Menopause and Hysteroscopy - Menopause Message Board

nornie · 09-19-2005, 08:30 PM

Hello ladies,

Not sure this is the best place to ask this question as most of you are still having periods. But of the few who still post here and are post-menopausal (Hellas, Molly, Twanger...) maybe one of you might be able to help. Sorry for the lengthy post, but I don't know how to shorten it.

In 2003 I had a short, light period (definitely a period not just bleeding) at 14 months post and my gyn said we should do a biopsy to be safe, but said he couldn't in the office because of another problem I had at the time, so he did a D&C. All was fine, but I couldn't stop bleeding after the D&C and eventually had to take BCPs for a month to get the bleeding to stop. Not a pleasant experience. I had gone to another gyn for a 2nd opinion about why I had so much bleeding afterwards and she did an ultrasound in her office and said I had a uterine polyp which was missed on the D&C and it probably got nicked during the scraping and that's why I was bleeding. It was at this time it was discovered I was severly hypothyroid and so I paid attention to getting that regulated and all was fine for 2 years.

Here we are today and I've posted before about my bouts of bloat which come and go. My last bout in early August was really bad and I got so scared I asked for another ultrasound. Of course the day of the ultrasound all the bloat had disappeared and has not returned. Nevertheless, this 2nd ultrasound showed the ovaries were normal (what I was concerned about with the bloat) but it also showed the aforementioned uterine polyp. Now my gyn wants to do another D&C. I asked him if he did a hysteroscopy during the first one (because I figured if he had done it then he would have seen the uterine polyp, removed it, and I wouldn't be facing a second D&C!) Anyway, he said he never does them on post-menopausal women because the cervix is too rigid. So without hysteroscopy, how is he going to remove the polyp now? I asked him that and he said, "well, I'll just scrape everything out." Huh? I thought that you could still "miss" a polyp on the scraping and I'm afraid I"ll end up as before with continuous bleeding after the D&C. He then said that he could see if they have a really thin scope in the O.R. that he could use. Now my confidence is not very high - if he doesn't know if they have a thin hysteroscope he's obviously never done one on a post-menopausal woman! This doc is listed in the Top Doctors book and is very well-respected around here. I don't know what to do. Has anyone heard of this - that hysteroscopy is not performed on post-menopausal women? Would a D&C without hysteroscopy remove a polyp? Should I go ahead or get another opinion? Find another doctor?

I would really appreciate any thoughts, advice. I'm so scared, worried, confused, nervous, you name it. If you've managed to read through this whole post, thank you!

Nornie

LINDA505 · 09-20-2005, 08:57 AM

Dear Nornie,
I Am Post Menopausal For 5 Yrs. And Had Spotting . I Had Pms, Sore Breasts
And Everything Prior To The Spotting. 34 Days Later The Same Thing...sore
Breasts, Pms. Had An Endo Bx Which Showed Mild Disordered Proliferative
Endometrium. Transvaginal U.s Showed Endo Thickening Of 8mm. I Am Going
Friday For A Hysteroscopy And D And C. The Female Gyn I Go To Said She Does This Procedure Every Week On Post Meno Women Who Have Bleeding Or
Spotting. She Also Told Me That If Doesn't Matter If You Had Spotting Or
Bleeding It Is Treated The Same Way. Did You Have A Thickened Endometrial
Lining When This Was First Done? I Still Am Confused As To Why This Has
Happened To Me And I Am Hoping That She Will Find A Polyp And That Will Be
The Cause. Endo Bx's Are Not A 100% As She Said That Even Though It Did Not State That I Did Ot Have A Polyp I Could Still Have One. Also The U.s
Is Not 100% Accurate As You Can Still Have A Fibroid Or Polyp That Did Not
Show Because Of Where It Is And Also The Technician May Not Be As Experienced In This. I Do Not Understand Some Of These Doctors And Feel That They Just Don't Want To Be Bothered With Doing The Right Thing. My
Gyn Told Me That The Hysterscope Is As Small Around As A Pencil. I Would
Imagine That If A Child Could Get Through Your Cervix A Pencil Would. I Would Think That The Only Way To Get A Good Result Is For The Gyn To See
What The State Of Your Uterus Is In And That Can Only Be Done With The
Use Of A Hysterscope. Find Another Gyn Who Will Do This Procedure On You
And Save Yourself All The Worry. I Can Certainly Understand What You Are
Going Through. This Has Been For Me Since June And Here It Is Almost Oct.
And I Still Have To Wait And Wonder What God Has In Store For Me. I Pray For The Both Of Us That We Will Get Through This And Move On With Life.
If You Would Like To Email Me My Email Is Lev505@ntelos.net. Good Luck
And Let Me Know How You Are Doing
Linda

