at my blog article on the menstrual cycle.  
As best I understand your situation--it sounds something like this:
In a normal cycle, during the first half or follicular phase, the ovaries are producing estrogen which causes the lining of the uterus to grow and thicken. At midcycle, ovulation occurs and the ovaries begin producing progesterone.  This causes the growth of the lining to stop, and it then differentiates and prepares for pregnancy.  If no pregnancy occurs, at the end of the cycle the lining sloughs off in the form of the period.

IF no ovulation occurs because of hormone imbalance, or menopause, etc.  No progesterone is produced, and the lining continues to thicken and grow. There can be a long time in between periods.  This can show up on ultrasound as a very thick lining.
Eventually the lining gets so thick that it starts to collapse and break up--this causes bleeding which is sometimes very heavy or prolonged, sometimes lots of clots.

If this goes on over a very long period of time, the lining can become cancerous.

There are a couple of very simple ways to treat this--one way is to give oral progesterone--this will cause a period.  It can be done monthly or quarterly. Progesterone is safe for smokers.

Another option is the Mirena IUD which delivers progesterone locally to the lining, but doesn't get hormones into the blood stream (good for smokers!)This will keep the lining thin.

If a biopsy has been done to rule out cancer, a third option would be endometrial ablation which cauterizes the cells that create the period in the first place, and prevent the initial build up.

Hope at least one of these options might work for you!
Good luck quitting smoking! Chantix is supposed to work really well.

Dr B

[anxious09]

hi to everyone,

i have the foll question :

i am 33 fem with 3 children, aged 6.5/5.0 and 18 months old.
2 first were naturally delivered my daughter by c-section as she was not positioned.

anyway, i got my period yesterday and today i have sort of blocks of blood not like regular bleeding. to be quite honest i am a scared. does this mean something?

it came when it was supposed to but i don't know what to make of this?