abnormal vaginal bleeding

Started bleeding March 24...seen by family Dr. March 28th and immediately referred to a gynecologist for further evaluation. A vaginal and pelvic ultrasound was ordered and done the same day that I was seen by the Gyn. Ultrasound showed the the lining of the uterus was 3.5 cm thick as compared to a normal of 5 mm. Pap smear and Endometrial biopsy done and reported as normal. Have been referred to a gyn oncologist surgeon for further evaluation. Is all this necessary??? the biopsy was negative and I may just have simple hyperplasia so why an oncologist? I find this scary as well as the time that it is taking to find out what is wrong. I an 57 years, have never been pregnant and am still bleeding. I have been post menopausal for 17 years next month having finished at age 40. Has anyone else been throough this and what was the final outcome?

Thank You
Phyllis

Hi Phyllis,

Well, to answer your question about if all this is necessary, I would think so. Your symptoms definitely need to be evaluated to find the cause.

I can understand feeling frightened, and having had cervical cancer, I know only too well how frustrating it can be to wait for test results. I am very glad to see that you are being referred to an ONC GYN. They are the experts in suspected or positively diagnosed gyncecologic cancers and have the most up-to-date knowledge of how to proceed.

Please don't misinterpret what I have written to assume that you have cancer. But since your test results have been negative thus far in finding the cause of your problems, I'm sure that the intention is that you get the best care available in diagnosing the problem so it can be treated.

Please let us know how you are. We care and are here to offer lots of support and hugs; : has been known to help some too during the stress of waiting, at least for me!

Best wishes and lots more s

Hi Phyllis

I agree that it is a good thing you are being referred to a gyn/onc. If you were pre-menopausal your symptoms might not warrant it, but after menopause your uterine lining should be thinner, not thicker than normal. An endometrial biopsy is not very accurate, since it only takes samples from a few areas and there is much more that is not sampled. This does not mean you have cancer, but bleeding after menopause is the hallmark symptom of uterine cancer and it is really best to have an oncologist assess the risk.

Yes, it is unnerving to be taking so long. But uterine cancer is usually slow growing, so if there is no indication of any other problem this amount of time probably won't make a difference. The gyn/onc might help decide how extensive your surgery should be and who should do the surgery.

Phyllis, I'm 56 and many years post menopause too. Had bleeding, endometrial biopsy then vaginal ultrasound which my gyn thought showed a lining of more than 2 cm. Dr suggested hysterectomy, I compromised on a D&C with hysteroscopy and it turned out to be one big polyp, totally benign. Unfortunately, she was unable to remove all of it and so I'm scheduled for hysterectomy after all. Sometimes I wonder how much they can really tell with the ultrasounds since this is the 2nd time I've been thought to have a thick lining that after D&C turned out to be a big polyp. Good luck and don't let your dr referring you to a onc scare you too much, never hurts to be extra careful.

Thanks to all of you for taking the time to reply to my questions and concerns. I will certainly keep you updated as I find out what is going on. Will be seeing oncologist gyn on tuesday, 4/15/03. This is a wonderful outlet to ask questions and speak to others who have similar problems.

Thank you all very much again.

Phyllis

Went to oncologist yesterday and will be having a hysteroscopy in the very near future, (waiting for a date) I've heard that this can be painful. It will be done in the office and then repeated in the OR if needed. Has anyone had any experience with this? I have read that I may be given a local anesthetic in the cervix and was advised to take some ibuprofen before going to the appt.


God Bless everyone

Phyllis

Hi Phyllis

I'm glad you've seen the gyn/onc. I had my hysteroscopy under a general before surgery, so I can't tell you for sure what it would be like in the doctor's office. However, I've had plenty of uterine biopsies done and I have to say that any time somebody puts something through the cervix the cervix has to dilate a bit and it causes cramping. A local anesthetic probably makes it better - I didn't have that, as a biopsy only takes a few seconds and the pain goes away pretty quick.

Hope things go well for you.

Phyllis,

I purposely by-passed that procedure. I qualify for a hyst without pathology results. I told the DR she could biopsy my uterus to pieces when it was out of my body and in her hands.

The reason I did this was I had a bad experience when they numbed my cervix for the LEEP. I won't say more for fear of scaring you but believe me, it was a serious reaction. The upside is the numbing agent wears off quickly so the DR was able to get me through the reaction. I simply didn't want to risk it again.

This is also one of the reasons I don't think they'll give me an epidural - the risk of my reaction.

So, I haven't had the test you're facing and the downside is I'm going into my hyst not knowing what my pathology results will be. I'm a little worried but I decided there was gonna be a limit to the poking and prodding. I've had enough.

I am 50 and had menopause 4 years ago. Ten years ago I had simple endometrial hyperplasia. It was treated with Depoprovera. Just after New Year's this year I began bleeding so I went to my family doctor asap and had an ultrasound. It showed thickening of the lining so I was sent to a gynecologist. He did a biopsy and it showed complex endometrial hyperplasia with atypia. In about 25% of these cases, when they do a hysterectomy, they find cancer -- even though the biopsy did not show it. So the standard treatment for someone in their 50s is hysterectomy with removal of the ovaries and fallopian tubes.

They don't usually refer us to an oncologist until cancer is confirmed and follow-up treatment required. Instead, they assume that cancer is likely to be there.

I am still waiting for my date at the castle to be confirmed. The process is a rather lengthy one from start to finish here at least (and that is without any outside disruptions). It will soon be 5 months since I first showed symptoms.

Best wishes for a complete recovery from whatever is wrong.

I recently had a hystroscopy (along with a D&C) and I was given something to relax me in an IV and a local. I did not have any pain during the procedure, and nothing more than light cramps afterward. The local would definitely have been sufficient for pain control.