1. < Gynecologic Cancers

Medical test options for post menopause spotting, cramps

Posted by leeosteo @leeosteo, Jul 28, 2023

I'm 66 and had vaginal spotting for four days in June. Did not see a doctor until July due to caregiver support for family member. Met with my gyn PA for physical exam. She ordered an ultrasound which showed previous fibroid was unchanged in size (roughly 1.5") and my uterine lining increased from 3cm to 5cm. She has suggested a biopsy but that I meet with one of the doctors in the office to discuss options. She said some women wait until the uterine lining is 10 cm or greater to do anything. I'm not comfortable with that, specifically because the cramping is getting worse.

My appointment with the doctor is August 31. My situation is a bit more complicated since my vaginal has narrowed making an in office biopsy more difficult. The PA mentioned I might need to go to the hospital for the biopsy.

Not having the benefit of meeting with a doctor, I'm leaning towards a biopsy. What is the difference between dr office vs hospital biopsy?

Does anyone else have a narrow vaginal with same symptoms? If so, how was this handled for you? I realize everyone is different. I'm just trying to get an idea of what I should be considering and questions to ask the doctor.

Also, my cramping seems to be getting worse. What does this mean? Not sure I can wait until August 31 with this pain. I am on the wait list to see the doctor earlier if there is a cancellation.

Interested in more discussions like this? Go to the Gynecologic Cancers Support Group.

leeosteo | @leeosteo | Jul 29, 2023

Great advice. Thank for the follow up reply. I plan to ask for the biopsy at minimum and discuss other options she might present e.g. D&C.

REPLY
aardvark2118 | @aardvark2118 | Jul 29, 2023
In reply to @leeosteo "aardvark2118, thanks for sharing your story. May I ask how thick your uterine lining was when..." + (show)
@leeosteo

aardvark2118, thanks for sharing your story. May I ask how thick your uterine lining was when you had the hysteroscopy and d&c?

Jump to this post

Sorry forgot to answer this question. When first ultrasound was done lining was 7. Year later lining was 17

REPLY
Mentor
Helen, Volunteer Mentor | @naturegirl5 | Jul 29, 2023
In reply to @leeosteo "Helen, thanks for your reply. Fortunately, I was able to get my August 25 GYN doctor..." + (show)
@leeosteo

Helen, thanks for your reply. Fortunately, I was able to get my August 25 GYN doctor consult appointment moved up to this Monday, July 31. I appreciate you and val64 sharing your experiences. This gives me a good idea of questions I should be asking the dr. How thick was your endometrial lining when you had the D&C?

Jump to this post

@leeosteo I reviewed the ultrasound report and it indicates that endometrial thickness was 18mm at the fundus which is the top of the uterus opposite of the cervix. The report indicates « abnormal endometrium. Worrisome for malignancy. Further evaluation is advised ». I had the D & C 4 weeks later and that’s when the pathology report indicated endometrial adenocarcinoma.

My endometrial lining was at the high end of what was considered « normal » for post-menopause. My gynecologist wasn’t alarmed by the ultrasound because he thought I did not have the usual risk factors but in fact I did. I was menopausal about about age 57 and I have never had children. These are two risk factors.

In retrospect I know the endometrial cancer was caught pretty early because I had a radical hysterectomy within two weeks of the D & C and the cancer was endometrioid adenocarcinoma, Stage 1a, FIGO Grade 1.

It’s great that you got your GYN consult moved to July 31. Will you please let me know what you find out at your appointment? I’ll be thinking about you on Monday.

REPLY
1 reply
Mentor
Helen, Volunteer Mentor | @naturegirl5 | Jul 29, 2023
In reply to @leeosteo "Helen, did you have any issue with a narrowing of your vagina?" + (show)
@leeosteo

Helen, did you have any issue with a narrowing of your vagina?

Jump to this post

@leeosteo No, there was narrowing of my vagina going into the D & C and as far as I know the uterus was accessible through my cervix. I was asleep and when I woke up the D & C was complete. I did have some abdominal pain but that was from the carbon dioxide introduced into the uterus during the hysteroscopy and once the carbon dioxide dissipated the pain went away completely.

REPLY
1 reply
Linda Constant | @laconstant | Jul 30, 2023
In reply to @val64 "My situation was somewhat different, but the two main options that I know of are an..." + (show)
@val64

My situation was somewhat different, but the two main options that I know of are an office biopsy and a "hysteroscopic D&C," which is done in the hospital under anesthesia. I had both of these, or rather, I had a failed attempt at an office biopsy, and then a month later had a D&C. From reading this forum, it sounds like failed office biopsies are quite common. It should be somewhat comparable to a pap smear, except that they have to push the little plastic stick through the cervix. Not being able to get through the cervix seems to be the cause of failures. I learned on this forum that some doctors have women put misoprostol pills in their vagina prior to the office biopsy to soften the cervix, which apparently reduces the failure rate.

My 2 cents worth is that you should definitely at least have a biopsy: you don't just have slight endometrial thickening, you have symptoms too. If a D&C is possible with your vaginal narrowing, it might also make sense to go straight to that, in the hope that they might scrape out whatever is causing your problems, even if it is "benign."

