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Postmenopausal bleeding, timing of meds& 15mm lining

Hi my last period was 11/2011 so i guess as of 11/2012 i started menopause. March 2013 i started climara patch& progesterone but since the patch gave me hives i was only partially compliant. Also i'd forget to take the progesterone sometimes.

Tests:
1.Ultrasound 8/2012( before true 'menopause' began because only 8 months of no periods not 12).
The endometrium thickness 7.7mm
Ovaries i forgot but they were both bisible.

2. Ultrasound 11/2013: 15mm. & also tech couldn't see the right pvary. Report said no adnexa(??) masses seen. The only thing said was about the 15mm
I had postmenopausal bleeding aftrr i stopped the patch cold turkey & progesterone both for 1-2 weeks. The bleeding was spotting like my last 2 days of period would have been.

3. I've never been able to tolerate anything inside there incl dr. Exam, a tampon, of course never had sex either.
Therefore they didn't do transvag just abd Ultrasound.

4.He plans on setting me up for biopsy... Would it be best to do biopsy, hysteroscopy AND D&C while i'm under?

5.ONE possibly MAIN thing is I forgot to tell him about the noncompliance...as well as restarting my meds. Could that be the cause of thickness esp since the bleeding stopped around a week after restarting my comb HRT?

Thanks-apologize for the length.

3 Responses
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603463 tn?1220626855
MEDICAL PROFESSIONAL
Hi!
If you were my patient, I think I would give you the option of a three month trial of hormone therapy with strict compliance with your progesterone and then a repeat ultrasound.  Ultrasound can be done trans-labial without having to insert the vaginal probe into the vagina.
OR a D&C hysteroscopy right away.
It may be difficult for you to tolerate the ultrasound probe etc due to  atrophy of the vaginal tissues caused by low hormone levels.
Using a vaginal preparation of estrogen.
I think given the thickness, I would lean toward the D&C, but I would definitely do this with sedation in the OR.
Hope this helps!
Dr B
Helpful - 1
Avatar universal
Has anyone experienced what i posted( above)?
Thanks
Helpful - 0
Avatar universal
Hi thanks for your helpful reply.
One question regarding your response: you said I could either do 3months being compliant - would one minth work or 6 weeks??OR
"D&C hysteroscopy right away". Why the 'right away' part? Is it b/c of the 15mm? I just noticed yes but the tech said she could see left but not right ovary whereas radiologist
said couldn't see either, adnexa image suboptimal, no masses seen. Could have been tech or rad error?

Have you seen/ heard of 15mm due to noncompliance or even mistaking my ovary for part of the uterus?
Thanks again.
Helpful - 0

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