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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Postmenopausal Bleeding, Ultrasound Shows Endometrium Thickening. What Is The Safest Method ?

Hi, I recently saw my Ob/Gyn because I had postmenopausal bleeding (I am 64, approx. 8-10 yrs postmenopausal). Bleeding lasted about a week. He endeavored to do an in-office uterine biopsy, but had difficulty because of cervical stenosis. He gave me a local anesthetic and cut an opening and did the biopsy. I waited 2 weeks for the results and received a call saying he could not get an adequate amount of tissue for biopsy results. I also had an ultrasound (internal and external) and was told my endometrium is thickened (I don't know how thick at this point). They set up an appointment for next week to 'discuss' having a hysterectomy. I have been researching hyperplasia, and am concerned that it is premature to talk about a hysterectomy without a clear tissue evaluation. Should I ask for a D&C to get a better evaluation? Might that be problematic given the stenosis? Is hormonal treatment an option? Depending on the thickness of the endometrium, is that alone an indicator of pre-cancerous condition that would warrant a hysterectomy? Is asking for a 2nd opinion reasonable? I have read that seeing a gynecological oncologist would be a smart thing to do. As you can see, I have many questions, and depending what I read, get many different opinions as to the best approach. I am just cautious about removing organs, if the problem doesn't warrant it, but also I do not want to risk cancer. I want to do what is safest, but prudent. Any advice would be appreciated. Thank you, AAAA
Wed, 17 Jul 2013
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General & Family Physician 's  Response
hello,
Thank you for consulting HCM.I want to tell you the postmenopausal bleeding is the commonest symptom of endometrial cancer and that too in your usg you came to know that the endometrial thickening is present and thats the reason to make you free from cancer your doctors decided to remove you uterus and thats a clever idea.But remember that to take adjuvant therapy even after removal of the uterus to prevent future cancer or vault mass formations.Thank you.
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Postmenopausal Bleeding, Ultrasound Shows Endometrium Thickening. What Is The Safest Method ?

hello, Thank you for consulting HCM.I want to tell you the postmenopausal bleeding is the commonest symptom of endometrial cancer and that too in your usg you came to know that the endometrial thickening is present and thats the reason to make you free from cancer your doctors decided to remove you uterus and thats a clever idea.But remember that to take adjuvant therapy even after removal of the uterus to prevent future cancer or vault mass formations.Thank you.