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    Old 12-14-2005, 08:53 AM   #1
    Marise5
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    Senior, post menopausal bleeding

    Hi. I am a newbie here and just turned 70. My health is generally good, except for some high blood pressure for which I have taken three medications for some years. I have had bleeding now for about 3 weeks (it is 20 years plus since menopause!) I should get the results of a pap next week and am going for a pelvic ultrasound on the 29th.
    The research shows that only about 28% of pm bleeding turns out to be cancer, and someone mentioned that medications can be a cause of this bleeding.
    What kinds of medication? and what other causes are there?
    Would appreciate any information you can give me.
    Thanks, Marise

     
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    Old 12-30-2005, 08:30 PM   #2
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    Re: Senior, post menopausal bleeding

    I am sorry you are going throught this and glad you've consulted your doctor, as all post-menopausal bleeding requires investigation.
    A shift in hormones can cause post menopausal bleeding. HRT (Hormone replacement therapy) could cause this, as can other medicines that might affect a woman's hormones. (My 74 yo mom had a new onset of hotflashes when she started her osteoporosis medication.) Our fat cells can also produce estrogens, so some women can have PMB related to weight, or a change in weight. Sometimes those women might have a Progestin Rx'd to keep the estrogen in balance and help keep the uterine lining healthy.

    On the other end of the spectrum, too little estrogen can cause Vaginal atrophy (thinning of the tissues) and dryness can make the lining more suseptible to bleeding much the same way a nose bleed can occur. Sometimes adding a small amount of vaginal estrogen helps keep the vaginal tissues healthy when this is the cause. (I use a prescription cream.)
    Did your doctor do an endometrial biospy during your pap? (Procedure is very similar to the sample taken from the cervix, but the sample is taken from the inner lining of the uterus and sent for pathology to look for abnormal cells.)

    I hope your ultrasound is okay and hope nothing serious is found. Whatever the cause, I think it's important to be diligent about your follow-ups. Good luck with your work-up. Please keep us posted.

    Sending prayers & a hug your way.

     
    Old 12-31-2005, 08:12 AM   #3
    Marise5
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    Re: Senior, post menopausal bleeding

    Welshterriermom, Thanks very much for a taking the time to reply. Like most of us I did have HRT around menopause but not since. I am a little overweight so estrogens may be the cause. I was moving heavy furniture around my apartment for a few days before it started - so it's possible the strain could have released a buildup of the lining?? I think I do have atrophy but the Doc.said everything looked "healthy" when he did the pap.
    No biopsy - it was hard enough doing the pap (I am such a coward!).
    The US took a long time and the technician was very serious - took lots of pictures and ending up looking at me with great sympathy as I left, and wishing me "good luck". It's funny how you look for these clues, is'nt it.
    Doctor also has me scheduled with a Gynecologist pending the US results.
    I don't have friends I can confide in and I don't want to worry my son with this until I know something for sure. Anyway, thanks again for your thoughtful reply and support.

     
    Old 01-04-2006, 02:53 PM   #4
    Marise5
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    Re: Senior, post menopausal bleeding

    Hi. I went for results today, pap was normal, estrogen was high, my doc was all set to put me on progesterone until he saw the US results. Not good!Apparently I have a 5 cm mass in the lining of my uterus and a 7 cm one in my right ovary. The report says they are "suspicious for carcinoma". Doctor said probably they will do a hysterectomy and got me an appointment with a Gynecologist next Tuesday.
    I am going to ask him about getting a PET scan, because if it is cancer that has spread already then I want to know the extent before deciding on treatment. PET scans advertise that they can do a whole body scan and see a lot more detail than US or even MI. Only drawback is that they are not covered by ohip yet so I would have to pay.
    I told my son that they had found "something" suspicious and I may have to have an operation. I also told him about one of these posts about a 73 year old having an hysterectomy and still going stong at 87. So he is concerned but not too upset. I am surprisingly philisophical about it so far, or is the word "fatalistic"?
    I hope you don't mind my posting in detail. I thought it would be good for any readers in the future to see the whole story.

     
    Old 01-04-2006, 03:46 PM   #5
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    Re: Senior, post menopausal bleeding

    Hi i'm trying to find out answer to something.......i had an ultrasound done because of post/menopausal bleeding (i've been on HRT's for about 15 years and never had this untili now).........dr. says i have 7mm thickness and wants to get tissue biopsy. Says 4mm is "normal" but since I'm on HRT's maybe 7mm is normal? She didn't know. Any way i can find this out. In the meantime, i have a choice to be "out" for this procedure or using vicodin and something to make me sleepy. I DO NOT DO PAIN. Last time she tried to do this it hurt too much, but i had no meds. Thank you.

