Post menopausal, scheduled for an endometrial biopsy (pain, cyst, bleeding)

[Giesela]

I recently had a transvaginal ultrasound that found that my endometrial lining is greater than 5mm and there was also something that looked like either a cyst or a polyp (the nurse used both words on the phone but she wasn't the nurse who reviewed the ultrasound).

I'm 59, menopause done at 51. I am guessing the most likely reason for checking and outcome is cancer or pre-cancer?

I feel like I should be flipping out. I normally do except when its serious when I sort of ignore it. Should I guess I should be flipping out about not flipping out I was planning on retiring next year

Anyone with any first or second hand experience with this sort of thing? I have none.

[Hedgehog_Mom]

I'm in my 30's, no sign of menopause yet. I am quite overweight which is a risk factor for problems with the endometrial lining. I had heavy menstrual bleeding that went on for a couple of months, so I had an ultrasound done and it showed thickened endometrial lining. I had the biopsy the same day and got my results a couple of weeks later, which showed complex endometrial hyperplasia w/o atypia.

Basically, there are four stages:

simple hyperplasia w/o atypia
simple hyperplasia w atypia
complex hyperplasia w/o atypia
complex hyperplasia w atypia

Generally complex hyperplasia with atypia is considered the first stage of endometrial cancer.

My doctor prescribed Provera. It helped with my bleeding at first but I hemorrhaged a couple of months later and ended up in the ER. They did another biopsy which did not show any hyperplasia...basically the Provera had cleared it up. But that meant I had to have a hysteroscopy and D&C to make sure they hadn't just done the biopsy in places that missed the precancerous cells. After the D&C, the doctor (not my usual ob/gyn) told me that the tissue she saw on the scope looked very abnormal and she was assuming it was all cancerous, so she cut out as much as possible for testing. She also removed a polyp. When the test results came back, there was no cancer and no hyperplasia. I've had a couple of biopsies since then and they've all come back clean.


About the biopsy, it's a little more uncomfortable than a pap smear. I would suggest taking some ibuprofen before the appointment. The biopsy can cause some cramping. Usually they'll have you lie down for a while after the biopsy. I insisted on sitting up sooner than they recommended once, and I fainted.

[Giesela]

Hedgehog_Mom,

Thank you for your reply. I haven't done a ton of googling yet so am still a bit unsure whether I should be worried about entrometrial cancer or uterus cancer or both/don't have enough info yet to distinguish.
This site gives survival rates for both
Survival by stage of endometrial cancer

Since I have something that looks like a polyp or cycst I'm assuming I'll end up with a D&C and am sort of wondering why they just don't go straight to that vs the lining biopsy.
I need to call Monday and ask some of these questions.
I have decent health insurance and am pretty good about asking the Dr questions but really haven't had any issues so its been mostly a non issue. The one little thing that I didn't thing was anything (the tiniest bits of blood on my panti liner over many years since menopause) is now the one thing that I should have paid attention to. The amount of time this has been going on is what is freaking me out the most. Survival rates go down pretty fast when caught late.

Glad you've been coming up in the clear.

[Hedgehog_Mom]

The biopsy is done in the doctor's office without any anesthesia. It's pretty quick, a minute or two. They insert a speculum, then a tool to hold the cervix steady (that's what can cause cramping), then a couple of very thin flexible straws to take the samples, which feel like a sharp scratch or a poke. I'm usually a little crampy the rest of the day and fine after that.

When I had the D&C and hysteroscopy, it was supposed to be an outpatient procedure but I had to stay in the hospital overnight and then I wasn't supposed to lift anything for 3 weeks and they prescribed pain pills to take during those three weeks. So it was a bigger deal than I thought it was going to be. It cost me about $2200, even with very good insurance, and the biopsy usually ends up costing me about $170, so I definitely prefer the biopsy.

I had problems for about three years before I had the really heavy bleeding that scared me enough to see a doctor. I was really heavy (between 350 and 400 lbs) and speculum exams are difficult and uncomfortable at that weight, so I put it off until I was bleeding so much that I had no choice. My doctor told me later that a lot of women that size are so shy about seeing a doctor that they wait until it's too late for the problem to be treated easily. In a way, I was lucky that I had really heavy bleeding that forced me to get treatment.

[Nightengale212]

Originally Posted by Giesela

I recently had a transvaginal ultrasound that found that my endometrial lining is greater than 5mm and there was also something that looked like either a cyst or a polyp (the nurse used both words on the phone but she wasn't the nurse who reviewed the ultrasound).

I'm 59, menopause done at 51. I am guessing the most likely reason for checking and outcome is cancer or pre-cancer?

I feel like I should be flipping out. I normally do except when its serious when I sort of ignore it. Should I guess I should be flipping out about not flipping out I was planning on retiring next year

Anyone with any first or second hand experience with this sort of thing? I have none.

This coming January will mark my 12th year as an endometrial cancer survivor My story began when I was age 44 and my period stopped which made me suspect I was entering menopause. At that time I noticed I had developed an intermittent very light pink scant discharge, and when that did not resolve in a few months I made my way to the doctor as I had this sinking feeling something was seriously wrong. I had my gyn exam and following my doctor said all looked good and felt my symptoms indicated I was likely entering menopause. I then blurted out I know something is seriously wrong with me!! My doctor responded to my outburst saying he knows better than to argue with a nurse, and then sent me back into the exam room to get undressed as he was going to perform and endometrial biopsy. Yes, this procedure was painful for me but only for a few seconds and I did not have any pre procedure pain meds.

A week later my doctor called to inform me that I had endometrial cancer. But the good news was from what he could tell from the biopsy he felt confident my cancer was at an early stage. My surgery was scheduled two weeks later, and prior had a CT scan and other tests which all turned out normal. My surgery was a total abdominal hysterectomy which included removal of my ovaries, and all pathology done during my surgery came back very low stage and grade which meant I would need no further treatment.

I recovered pretty well except for having my staples removed too soon which caused my surgical wound to split open leaving a gaping hole but that eventually healed in time. Today Davinci robotic surgery has replaced the procedure I had which leaves almost no surgical scar and recovery much quicker. I guess the worst for me was going through surgical menopause at about 6 months post op which I felt like I stepped into a different body and brain!! Since my cancer was estrogen driven, I could take no hormone supplements so little gave me symptom relief but within a year I was back to normal which was a very small price to pay for having a 2nd chance at life.

I consider myself one lucky lady!! I wish you a clean bill of health, and if you should have any additional questions that you think I may be able to answer for you do not hesitate to send me a pm.