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Heavy menstrual periods, mid-cycle spotting. Internal scan showed thick endometrial lining. Advised dnc, testing the lining, mini progesterone pill. Any other alternatives?

Hi, I have just turned 41 years of age and for the past year or so have suffered with very heavy menstrual periods, some months loss is anywhere from 90 mls - 200 mls per cycle. Last month I had a bit of mid cycle spotting, so I became concerned, went to my gynecologist this week and he did an internal scan and said that my endometrial lining is approx 15 mm, was on day 17 / 18 of my cycle, with a cycle of normally 28-30 days sometimes go to 34 days. I am away that I have slightly polycistic ovaries and I know i probably do not ovulate every month, probably suffering from low progesterone on and off over past number of years. I have three children, first one at 28, then 32 and then 38. He has advised me to go for a d&c and to check the lining at the lab just in case, I am now very worried and scared that there might be something more serious, even though he said it is rare at my age. He has suggested the marina coil or a mini progesterone pill , is there any alternative remedies in the meantime, I am scheduled for the d&c in four weeks time, I am very worried. My own mother has suffered from heavy menstruation in her 30 s and 40 s too.
Asked On : Mon, 4 Jun 2012
Answers:  1 Views:  206
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OBGYN 's  Response
Mar 2014
Hello and welcome,

The symptoms that you mention are very common at your age and are mostly due to hormonal imbalances.

Cancer of the endometrium is less likely at your age whereas hormonal dysfunction is more likely. I do understand your fear but there is no reason to be scared at all. Most likely the result would be something that may show either estrogen excess or dysregulation of estrogen and progesterone.

I will give and example of the likelihood of cancer vs hormone imbalance: imagine you are walking on a lawn road blindfolded and your friend tells you that she has picked up a part of the lawn. Is it more likely to be grass or weed. The answer is grass. Weeds will be there occasionally but the chance of picking up grass is more likely in a lawn. Similar is your case. The hormonal imbalances are the grass and cancer a weed. So the report is more likely to show a hormone disturbance than cancer.
Do not take any alternative treatment until then as it will affect the report. If the report is hormonal imbalance, any progesterone preparation pills or mirena will help. Endometrial ablation is also an alternative and may be discussed with your doctor after the report.
You have had children and are not very old, so it is less likely to be cancer. Do not worry.
Hope this satisfies your query.
Thanks for using HCM.     
Feel free to ask any more questions that you may have.
Dr Madhuri Bagde
Consultant Obstetrician and Gynecologist
Answered: Sun, 6 Apr 2014
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