Question: I am 54 years of age. No period for 7 months and then light bleeding for 21 days. Is a uterine biopsy something that should be performed because of 3 weeks of bleeding during perimenopause?

Dear Dr. XXXXXXX

Hello. I am VERY scared to have this biopsy performed. I am getting very stressed since I have read many testimonials and a friend of mine also had an especially PAINFUL time during the biopsy and also a lot of bleeding afterwards. (Out of 30 testimonials from women who had this done, only 2 said it was bearable.)

I am fearful of bleeding a lot afterwards and also a little scared of the pain that may be associated with this. The doctor also wants to do a sonohystergram which is probably uncomfortable, as well.

Dr., are those the only 3 possibilities, that you have listed above? Are fibroids also possible? Or, is it just possible that NOTHING at all is wrong, even though I have had light staining/bleeding for 21 days?

Another doctor from XXXXXXX (about 2 weeks ago), said what I experienced seems to be normal during perimenopause.

I do not have vaginal dryness and I rebuke (in Jesus' name) cancer or polyps! I am writing to further answers and hope you do not let my faith in the Lord let you answer any differently than you would have. I thank you for writing to me and giving me answers.

Isn't it still typical for women to have irregular menses or bleeding as long as they are not in full menopause, meaning that no period for 12 consecutive months?

Are there any other symptoms? Right now, I feel well and have changed my diet pretty much, not eating refined sugars, not much meat at all, unless the animal is grass fed and has had no hormone injections, etc.

I appreciate your next reply. I may have more questions.

Sincerely,

XXXX

Hello, again, Dr. Richa~

I thank you for additional information regarding the tests.

I will admit that I do not look forward to this test and believe the women who said they experienced excruciating pain, which was probably the case. Some said it was worse than giving birth!

When I was in labor with my son, I had hemorrhaged at the onset and all the way through up until delivery. XXXXXXX was born 11 hours from the onset of labor.

I do recall very sore nipples and lower back pain a couple weeks before the blood started in January 2015. I pray it is from perimenopause.

I wish there was another way to test. In this day and age, you would think that doctors would not subject patients to a lot of pain and perhaps numb the area.

Honestly, I read the testimonials from this site: http://www.stirrup-queens.com/2006/07/endometrial-biopsy/ and it scared the heck out of me!

Dr., my dr. said I could take either motrin or Tylenol. Since I am scared of bleeding a lot, should I opt for Tylenol or would motrin be okay to take? I know it can cause more bleeding, being a NSAID. Is that correct or am I wrong about this?

Which would you recommend to lessen the pain from the procedure, if this would even help at all?

Some women have taken zanax (not sure how to spell this) but it is a sedative, I suppose. I do NOT take any drugs, only blue/green algae, digestive enzymes and probiotics, along with vit. D3. I have purchased a book from an M.D. on how to shrink/rid oneself of fibroids with a healthful diet. I believe very much that our food has much to do with our overall health.

I had blood work done and PAP revealed "Endometrial Cells Present" and "Negative for Intraepithelial Lesion or Malignancy," thank God for that! I did have slight bleeding. It was 19 days when I had the PAP and a couple days later, no more bleeding. Then nothing for 14 days, and then it began again for 10 days.

TSH, 2.08 uIU/ml, FREE T-4. 1.01NG, both of these were in range.

Vit. D levels were insufficiency.

FSH/LH Follicle Stimulating Hormone: 18.4 mIU/ml;

LH 6.9 mIU/ml

Estradiol Serum 98 PG.

I don't know if you can make sense of this since your lab probably has different numbers, perhaps? I did not find out what any of these results mean.

What happens if there was a lot of bleeding? Does one have to go to the hospital or does she wait until it passes?

I just feel very anxious about having these 2 tests done.

Thank you.

XXXX

Dear Dr. XXXXXXX

I thank you SO much for answering my questions.

I do have some more, if you would be so kind to answer again.

