Advice for diagnosis of Endometrial Hyperplasia and bleeding

Posted by misty51 @misty51, Sep 22 2:24pm

Hi, it's nice to find a support network like this. I'm a 51 yof who is in menopause and I have been for about 2 years now. I stopped having periods about a year and a half ago, outside of spotting here and there. I began having midline backpain that goes into my buttocks and sometimes down my right leg. I had a transvaginal ultrasound that showed 14 mm thickening of uterine tissue. I went to my ob/gyn yesterday and up until then I had not had very much bleeding/spotting. Yesterday she told me she felt I am in a grey area of menopause and she is scheduling for a endometrial biopsy. I am very scared because I'll be awake but they will be giving me loopy oral meds that they say will help me relax. I'm very worried because the very next day I began having more than spotting, almost like the beginning of a period with breast tenderness. I have severe midline back pain somedays and I believe it is due to potential endometriosis. I had 3 C-sections in the past. I just don't understand what is happening and am so worried. Has anyone else had these symptoms? Anyone had the endometrial biopsy while awake but given oral relaxation meds?

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I had a biopsy to see if I had endometrial cancer so I think it is the same type of biopsy you are referring to, but I’m not sure. The nurse suggested I take 3 Advils 1 hour before my appointment. It helped and I got through it. I see you have had 3 c-sections. I have never been pregnant so I don’t know much about pain and I have to say the biopsy procedure went quickly. A nurse was there as the Gyn performed the procedure and helped me with breathing to help keep me relaxed and focus.

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I had a failed attempt at an endometrial biopsy with no drugs at all. They were unable to push the little plastic stick through the cervix. It wasn't that painful, but then again, they didn't get a sample of the endometrium. From reading this forum, failed endometrial biopsies seem to be pretty common. Some doctors prescribe vaginal misoprostol pills beforehand, which apparently increase the success rate. Might be worth asking about.

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@pugpeople

I had a biopsy to see if I had endometrial cancer so I think it is the same type of biopsy you are referring to, but I’m not sure. The nurse suggested I take 3 Advils 1 hour before my appointment. It helped and I got through it. I see you have had 3 c-sections. I have never been pregnant so I don’t know much about pain and I have to say the biopsy procedure went quickly. A nurse was there as the Gyn performed the procedure and helped me with breathing to help keep me relaxed and focus.

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Yes, it is the same biopsy. I've read too much on it and I have anxiety anyway so now I am extremely nervous that it is going to be very painful. Can I ask you how everything turned out for yourself? Thank you for replying too, I really appreciate it!

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@val64

I had a failed attempt at an endometrial biopsy with no drugs at all. They were unable to push the little plastic stick through the cervix. It wasn't that painful, but then again, they didn't get a sample of the endometrium. From reading this forum, failed endometrial biopsies seem to be pretty common. Some doctors prescribe vaginal misoprostol pills beforehand, which apparently increase the success rate. Might be worth asking about.

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Were you having any of the symptoms that I am? They say they don 't think the midline backpain is related, but I know it is. For instance, yesterday that pain was more severe and the bleeding was more than spotting 🙁 It is very similar to my periods in the past, the pain in the back I mean. I had that same pain when I was younger. Thank you for taking the time to reply!

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@misty51

Were you having any of the symptoms that I am? They say they don 't think the midline backpain is related, but I know it is. For instance, yesterday that pain was more severe and the bleeding was more than spotting 🙁 It is very similar to my periods in the past, the pain in the back I mean. I had that same pain when I was younger. Thank you for taking the time to reply!

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I had basically no symptoms (of what did turn out to be endometrial cancer) other than very minimal postmenopausal bleeding. When I was in perimenopause, about 3 years earlier, I had crazy bleeding with multi-month gaps in between, which at the time I assumed was just how perimenopause was. But maybe it was a sign of problems.

Waiting for tests and results is miserable and anxiety provoking, but unfortunately there isn't much you can do but let the testing play out and see what the doctors say. There are probably several conditions that can cause symptoms like that. Try to think about other things instead of worrying. Good luck with the biopsy.