Jump to this post

I had spotting for 2 months and decided to see a gynecologist. When he examined me he had me come back the next day. He had me take 2 pills an hour before my appointment. He did an ultrasound and a biopsy. He thought it was a polyp it was a tumor, the biopsy showed that I have endometrial cancer. His wife who is an obgyn/ gynecologist oncologist took me in to see her right away. My appointment with him was the end of June. I saw her on the 12th of July, I’m being operated on tomorrow July 31. Having a complete hysterectomy and removal of some lymph nodes to make sure it hasn’t spread. Mine is grade 1. When the operate and have everything tested then I’ll know what stage it’s in. I would not wait. I would find another Dr fast. He told me my uterine wall had thickened and wasted no time in getting me to see an oncologist once the biopsy came back positive

REPLY
2 replies
Linda Constant | @laconstant | Jul 30, 2023

I thought I had answered your question but I responded to someone else’s. I’m 75. I posted a comment with my picture you should be able to find it.

REPLY
leeosteo | @leeosteo | Jul 30, 2023
In reply to @laconstant "I had spotting for 2 months and decided to see a gynecologist. When he examined me..." + (show)
@laconstant

I had spotting for 2 months and decided to see a gynecologist. When he examined me he had me come back the next day. He had me take 2 pills an hour before my appointment. He did an ultrasound and a biopsy. He thought it was a polyp it was a tumor, the biopsy showed that I have endometrial cancer. His wife who is an obgyn/ gynecologist oncologist took me in to see her right away. My appointment with him was the end of June. I saw her on the 12th of July, I’m being operated on tomorrow July 31. Having a complete hysterectomy and removal of some lymph nodes to make sure it hasn’t spread. Mine is grade 1. When the operate and have everything tested then I’ll know what stage it’s in. I would not wait. I would find another Dr fast. He told me my uterine wall had thickened and wasted no time in getting me to see an oncologist once the biopsy came back positive

Jump to this post

Linda, thank you for your response. Do you remember how thick your uterine lining was? I'm thinking of you and hope all works ok tomorrow.

REPLY
leeosteo | @leeosteo | Jul 30, 2023
In reply to @naturegirl5 "@leeosteo No, there was narrowing of my vagina going into the D & C and as..." + (show)
@naturegirl5

@leeosteo No, there was narrowing of my vagina going into the D & C and as far as I know the uterus was accessible through my cervix. I was asleep and when I woke up the D & C was complete. I did have some abdominal pain but that was from the carbon dioxide introduced into the uterus during the hysteroscopy and once the carbon dioxide dissipated the pain went away completely.

Jump to this post

Thanks Helen.

REPLY
leeosteo | @leeosteo | Jul 30, 2023
In reply to @naturegirl5 "@leeosteo I reviewed the ultrasound report and it indicates that endometrial thickness was 18mm at the..." + (show)
@naturegirl5

@leeosteo I reviewed the ultrasound report and it indicates that endometrial thickness was 18mm at the fundus which is the top of the uterus opposite of the cervix. The report indicates « abnormal endometrium. Worrisome for malignancy. Further evaluation is advised ». I had the D & C 4 weeks later and that’s when the pathology report indicated endometrial adenocarcinoma.

My endometrial lining was at the high end of what was considered « normal » for post-menopause. My gynecologist wasn’t alarmed by the ultrasound because he thought I did not have the usual risk factors but in fact I did. I was menopausal about about age 57 and I have never had children. These are two risk factors.

In retrospect I know the endometrial cancer was caught pretty early because I had a radical hysterectomy within two weeks of the D & C and the cancer was endometrioid adenocarcinoma, Stage 1a, FIGO Grade 1.

It’s great that you got your GYN consult moved to July 31. Will you please let me know what you find out at your appointment? I’ll be thinking about you on Monday.

Jump to this post

Helen, I'll keep you posted on my dr appt tomorrow.

REPLY
1 reply
Mentor
Helen, Volunteer Mentor | @naturegirl5 | Jul 30, 2023
In reply to @laconstant "I had spotting for 2 months and decided to see a gynecologist. When he examined me..." + (show)
@laconstant

I had spotting for 2 months and decided to see a gynecologist. When he examined me he had me come back the next day. He had me take 2 pills an hour before my appointment. He did an ultrasound and a biopsy. He thought it was a polyp it was a tumor, the biopsy showed that I have endometrial cancer. His wife who is an obgyn/ gynecologist oncologist took me in to see her right away. My appointment with him was the end of June. I saw her on the 12th of July, I’m being operated on tomorrow July 31. Having a complete hysterectomy and removal of some lymph nodes to make sure it hasn’t spread. Mine is grade 1. When the operate and have everything tested then I’ll know what stage it’s in. I would not wait. I would find another Dr fast. He told me my uterine wall had thickened and wasted no time in getting me to see an oncologist once the biopsy came back positive

Jump to this post

@laconstant This has all happened so quickly for you. I’m so happy to hear that once you had the results of the biopsy that your gynecologist made everything go quickly for you. My radical hysterectomy was robotic laparascopy and a same-day procedure in the hospital. I went back home with a few small bandages where the incisions were made and although I was fatigued my recovery was quick.

I’m wishing you positive energy tomorrow knowing you are in good hands. How are you feeling today? Will you return here when you’re ready and let me know how everything went?

REPLY
View MoreView Less
Please sign in or register to post a reply.