From the blood test results, were you able to interpret or do I have to provide you with the ranges that are within normal limits?

I wish you were my doctor, since you seem to have compassion and a heart. : ) My doctor is not one I will see again; I will be looking for another who will answer questions and not be abrupt and he does seem uncaring. Honestly, he may just want to do these tests for additional money, sorry to say this.

So, from the results, it shows that I am definitely in perimenopause, correct?

Also, have you had patients who had a period (and are around my age), in perimen, and no period for say, 7 or 8 months and then had blood for 3 weeks and then nothing for 2 weeks and then blood again for 10 days?

Please tell me if this seems very abnormal or normal in this situation?

Also, can Motrin cause more bleeding if I have some moderate bleeding after the biopsy? Would you suggest Motrin over Tylenol? 400 mg or 600mg? My dr. said I could take between 400 - 800mg, so I really do not know what to do. He does not take time to explain. He just wants to get to the next patient and that is why I will not keep him as my doctor.

As far as anesthesia, he plans to do this with NONE at all. Just use the instruments and the pipelle (I believe that is how it is spelled). He first plans to perform the sonohysterogram and then the biopsy simultaneously.

I am very anxious about this, nervous, is more like it. I cannot relax, Dr. XXXXXXX I am worried if there is, God forbid cancer or any growths, even though I believe I am well. But, I want to know. However, I am so frightened and perhaps because I do not feel comfortable with this doctor.

You remember that there were endometrial cells present on the PAP, but there was a slight amount of blood, at the end of my period when I had this done in Feb. 2015, and these cells had shown up also in 8/2012 when I had the PAP and that dr. (from this same practice) came on the phone to say the test was not normal but then remembered that there was slight bleeding at the time the PAP was done and said that was why.

When you perform these tests, do you do the biopsy with NO anesthesia? If so, do your patients bear the pain without fainting? And, did you see cases wherein the patients had bled too much afterwards, like what percentage?

Please answer all the questions. I would greatly appreciate this and thank you so much for your time.

Do you practice in India? I think XXXXXXX doctors are awesome! : )

Sincerely,

XXXX

Dear Dr. XXXXXXX

Thank you for additional answers. Years ago, I had gotten cervical papilloma and had a cervical biopsy with NO numbing and NO motrin before. Then, the doctor used something to freeze them. I am not sure, but think it was called cryo something. Sorry, this was 22 years ago, so I cannot remember what it was called. I am not saying that I am so brave, but I also have my cavities filled with no novacaine. My dentist said that I am brave and he doesn't have many patients who do this.

I can tell you that I am very scared of this biopsy, and wish I was not. I actually have been feeling well for the past 10 days and thank God, no bleeding at this time. I am so fearful of bleeding a lot and that is probably because I hemorrhaged at the onset of labor 20 years ago and still remember it clearly. I know this is different but I just hate to think of some of my uterus being removed.

Dr., does the tissue grow back soon after or will there be scar tissue after a biopsy? When I had the freezing of the HPV frozen, it did leave me with scar tissue. I was surprised that the doctor who examined me while I was bleeding profusely during labor commented that he felt scar tissue.

Is it risky because of this or not, because the biopsy is done on uterus and not cervix?

My husband has been a podiatric surgeon for about 25 years. He no longer does this, but still makes some house calls and works in a hospital but does not perform podiatric work there.

What is the name of the pills you mentioned, in case there is a lot of bleeding? Are they tablets? I am not at all familiar with the name. Was it Terpac? I cannot remember.

Is the cramping afterwards severe for most women? I read about a nurse who said it was the worst pain she ever endured and had to cancel her patients for the day because the cramping afterwards was also very strong.

I do not look forward to either of this.

Another question: With the sonohysterogram (not sure if that is spelled correctly), that can detect fibroids or polyps, correct? And also show the thickness of the lining of the uterus. What is a normal thickness?

Is this test alone pretty accurate in determining whether cancer is present? What percent of accuracy would you say it is for this test?

