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How is Ablation interrelated with treatment for hyperplasia?

Mar 2013
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Practicing since : 1998
Answered : 5971 Questions
In August 2013, went to Gyn to get help with excessive bleeding that caused Anemia. Gyn did a pap; normal, vaginal ultra sound; fibroid, lumpy uterus and endo biopsy; normal. Gyn suggested the Novasure ablation and I agreed. At pre-op appointment, Gyn suggested a hysteroscopy and d&c along with the ablation. I agreed to this as well. September 2013, hysteroscopy found that a had a large fibroid that was left in, a lot of polyps that was removed and that the ablation went well. At 2 week post-op, Gyn stated that my lab report from the d&c showed that I have complex endometrial hyperplasia without atypia and that it can lead to endometrial cancer but I shouldn't be worried about it because I did the ablation and he'll (Gyn) see me in 2 years. I am 45 years old, going to be 46 this year. Has been experiencing the mood swings, hot flashes, night sweats, melasma to name a few. I am not currently being treated for the complex endometrial hyperplasia w/o atypia and/or the perimenopause. My mom passed at 60 years old due to complications from being diagnosed with numerous cancers; breast, pancreatic and large cell lung. Both of her sisters died before the age of 60; one from ovarian cancer and the other from colon cancer. My question is, should I be worried that I am not being treated for the complex endometrial hyperplasia w/o atypia? P.S. Still break out and suffer from cramping every month, but no period since the the 2nd month after the ablation.
Posted Mon, 27 Jan 2014 in Women's Health
Answered by Dr. Aarti Abraham 32 minutes later
Brief Answer: EXPLAINED BELOW Detailed Answer: Hello Thanks for writing to us with your health concern. Ablation is a kind of treatment for the hyperplasia. Also the polyps were removed. Annual follow up with a transvaginal ultrasound, endometrial biopsy ( if needed ) and Pap smear should be sufficient for you. If you are not having heavy periods, there is no indication for any particular hormonal treatment, considering the extremely high risk for cancers in your family. Hormone replacement therapy too, is not a viable option for you, for the same reasons. Hence, do not worry about not being treated for the hyperplasia / perimenopause. Just have annual follow up and a check up if you develop menorrhagia again. get your blood sugars done, and keep your weight in check. All the best. Please feel free to discuss further.
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