Post-menopausal abnormal bleeding- Hyperplasia......

Hello,

I am somewhat new to this site...though I have used it in the past. I have some questions, and hoping some can give me some feedback. My immediate issues are post-menopausal bleeding, diagnosed with Simple Hyperplasia.

Here is some quick background: I am 49 years old, had surgerical menopause at 42 due to both ovaries being removed because of cysts - uterus kept intact. For past six years no bleeding AT ALL - too HRT for the first two years.

All of the sudden this past Sept. I wake one morning to find vaginal blood on my underwear. Paps have always been fine. Had a edometrial biopsy w/ D&C on Oct 8 pathology showed simple hyperoplasia. Dr put me on medroxyprogesterone 14 day cycle two weeks after D&C. After two days on pill, began to spot, breakthough bleed and felt horrible. by day 10 I was bleeding profusely, finished pills and two days later (last Sunday) ended up in ER hemmoraging. On-call doctor said only way to stop bleeding was D&C. Had procedure done was in hospital for two days. Bleeding stopped imediately. lost over a pint of blood - but no need for transfusion.

Have been home resting all week....very light spotting. Got second pathology report yesterday - hyperplasia gone, but lining still a bit thick. Dr wants to put me on Prometrium (hopes I will tolerate it better) for three 14 day rounds and then have another D&C w/biopsy end of February.

Has anyone had this kind of reaction to Progesterone? Can you give me some feedback regarding medroxyprogesterone vs. Permetrium. Dr said I "should" take the 14 day round then bleed like a light period.

Any feedback and/or support would be helpful. I simply cannot go through that horrible bleeding again.

P.S. I am a very high risk for hysterectomy as I have had past abdominal surgeries that could hinder my recovery. So surgery is the VERY LAST resort. Thanks.

Hi I've never been on medroxyprogesterone, but I just wanted to say that it is a synthetic progestin, not progesterone. Prometrium, on the other hand, is natural progesterone. The two are very different. There can be a wide range of responses to medroxyprogesterone therapy; chances are you'd do better on natural progesterone. Still there is no way to predict what your response will be.

If you need to avoid a hysterectomy, this may be a good option. Here's a link to a summary of research results on the use of progesterone to treat endometrial hyperplasia:

http://cancerres.aacrjournals.org/cg...stract/38/1/78

If you find you have too many side effects from oral medications like the MPA or Prometrium, you might ask your DR about trying either the Mirena coil or natural progesterone vaginal suppositories, either of which would act more locally than the oral medications.

I hope this helps.

s,
-Linda