     
    Old 01-04-2006, 04:27 PM   #6
    Marise5
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    Re: Senior, post menopausal bleeding

    Hi Dyrosie. It is important, as you can see by my previous posts, to find out why you are having the bleeding. I am a total coward too when it comes to tests and things. Even when I had my teeth out I opted for a general - "Just do what you have to and wake me up when it's over!"
    Nevertheless you have to consider that general anaesthesia has it's risks too. With my pap I told the Doctor how painful this was for me some years before - he said that instruments had changed now. Back then they were stainless steel and came in one size fits all. Now they are plastic and come in a range of sizes. It was'nt comfortable - but bearable. Good luck.

     
    Old 01-04-2006, 04:41 PM   #7
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    Re: Senior, post menopausal bleeding

    Ladies.. I will keep you in my thoughts and prayers.. I had post menapausal bleeding a few years ago. Actually I just thought the whole thing was the last hurrah..fortunately I went in to have it checked out. I did pretty much the usual routine..had the ultra sound..found a thickened lining. I can't remember now what it was..14 maybe? or 7 cm.? Anyway..then had the biopsy. I took a vicodan and a valium..it was not a problem..little pinch maybe..that was it. So..didn't even give the results too much thought..just put it out of my mind..got a call within a week..it was endometrial cancer. It is actually a good kind of cancer generally. Funny to hear someone tell you that isn't it?

    Well...had the surgery..they took everything out. No spread. Early stage and early grade and no further treatment. Just close check ups. Please Please Please insist on seeing a gyn/oncologist for this surgery. If they know it's cancer they will usually offer to make that referral. The reason you want that kind of doctor is that the actual surgery is different. It's much more complex, they take a look at much more tissue, sample lymph nodes and know exactly where to look to take it all out and make sure they have a very good picture of what's what. Please don't skip this part.. a gyn/onc is very important. I know more women who have had to go back for surgery cause the pathology comes back and they have to go back in and take more out. Believe me, you don't want that to happen. This is a great site for info but there are other ones that are very helpful also. I found such wisdom from ladies... our sisters having hysters...do a google search and you'll find some good places. The women who have been through it all can offer great tips and support. Let us know how things go. We are here to support those that need to have surgery maybe. If it ends up being cancer..please know "it's the good kind".. hmm...you just have to laugh!

     
    Old 01-04-2006, 04:45 PM   #8
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    Re: Senior, post menopausal bleeding

    Marise, thank you for responding. I think i'd be in "twilight" sleep which has less risks. I totallly freaked out last time she tried to do it. And it WAS with the thin plastic tubing, and i stood it, so i thought, but apparently, she didn't get enough sample and now has to make "several passes" which just fills me full of too much anxiety. I'm in GREAT health, i work out, walk, etc. Good blood pressure and appropriate weight, so I should be ok with twilight sleep.
    I cannot do the dentist without nitrus. In fact, I had two crowns done and one i still can't chew on that side or eat cold things but i refuse to go thru that again, so I just chew on the right side and it hasn't hurt me to forgo ice cream!
    What did they find out with you? Do you have to have any more treatments/procedures? Were you ever on HRT's? I tried to go off once and want to try again, but I was a mess!

    Last edited by dvrosie; 01-04-2006 at 04:47 PM. Reason: misspelled words

     
    Old 01-04-2006, 04:56 PM   #9
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    Re: Josie115

    Josie, Were you ever on HRT's? Do you think they are more harmful? I've been on way too long, but tried to go off once and i was a mess! I'm 58, in good health, walk, exercise, etc. Did they "get it all" and you didn't have to go thru chemo/radiation? I probably will be put "out" or in twilight sleep for the biopsy. It is very uncomfortable/ she tried to do it once but didn't get enough tissue sample.

    Last edited by moderator2; 01-06-2006 at 08:29 AM. Reason: no emails - please read and follow the posting rules

     
    Old 01-05-2006, 04:27 AM   #10
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    Re: Senior, post menopausal bleeding

    To answer a couple of questions... yes they got it all. You always will think about it..you almost never stop thinking it could be somewhere else...we all call that cancer head. You of course are probably thinking the worse and let me tell you.. everyone does it. It's just natural and believe me, it's the worst part of getting a cancer dx. You may have a very simple fibroid..who knows, but the waiting and tests are what gets you!