I know I have asked several more questions. I look forward to your reply and thanks, again, in advance!

Sincerely,

XXXX : )

Dear Dr. XXXXXXX

Thank you, again, for additional replies. I had written to you but the message did not go through. So, I will try ask a few more questions, some of which may have already been asked. Your patients are lucky to have such an intelligent and caring doctor such as yourself! : )

As far as the analgesics, would you honestly recommend motrin over others? I don't recall what your answer was days ago. I am concerned about bleeding more since motrin can do this, correct? I will go along with your recommendations. Can motrin cause more bleeding than if I took, say, Tylenol? Is Tylenol as effective? My husband doesn't think so, but I want as little bleeding as possible.

Dr. XXXXXXX I have to say that I am too frightened of the biopsy and hope I do not sound like a baby. But, having to wait one month keeps me too anxious and nervous. I have never taken a sedative but some women said this helped them. I am actually scared to mix analgesic with sedative, but it is probably safe. Women mentioned zanax (not sure if that is the correct spelling). I will pray to my God to be to help and calm me and for me to not be in a lot of pain and just to have good results, during and after the test.

If the dr. finds the uterine lining not to exceed 16mm, is it more than likely that no cancer is present. And if the lining is thicker, are there chances of something bad present?

When the PAP came back (this time and last time) with the endometrial cells present, I did have some bleeding. There was also blood noted in the urine. It was the next to last day of bleeding at the time of the PAP.

Do you think I can be safe putting off the biopsy and just having the hysterosonogram done or do you not recommend just this at this time?

I know you mentioned that I can send you the results? How can I do this? Do I photograph the results and then send? Where would I send the results from the blood tests I had?

If I go through with the biopsy, for how many days do you recommend no sexual activity with my husband?

Dr., I don't know for sure, but I am thinking that a few factors may have contributed to me bleeding again (if there are no fibroids). I have not had any cramping as I had before bleeding and right before I had the period for 3 weeks, I did have sore nipples. So that was probably my period, even though not normal as is the case during perimeno.

Three (3) years ago, we adopted a newborn. We went to see her out of state the day after she was born. She is now 3 years and 3 months. I have been very stressed with my daughter since she is very hyperactive and very disobedient. My son is (and was when he was little) very easy going and a true pleasure. I love my daughter very much but she is an extremely difficult child to care for. No one would know unless some stayed here for one day to see how she behaves and is so defiant. So, there has been much stress because of this.

Then, my diet has not been the best since I had not taken time to prepare foods since my daughter takes up every minute of time (unless she naps for one hour). There is a lot to do and not time for me anymore because of how her behavior is. I do NOT want her to take medications and am going to try a natural approach to help with this problem before she begins school. I know of a superfood supplement that has truly helped since I used to sell it to customers years ago, with good results. As a result of poor eating habits, I gained 18 lbs. in 3 years, and this is terrible for me! I have now lost 5 pounds just because I am eating fresh fruits and more vegetables and very little organic meat, and nuts, berries, etc. I am Italian but stay away from the bad things, like sausages and cheeses, for the most part. I do love certain pasta dishes but eat them infrequently.

I do NOT follow the S.A.D. diet (Standard XXXXXXX Diet), which is, in fact, sad. So many people eat fast foods and do not realize how much harm it is doing to their bodies and the consequences.

It is now 9 days and no sign of bleeding, thank God for this. I pray I will not have anymore periods/bleeding ever again. Having optimal health is the most precious thing while we are on this earth and no amount of money buys this for us. : )

Dr. XXXXXXX I guess you perform the biopsies yourself. Have you seen any patients have terrible outcome from it or do they all recover without problems? I wish this test was over already.

With regards to the Trapic-MF, how is that taken and what is the dosage? Is that to be taken ONLY if there is very much bleeding?

If you have any other suggestions, please let me know. I would also appreciate answers to questions that I may have already asked.

Thank you very much!

XXXX : )