I am 49 and possibly menopausal. I have missed periods for 4 months and then had a heavy w/ clots, followed by a month with little flow.
Then 4 months without.
The Dr. said my uterine lining was thick. Didn't tell me how thick...I had an ultrasound which confirmed the thick lining but no fibroids.
The dr. put me on progesterone to try to release the lining but nothing happened.
He gave me an additional 7 day dose of progesterone and still nothing happened.
They said that it had to come out but they didn't tell me the next step.
Just...take the pills and then call us either way...it has to come out and we'll discuss it then.
Which...left me silly SCARED!
What is the next step? I'm also obese and taking tamoxifen for reduced chance of breast cancer
The proper work up for irregular bleeding in a woman over 35 would include ruling out pregnancy, checking for an endocrine abnormality (e.g., thyroid hormone changes), assessing for structural lesions within the uterus (like endometrial polyps/fibroids usually by office hysteroscopy--i.e., looking inside the uterus with a small camera--or sonohysterogram--instilling saline into the uterus while simultaneously having a ultrasound), considering anovulation (not ovulating monthly reflective of perimenopause) and performing an endometrial biopsy to look for abnormal tissue inside the uterus (e.g., endometrial hyperplasia or cancer). With those results proper treatment can be instituted.
In your situation an endometrial biopsy will be critical because your obesity and use of Tamoxifen put you at risk for have precancerous or cancerous changes to your endometrium.
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