nornie · 09-20-2005, 09:18 AM

Linda,

Thank you so much for your reply! You have inspired me to call around to find another doctor. It's so hard to do that though, I hate going to new doctors and there just don't seem to be many good ones around here. Anyhow, I'm so sorry you are going through so much anguish. Try not to worry so much, it only makes everything worse. Since you had all those PMS symptoms, sounds like you are just having a hormonal imbalance. You can get that from an estrogen surge and it will also thicken the endometrium sine we are not regularly having periods at this stage. This seems to be a fairly common problem these days, we get estrogen from the foods we eat, the air we breathe. Do you by any chance eat alot of soy? I've heard that OD'ing on soy can give you more estrogen too. Since you didn't say whether you are on hormones - I'll assume you're not - but that could certainly induce bleeding. I'm glad you are getting your procedure done soon and it will put your mind at rest. Again, please don't worry. I know it's so easy to say as people tell me that too and yet I'm a nervous wreck. I can put it out of my mind for a bit, then the what-ifs come back full force.

I never had children, so maybe my cervix is extra-tight and that is why he won't do it. But I'm certainly going to seek another doctor anyhow. Just the fact that he didn't know whether the OR has a thin tube was very disappointing. And this doctor is chairman of the ob/gyn department! Scary.

Let us know how you are doing, too.

Nornie

LINDA505 · 09-20-2005, 02:58 PM

Nornie,
Thank you for your kind words as well and if you are not in any kind of hurry to get this
procedure done I would call your local hospitals and ask for the physician referral and see if they know of anyone who does this procedure on post meno women. I worked in
a hospital in Florida for 10 years and we had a referral line. You can also ask for the patient advocate in the hospital and talk with them. I know our hospital was very good
about helping patients in and out of the hospital.
Yes, I was eatting boca burgers about 3 or 4 times a week but the gyn said that would not do it. I also lost weight about 18 lbs in 3 months and I know that weight loss
can cause some estrogen to be released from the fat cells. I have discussed this with the Doctor but she still does not think it has anything to do with the spotting. I feel
it does to some extent as all this started to happen when I started to miss doses on
my Synthroid and was on a diet and had alot of stress and anxiety during that time.
I am not on hormones but will consider taking natural progesterone if my problem is
hormonal. I must have unopposed estrogen as my bx and ultra sound shows that I do.
I trust my Doc but i also know my own body and know that when I felt this surge of
Estrogen I stopped having hot flashes which I had every day for over 5 yrs.
Well enough about me........I know that there is a drug that you can take to dilate your cervix. I think it is Cytotec which was orginally prescribed for another problem but look it up and see if that is the drug they use. I agree that if this doctor is the
chairman of the ob.gyn department he should know what type of equipment is available in the OR. If you can wait I would and get it done right this time. My gyn said that is the only way to get a good scraping. Also, your thyroid can cause bloating. I had bloating for years on and off .When my thyroid was off I also experienced my eyes feeling weird and migratory bone and muscle pain. Let me know what you find out and Good Luck in your search.

Linda

LINDA505 · 09-20-2005, 03:11 PM

nornie,
I just checked out Cytotec and yes they use it to dilate the cervix. It is given orally
600 mcg or 400 mcg vaginally the night before the procedure. I remember we use to give it to patients along with NSIADS so they would not get ulcers. It nice to know that they brain is still working for me. All is not lost!!!!!!!!
Hope that this helps.