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Is D & C Required When Periods Are Irregular With Thick Endometrium Despite Taking Trapic-MF?

Posted on Mon, 17 Dec 2018

Question: Hi, iam 44 i missed my period 3 or 4 times from last 1 and half year. three times i have used hormonal tablets to get my period with the consultation of my doctor.(ie used in nov2016, XXXXXXX 2017and again in sep2017). after sep 2017 i dint get my period in oct and i got on 9 nov2017(with out any medication) . After that on 29jan2018 i got my period. During current period, I had moderate flow for 3days. After that am finding a small clots when i go for urine.After 8-9 days, a gynic doctor prescribed "Trapic-MF" tablets (2 per day) to stop the flow. But even after consuming 10 tablets, continued. she asked me to continue for 5 more days.
On 19 XXXXXXX i had ultrasound and thickness is 10.7and every thing is fine. I had paptest also it is also clear.
Hence, today we consulted a lady gynic doctor for prolonged period. She checked and told that the lining is pretty thick. She has prescribed to take Novelon tablet for 2 months 21 days each month.
Even after that it is not regularised she told to go for D&C.

Is D& C required??
I read that Novelon is a contraceptive. Is this the proper treatment?

I'm really afraid of taking such contraceptive tablets as causes unwanted side effects such as weight gain, hormonal changes, irregular periods in future etc.? Will this tablet stop prolonged flow?

Answered by Dr. Purushottam Neurgaonkar (45 minutes later)

Brief Answer:
Some more information. FSH, LH levels

Detailed Answer:

Hi,

First of all do not panic.

Your treating doctor has rightly said that the endometrium thickness is more for your age. Also, Trapic MF tablets are rightly suggested to control bleeding.

Cessation of menses is called as menopause. It usually occurs in between 40 to 55 years of age.
Some kind of menstrual irregularities do occur in some women, before actual cessation of menses.

I would like to know about few things, to help you out in a better way.

Have done any blood tests like FSH, LH? Do you have any history of medical illness like diabetes,high blood pressure, thyroid dysfunction etc?

Use of oral contraceptive pills is to regulate your menses, but you will need some attention towards endometrial thickeness also.

Please let me know about this to help you. Please feel free to communicate with me again. I hope this answer helps you.

Thanks.

Regards,
Dr. Purushottam Neurgaonkar
OBGYN

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Purushottam Neurgaonkar (16 hours later)

No i have not done FSH and LH tests.

I don't have Diabetes, Bp and Thyroid , gone for these tests.
I have vit D deffeciency it is 8.

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Thanks for the reply
can i start using Novelon does it help?

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Answered by Dr. Purushottam Neurgaonkar (6 minutes later)

Brief Answer:
Diagnostic hysteroscopy and endometrial biopsy. Vitamin-D3 supplements

Detailed Answer:

Hi,

It's good to know that you have no other medical issues.

As such, when a woman approaches menopause, the distance between 2 periods increases and amount of bleeding and number of days of bleeding decrease.
Also, there is thinning of endometrial lining.

As you have delayed periods but there is associated spotting or bleeding off and on, I will suggest you to get diagnostic hysteroscopy and endometrial biopsy done. This is almost a day care procedure and doesn't require overnight stay in the hospital. It will be of help to rule out worry about endometrial cancer or precancerous changes.

For your low vitamin D levels, capsule of vitamin D3, 60,000 IU once a week for 8 weeks and then once a month will be of help.

Please feel free to communicate with me again. I hope this answer helps you.

Thanks.

Regards,
Dr. Purushottam Neurgaonkar
OBGYN

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Brief Answer:
Novelon tablets can be started.

Detailed Answer:

Hi,

At present you can very well start using Novelon tablets, take the same everyday without missing or skipping. It will help to synchronize endometrial growth and will help to stop your bleeding issue.

But to know about the nature of thickened endometrium, you can get diagnostic Hysteroscopy and endometrial biopsy done after finishing the course of tablets and after finishing your next menstrual cycle.

I hope this answer helps you.

Thanks.

Regards,
Dr. Purushottam Neurgaonkar
OBGYN

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Above answer was peer-reviewed by : Dr. Kampana