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Questions about pelvic ultrasound, MRI, and if endometrial biopsy is necessary
I wasn't sure where to post this question but I thought this might be a good place.
I am 48 years old and believe over the last several months I may have entered Perimenopause. I had always been very regular with my menstrual cycles until this last year. (I quit bcp's 3 years ago after 20 plus years of use) I noticed the first day or two I would have very heavy bleeding, then lighten up for 4 or 5 days and then that was it. In February I bled for 22 days straight, which I had never done before so I went to the doctor, pretty sure it was Perimenopause. He agreed but sent me to get a pelvic ultrasound and then an MRI.
I hope someone can decipher them better than I can because I don't understand the results.I won't write out the whole thing, just try to give the basics. This is what the ultrasound said:
Impression:
1. Question of a subtle eterogeneous lesion within the endometrium measuring 1.1 x 0.8 x 0.6 cm. This may reflect an endometrial polyp versus hetergeneity of the endometrium. Endometrial carcinoma is felt to be unlikely. Further evaluation with pelvic MRI is recommended.
2. Heterogeneous round structure in the right adnexal region felt to reflect te right ovary. This can also be confirmed on pelvic MRI.
MRI:
Findings:
1. There is suggestion of a elongated polyp at the lower unterine segment.
Small fibroids are seen at the periphery of the areas, the largest of which is on the order of 6 mm.
Ovaries are unremarkable.
Minimal facet hypertrophic changes seen at the included lower lumbar spine with no significant stenosis present. Prominent periuterine veins are observed bilaterally. Remaining included bones and soft tissues are unremarkable.
Impression: Likely small lower uterine segment endometrial polyp, at limits of resolution of this examination.
Ok, after getting those two tests I recently saw a gynocologist to discuss whether it looks like I'm in Perimenopause and what things can be done and she recommended I get an endometrial biopsy to rule out cancer. I wasn't expecting that as I really don't believe I have anything to worry about with that and she even said 98% of the time it's not cancer, they just like to rule that out. After going online to learn more about this procedure, I've decided I don't want this test as I'm hearing it's very painful and really, I don't think I need this test, anyway, if they are only going by my periods acting different the last several months. It's my understanding that this can happen when we are in Perimenopause. The last few months I've been having a period of about 4 or 5 days and then 2 weeks later doing it again.
My question is, is this pretty normal for Perimenopause and can I take a wait and see approach before doing any invasive procedures? It doesn't even appear they are concerned about cancer, anyway, and I understand that's what this biopsy would be for. Would a regular Pap smear suffice for now?
If anyone is knowledgable in this area and can help me see what exactly was on the ultrasound and MRI and whether it's something that needs to be watched or is of no concern and whether this biopsy is something that would be recommended or can wait, I would really appreciate it! I really don't want to do any invasive or painful procedures if it's not necessary, especially if this is just Perimenopause.
Thank you so much and I look forward to any helpful advice!
I am 48 years old and believe over the last several months I may have entered Perimenopause. I had always been very regular with my menstrual cycles until this last year. (I quit bcp's 3 years ago after 20 plus years of use) I noticed the first day or two I would have very heavy bleeding, then lighten up for 4 or 5 days and then that was it. In February I bled for 22 days straight, which I had never done before so I went to the doctor, pretty sure it was Perimenopause. He agreed but sent me to get a pelvic ultrasound and then an MRI.
I hope someone can decipher them better than I can because I don't understand the results.I won't write out the whole thing, just try to give the basics. This is what the ultrasound said:
Impression:
1. Question of a subtle eterogeneous lesion within the endometrium measuring 1.1 x 0.8 x 0.6 cm. This may reflect an endometrial polyp versus hetergeneity of the endometrium. Endometrial carcinoma is felt to be unlikely. Further evaluation with pelvic MRI is recommended.
2. Heterogeneous round structure in the right adnexal region felt to reflect te right ovary. This can also be confirmed on pelvic MRI.
MRI:
Findings:
1. There is suggestion of a elongated polyp at the lower unterine segment.
Small fibroids are seen at the periphery of the areas, the largest of which is on the order of 6 mm.
Ovaries are unremarkable.
Minimal facet hypertrophic changes seen at the included lower lumbar spine with no significant stenosis present. Prominent periuterine veins are observed bilaterally. Remaining included bones and soft tissues are unremarkable.
Impression: Likely small lower uterine segment endometrial polyp, at limits of resolution of this examination.
Ok, after getting those two tests I recently saw a gynocologist to discuss whether it looks like I'm in Perimenopause and what things can be done and she recommended I get an endometrial biopsy to rule out cancer. I wasn't expecting that as I really don't believe I have anything to worry about with that and she even said 98% of the time it's not cancer, they just like to rule that out. After going online to learn more about this procedure, I've decided I don't want this test as I'm hearing it's very painful and really, I don't think I need this test, anyway, if they are only going by my periods acting different the last several months. It's my understanding that this can happen when we are in Perimenopause. The last few months I've been having a period of about 4 or 5 days and then 2 weeks later doing it again.
My question is, is this pretty normal for Perimenopause and can I take a wait and see approach before doing any invasive procedures? It doesn't even appear they are concerned about cancer, anyway, and I understand that's what this biopsy would be for. Would a regular Pap smear suffice for now?
If anyone is knowledgable in this area and can help me see what exactly was on the ultrasound and MRI and whether it's something that needs to be watched or is of no concern and whether this biopsy is something that would be recommended or can wait, I would really appreciate it! I really don't want to do any invasive or painful procedures if it's not necessary, especially if this is just Perimenopause.
Thank you so much and I look forward to any helpful advice!
So, the latest is I saw another Gyn who would rather do an hysteroscopy than an endometrial biopsy. I'm trying to decide what to do.
Ok I need to apologize for my post I just reread it and I noticed all of the typos I am so sorry. I was using my iPhone and autotext is on and changed my wording. I'm meant to say is and perimenopause . I am sorry. Lol
Alright first of all the irregular periods you mentioned I'd normal when in perfume pause. You have an endometrial polyp that you OB/GYN feels for the most part is benign, however recommended a biopsy to be sure. Honestly In my opinion it would be best to have the biopsy because although it appears normal there is a chance that it could be more. In the case that it is more you would want to catch it in the earlier stages before it has a chance to cause more problems. Having routine Pap smears is a good thing but you may not have any symptoms but the spot could be festering and it would not show. Again this is only my opinion.
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