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misty51 @misty51
I am sorry you are dealing with this, but I can relate. In July of 2021 I began bleeding very irregularly. At first it was every other week and then most days with only a day or so break in between. I was 47 and at first thought it was perimenopause. I scheduled an appointment with my PCP and she ordered an ultrasound and it came back with the endometrial strip being slightly thickened (I think is was 13mm) my pap smear came back fine so she started me on progesterone and said the bleeding would stop in a few days (which it did not). Once the ultrasound results were in she had the nurse call me and I told her I was still bleeding quite heavily so she sent me to a gynecologist and she agreed with my PCP that it was probably perimenopause but said for peace of mind she wanted to do an endometrial biopsy and she did it in the office that day. It hurt briefly and I had what she called uterine spasms for 24 hours or so and significantly more bleeding for a couple days. I took a few advil during that time and it wasn't bad. I got the results about a week later and they said I had complex hyperplasia with atypia, but that it was suspicious for adenocarcinoma. I was scheduled for a complete hysterectomy (including ovaries) a few weeks later. Other than the constant bleedimg I had pain that was in my lower stomach much like period cramps. I woke up after my laproscopic hysterectomy in a bit of pain from the procedure but the constant pain that I had for months prior was gone. I was given pain medication for afterwards but didn't need it. My tumor was pretty large and my uterus was very enlarged but that didn't show up with the ultrasound. Everything was contained so no treatments were required at that time.

It is a scary time but remember we are all different and all are here for you.

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@misty51

Yes, it is the same biopsy. I've read too much on it and I have anxiety anyway so now I am extremely nervous that it is going to be very painful. Can I ask you how everything turned out for yourself? Thank you for replying too, I really appreciate it!

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I had bleeding, I’m in my 60’s so definitely not normal. The biopsy and a follow up D & C was performed. It was confirmed I had cancer. Full robotic laparoscopic hysterectomy a few weeks later. I was shocked that I had no pain recuperating…discomfort but I didn’t need to take Tylenol or advil after around the 4th or so day. Now quarterly for one more year I get a pelvic exam. Next year it will change to every 6 months. Watching for bleeding and staying vigilant. I was so blessed from the first sign of bleeding to the surgery….it was 1 month. Early detection and quick response by medical staff made my experience better than most.

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@misty51

Were you having any of the symptoms that I am? They say they don 't think the midline backpain is related, but I know it is. For instance, yesterday that pain was more severe and the bleeding was more than spotting 🙁 It is very similar to my periods in the past, the pain in the back I mean. I had that same pain when I was younger. Thank you for taking the time to reply!

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@misty51 When I get anxious about an upcoming procedure I tell myself that having the test or screening is far better than doing nothing. I’ve had so much experience with anticipatory anxiety that I can also reassure myself that the anxiety before a procedure is much worse than the actual test or procedure.

I didn’t have an endometrial biopsy when I developed spotting. I was post menopausal. My gynecologist first ordered an ultrasound and then we went straight to a D&C. I’ve talked with people who experienced pain with an endometrial biopsy and some who did not. There are lots of good suggestions here on how to prepare yourself. And ask the doctor or nurse for suggestions too.

When is the endometrial biopsy scheduled?

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@naturegirl5

@misty51 When I get anxious about an upcoming procedure I tell myself that having the test or screening is far better than doing nothing. I’ve had so much experience with anticipatory anxiety that I can also reassure myself that the anxiety before a procedure is much worse than the actual test or procedure.

I didn’t have an endometrial biopsy when I developed spotting. I was post menopausal. My gynecologist first ordered an ultrasound and then we went straight to a D&C. I’ve talked with people who experienced pain with an endometrial biopsy and some who did not. There are lots of good suggestions here on how to prepare yourself. And ask the doctor or nurse for suggestions too.

When is the endometrial biopsy scheduled?

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It is Oct 10 but i am thinking a hysterscopy would be a much better option for me. I have every symptom of endometriosis and the hysterscopy would be far more detailed and beneficial!

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@misty51

It is Oct 10 but i am thinking a hysterscopy would be a much better option for me. I have every symptom of endometriosis and the hysterscopy would be far more detailed and beneficial!

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@misty51. Thanks for letting me know your appointment date. Can you talk with your doctor before the appointment to see if a hysteroscopy is possible? I had a hysteroscopy with the D&C and I had light anesthesia for the procedure. I don’t recall being awake or feeling any pain during the procedure. I was uncomfortable afterwards because there the doctor introduces carbon dioxide into the uterus in order to inflate it to the procedure. But the pain went away quickly and within an hour or so I only took Tylenol.

When do you think you’ll talk with your doctor? Is there a patient portal where you can message them with your question?

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