Menometrorrhagia

[Malarkeycm]

I am 28 and I have had 2 DNC's in the last 10 months.  I just got the results of my second one and I am confused.  They say I have Predominantly endomentrial tissue demonstrating disordered proliferative features with cystically dilated endometrial glands.  What does that mean?  It also says I have endometrial hyperplasis.  Last year when I had the frist one it came back with atypia cells and that i had pre maligmant potentl.  What does this all mean.  I have been bleeding non stop scine before Chirstmas and This had been going on for over 7 years.  I have tried everything, hormones, birth control even male hormones.  Nothing is helping.  I am at the point where I want it all taken out and be done with it.  I have a wonderful daughter and even getting her was a nightmare.  What can I do?  What are my options?

[Machelle Seibel, MD]

The best thing to do with this problem is to sit down with your doctor and have a long discussion about your options. If he or she cannot help you, talk to another doctor, maybe a gynecology oncologist who deals with cancer. What you have is NOT cancer. In general, the type of problem you have can lead to cancer, but it takes about 10 years for that to happen. Nothing bad happens quickly and you are being checked which is good. You have nothing to worry about right this minute.

That doesn't stop things from being worrisome or a nuisance. Typically, the birth control pill works well for this. One that is a little higher than the low dose ones might be needed and at least 3 months of treatment might be required to stop the symptoms of abnormal bleeding. To make the cystic hyperplasia go away (this is just a description of what the glands look like on the microscope when ovulation does not occur) might take up to a year of treatment.

Another medication for this is Megace. It is not a chemotherapy, it is a hormone progesterone. But it has been used to treat this problem. You can ask your doctor about dosages of 40 to 80 mg daily. It can cause weight gain and can be a problem if you have diabetes. But it is an effective medication for cystic hyperplasia.
At 28, you might want to have another child one day and it is a good idea to keep trying hormone therapy before doing surgery which is irreversible. Most women are able to have this problem controlled with medication.
Machelle Seibel, MD