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02-06-2016, 02:46 PM
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HysterSister
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Posts: 723
Hysterectomy: August 12th, 2015
Surgery Type: DvH
Ovaries: Removed both
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Re: Abnormal Uterine Bleeding
Hi! I was in the same situation as you 5 years ago. I had a 24 mm endometrium with spotting. Doc wanted to treat conservatively. I had a D&C (she wasn't able to get an office biopsy) and a hysteroscopy. D&C is considered the gold standard for biopsy,( short of actual pathology on the uterus as a surgical specimen-which is the definitive biopsy for cancer) Usually a hysteroscopy is performed with the D&C as it allows the doc to visualize the inside of the uterus. You are sedated for the procedure so it's not painful at all. Postmenopausal bleeding is not normal and can be caused by unopposed estrogen, which was the case for me as I'm overweight and adipose tissue can produce estrogen. Fibroids, Or it can be caused by cancer, so it's best to explore further via the D&C. If no cancer is found, the conservative treatment is progesterone: either orally as Prometrium or Provera, as a monthly injection as Depo Provera or by the placement of a progesterone IUD called Mirena. If the Progesterone doesn't work or cancer is found, the standard treatment is hysterectomy. In my case the Prometrium worked at first but then the bleeding started again and got progressively worse. I was concerned about cancer so in August I had surgery by a gyn/onc. I had to travel to a larger hospital, but in retrospect I'm glad I did and the surgeon was very proficient in robotic assisted laproscopy. Fortunately my pathology came back as no cancer.
The diagnostic process can be nerve wracking, so for me at 61 I'm glad it's all over. my advice would be to seek out a gyn/onc if you want surgery--they have more experience than most local gyns because the bulk of their practice is surgery. Feel free to ask any questions that come up for you.
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