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Old 04-02-2013, 06:12 PM   #1
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Biopsies, Scopes & Needles..Oh,My!

During my last physical my doctor felt my uterus was enlarged, irregular and firm and sent me for an abdominal and transvaginal ultrasound.

The results? Polyp and fluid in endometrial cavity, and 3 fibroids. I am 4 years POST menopause and I have never had a fibroid or polyp before. I was under the assumption fibroids got smaller after meno....I didn't think I could grow some! My doctor referred me to a gynecologist, she said the polyp definately had to be removed and the fibroids checked.

Can anybody enlighten me as to what tests I'll probably have to have? What is an endometrial biopsy like? I've read polyps are removed by hysteroscopy, sometimes with a D & C to check if fibroids have any atypical cells. Would they do an endo biopsy and a hysteroscopy? Can they just check the fibroids while they do the hysteroscopy, and forget the endo biopsy.

Yes, I am a big chicken......I'm more worried about the tests than the findings. I'm told both fibroids and polyps are rarely malignant. Do they ever just leave them alone. Thanks for any answers!
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Old 04-03-2013, 10:11 AM   #2
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Re: Biopsies, Scopes & Needles..Oh,My!

Fibroids usually have a growth spurt just before menopause. I wonder if yours developed then and have just taken this long to grow. I do know of women who developed fibroids around the time of menopause and they didn't shrink after meno. Some women don't have as great a drop in their estrogen at menopause so it would seem reasonable that their fibroids may not shrink. Also, the testosterone still being produced by your ovaries post-meno gets converted into estrogen feeding the fibroids. And estrogenic foods can also feed fibroids. I believe some meds and health conditions can also increase chances of fibroids and polyps. For example, estrogen antagonists used for breast cancer (e.g. Tamoxifen) increases risk for polyps and even endometrial cancer.

Yes, fibroids and polyps are VERY RARELY malignant (I believe less than 1%).
And I've always read that they don't need to be treated if they aren't causing problems such as heavy bleeding or pain.

As far as biopsies, an endometrial biopsy will check for abnormal cells in the uterine lining...not sure if it can be used to check the fibroids. Some women say it's quite painful; others say it wasn't a big deal. I had one and it wasn't a big deal. You may want to ask about taking a painkiller beforehand if you decide to proceed.

If you decide to have the polyp removed, they usually do a polypectomy and then send it off for biopsy. If the fibroids are small and you want them removed, they may be able to remove them with the hysteroscope. But some doctors have different skills than others so this may not be offered to you.

 
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Old 04-03-2013, 01:24 PM   #3
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Re: Biopsies, Scopes & Needles..Oh,My!

Thank you for your answer! I see my regular doctor tomorrow to go over the results, and the gynecologist she referred me to can get me in next week. I won't have to wait very long for answers.

I'm pretty sure the fibroids are new. Right before menopause, I had several vag/ultrasounds to check the lining of my uterus and to watch ovarian cysts. I had chronic anemia, so I'm sure they checked for fibroids. As soon as my period stopped so did the chronic anemia. I've had pelvic exams every year and this is the first time the doctor noticed any difference.

Also, I haven't had even one spot of blood since my period stopped, and with all the prodding I've had lately, there still isn't any blood. The fluid around the polyp was determined to be blood on the ultrasound, but none of it has leaked.

I was hoping the lack of any bleeding would be a good enough reason to leave well enough alone! I guess I'll know more tomorrow. Thanks!
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