    I didn't have a problem with having the biopsy. Plus.. when my doctor called she said she was VERY confident that it was caught early and that surgery was all I would need because she got "good samples". So, if you need twilight sleep..go for it. You want them to be able to get anything and everything they need to make sure you get the right dx. before surgery. Also, it happens that you can go ahead with the surgery and the final pathology comes out different from the "clinical" dx. So..the better the clinical (uterine biopsy), the better the chances of no surprises once they go for surgery.

    If...and remember it's still an if...you get a ca dx. they will give you a grade and a type...staging is done during surgery so, from the biopsy you'll get (if it is cancer) a grade..1,2,3...the higher the grade the more aggressive the cells are..mine was 1. Since it was also higher in the uterus, it meant that it was more likely to have not involved the cervix and that is a good thing apparently. My situation ended up being that I was staged as a 1a and grade 1, adenocarcinoma. I go every 6 months for a peek..no big deal. Since it was so early and so low grade I think they even think I could go less often..it's slow growing ... in my mind.. it's still a good reason to keep a good eye on everything and I always feel better after a check up.

    ..have to run to work now, but will be back later in the afternoon.. you'll be ok!

    Last edited by moderator2; 01-06-2006 at 08:31 AM.

     
    Old 01-05-2006, 01:15 PM   #11
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    Re: reply back to Josie 1-5

    josie, thank you so much! you are being wonderful to a complete stranger. I guess this is the only way to communicate. I live in CA. are you in another time zone? i am a little weepy today, just running thru my options. I think the twilight sleep is better for me, but..........the dr. can't schedule the OR until Feb. 16 and i might be a wreck by that time! i don't know how effective the meds will be that she'd give me, the vicodin and all, so it's just not clear. She told me on the phone that she doesn't think it's cancer, but she didnt' say why. she's very thorough and i have complete faith in her. I did lots of internet checking, of course, and i really only have two of the five listed symptoms. You were VERY lucky. If this isn't too personal, i'd like to ask a question.........I had about two weeks of light/spotty bleeding, then it just went AWAY! Then about a month later, a couple of days ago, i had just one incident, and it went AWAY again! I wonder if it is cancer, does the bleeding continue and not stop? Also, you didn't say if you were ever on HRT's because i read conflicting things about that being good/bad for causing uterine cancer. Ok thanks again for your help and i'm VERY happy for your early detection and clean bill of health! Rosie

     
    Old 01-05-2006, 04:43 PM   #12
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    Re: Senior, post menopausal bleeding

    DVRosie...

    Sorry to have not answered the HRT question.. yes, I was on it but for a very brief time about 10 years ago. I was having major hot flashes and I went on premarin. Since I'm almost 53 (next week) it was early for real menapause but they were making me nuts. I probably stayed on them for about a year.

    I kept having regular periods until I was about 49 and I went on the shot for birth control..(more to get the periods to stop).. the cramps were killing me. Anyway.. I was only on that for about 9 months and quit. Then..I just didn't have any real periods after that...I'd have one and then 6-9 months another. Then almost a year would go by and then wham...the period of all periods. It just came out of the blue..a gusher that didn't quit. I was at work and wasn't sure if I should go home or straight to the er... well..I stopped by the drug store and then went home. This happened in november and the bleeding settled into a hard period for a few weeks and then tapered to just an annoying flow..not heavy for weeks and weeks. I think it was late january when I finally went to see my doc. That started the process and I had surgery in April. If I had known what I was in for, I'd have scheduled the surgery for the next day...as it was, I like to know everything, wanted time to research and then, was so reassured by my doc that it was early and no big rush..I scheduled it 6 weeks from when I learned it was cancer.

    As far as risk factors.. who knows. I was overweight for many years but had lost weight slowly over a few good years (about 70 lbs) Also, I'm diabetic. I started periods late (I was 16) have 2 daughters and I guess fairly early menapause? So.. who knows about risk factors.

    If your doctor said she didn't think it was cancer..then I'd be very reassured. Most doctors will not say that if there is a chance that it is. What she saw or why she felt she could say that is anyone's guess but if you like her and feel comfortable with her, than I'd be very reassured by that comment.

    The wait for the twilite sleep? That's a tough one. The worst part of that will be the amount of time you have to worry yourself sick about it. I can relate. On the other hand, if you have a hard time getting a good biopsy otherwise, I'd go for the later date. I just didn't have any problems for some reason with the biopsy. The waiting is always the worst part of all of this..

    I am in Ohio. Anyway.. I'm always happy to help. I needed support and help when I was facing all the unknowns and my family all lives out of state. I'd only lived here a year.. it was rough.

    So..any other questions or just need to chat or vent, that's what it's all about here. Just wish you didn't have to even deal with it!!

    Last edited by moderator2; 01-06-2006 at 08:30 AM. Reason: please read and follow the posting rules

     
    Old 01-06-2006, 01:06 PM   #13
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    Re: Senior, post menopausal bleeding

    Josie, sounds like you REALLY had a tough time. It also sounds like you're a strong woman! I am 58, started menopause WAY early, like 40 or 45, i can't really remember. My doctor doesn't seem to have an opinion about HRT's, if I stay on them or go off of them, but i want to ask her that if a person does have cancer and has been on them, do they take them off. That might be an indication right there! The studies i've read are so inconclusive. And my genetic history leans towards heart problems.

    I guess i'll wait to do the twilight sleep deal, i'm feeling a little less anxious today, but if i have another bleeding/spotting episode, i might just take myself in earlier! She DID say yesterday that it was a D and C (i thought that was different than a biopsy) and i know it is very uncomfortable, but i'm hyper sensitive.
    As far as i know i'm in very good health and all so.............
    The only thing is, i'm now considering retiring 6 months early! (Jan 2007 instead of June 2007) because the "life is short" theory gets very intense when you suspect it might be shorter than you thought~
    thanks, i'll try and remember to let you know the outcome, tho i might now know until end of Feb. Rosie

     
    Old 01-06-2006, 04:51 PM   #14
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    Re: Senior, post menopausal bleeding

    Well..hey.. a D & C.. I'd wait for the good stuff and sleep my way through that. I think even if I had a little bleeding before you are scheduled for that I wouldn't worry..

    As far as the hrt issue... unopposed estrogen is what tends to cause endometrial cancer to happen.. You are right about so much controversy on the do's and don'ts of hrt. My doctor basically said I wouldn't really need it..figured I'd been through the worst of all the symptoms..hot flashes, etc. and that I wouldn't really notice a differrence once the ovaries were gone. She was basically right. After surgery I had the usual ups and downs and some weepy cry baby times, but hey..I just had major surgery..I was entitled!..

    My gyn/onc has now referred me to a specialist in compounding hrt.. I asked about my nose dive in any interest in sex..he felt that some hormones wouldn't hurt..also, I've noticed lately the wrinkles and the sagging...yuck..either that or I'm looking at myself in the mirror more and finally noticed that age had crept in.. I've heard from some doctors that the issues of heart disease are more important than the risks of hrt and possible breast cancer..or uterine..I happen to think there is a solution of something somewhere in between and after reading up on compounded hormones, it makes sense. There really isn't any one size/one fix for all. WE are all so different.

    All of this is really premature in that you haven't been dx with anything yet..impossible not to do the "what if's"..but I learned something from one of the support boards.."don't waste a good panic".. I'm sort of getting the hang of it, but it sure has taken a long time.

    My biggest concern now is that I can't remember ANYTHING. I had surgery on my hand this summer after the crash and burn ski accident and I think the anesthesia did something...it's really bugging me though. Some hyster sisters have called this "brain fog"..and maybe they are right. Not so hot about getting older.. but don't like that alternative either!

    Glad to know I'm not just dumb about the computer thing in being able to connect with other posters on the site.. didn't really realize this site didn't allow. That's fine.. this works. Sorry to the moderator... my bad.

     
    Old 01-06-2006, 08:37 PM   #15
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    Re: Senior, post menopausal bleeding

    Hi Marise,

    I'm so sorry your ultrasound showed suspicious findings. I agree with Josie about seeing a gyn-oncologist. That's what I would do. If you already have the gyn appt. for tuesday you could go ahead and keep that, as multiple opinions are a good idea, but I'd consult with a gyn/onc too if you can.

    I'm glad you shared your situation with your son. I know it must have been difficult for you and how you didn't want to worry him. I would want my mom to tell me everything.

    I hope and pray these findings are not cancer. However, if it is, please know that there are good doctors and good treatments available. Try to stay busy between your appointments to keep your mind from too much worry. Do something special to pamper yourself - you deserve it.

    Please let us know how your appointment goes on Tuesday. You'll be in my thoughts and prayers.

     
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