Endometrial Atrophy

Hi Sharon, just found your thread as I have been surfing the net as I have similar problems.  Over the past three years I have been having vaginal bleeding on and off every six minths or so.  I am told I am post menopause as my hormone levels are very high but i have yet to go 12 minths without a bleed.  I have had scans and hysteroscopys and been diagnosed with Vaginal Atrophy and been recommended to have Vagifem but like you dont want to use it.  Before each bleed I have experienced vaginal discharge which i dont get at any other time, I wondered if you had had similar?

I am now awaiting the results of my first ultrasound. My nurse practioners called to give me the results but I missed the call and I am waiting with fear. I live in Colorado, USA. I am 60 years old, post meno since 2007, so I am older than most of you.  I observed spotting at he end of  October, 2014, very small amounts, and had bloating, cramps, and felt "puffy" all over.  Just like a period. Then it went away and I felt great. My clothes fit fine again and I had great energy, just like I usually do. Then I had a UTI at the end of November and just as I was finishing my antibiotics, on Dec. 11,  I had another bleeding episode and thought it was stilll the UTI. There was a little more bleeding this time, and with the cramps and bloating,        but still ended in two days and I felt  fit again. Nothing more happened until January 22 when the bleeding began and I noticed a bit of bloody vaginal discharge. This time I went back to the doctor because I then suspected it was not a UTI. They attempted a biopsy in the office, but the discomfort caused them to quit. I bled off and on for a couple of days after that, and I heard that was normally after that procedure, even though it was abruptly ended. Currently am not feeling anything, and am fit again. In fact, I feel phsycally great except for terrible emotional anxiety waiting for tomorrow to see if I can find out the results. It's nice to have a forum like this because the medical personnel have not really told me much.  

I just found this thread, too. Good to meet you.

Hi Joyce, when I have a hysteroscopy it's under a GA because my cervix is tight shut, guess that is what your problem was, and yes, it causes bleeding afterwards.  I wonder if the antibiotics upset the flora and fauna in your vagina and has made it more susceptible to bleeding.  Try to get a hysteroscopy under a GA, much more comfy.

Helen, my gynecologists and family doc (I have had 3 gynecologists) say that the only "true measure" of being post menopausal is the absence of any bleeding for 12 months straight.  Have you had an ultrasound done? (sorry if I've missed this somewhere in this thread)  It *may* be that you're still getting just enough estrogen to build up a lining and shed it sporadically or, alternatively, that you're still not "done" but, aren't building up enough lining to shed a full period every month???  *IF* your lining is above 5 mms in thickness...they *may* want to do a biopsy (done in office most often and I've had 4 of them) to rule out anything to worry about.  But, it's best to get at least an ultrasound done to see what thickness your lining is.  FSH, estrogen levels etc., go up and down like a yo-yo so, the only true measure as I've been told is "NO bleeding whatsoever for 12 months".  Best to be safe than sorry though.  And, the fact that you have vaginal discharge just prior to the bleed, is telling me that perhaps, you're still getting just enough hormonal stimulation every 6 months to have a bit of a "shed".  You just may not be "done" yet...no matter what the blood tests say.  Sounds like your body is trying to give up but isn't quite there yet.  Try not to worry too much but...do get it checked out if for no other reason than to have peace of mind once and for all.  

Joyce, try not to panic.  I know it's hard as our minds go nuts during times like this (ie: waiting for test results and the "not knowing" side of things).  Getting in to do a biopsy is difficult for some women as the cervix tends to tighten up and close over.  (They gave me Misoprostol suppository tabs to insert the night before to "soften the cervix" and were able to do it in office after that....though, not fun as it does cause a bit of cramping and bleeding).  BUT...you are NOT there yet!  You simply need to get the results of your ultrasound first.  By the way, they ALWAYS try to do a biopsy when post menopausal bleeding is at play.  As one of my gynecologists told me..."we are trained to suspect cancer with everything UNTIL it's proven NOT to be...that's just the way they train us to think".  So, on goes the testing that drives us nuts! 

If your lining comes back "thin" on the ultrasound...they likely won't even attempt another biopsy as there's not really any need to do it.  Chances of cancer or anything worrisome are far less in a thin lining.  They worry when they see a thickened lining.  And, you're right...they tell us very little which scares the living daylights out of us! LOL  

Like Helen has said...*IF* they were to see a thickened lining and want to investigate further...there IS always the option of going under a light GA in hospital and them doing both a D&C (which is also a biopsy on a grander scale) OR...hysteroscopy where they can also get a sampling (biopsy).  I've had this done too and while a pain in the butt to get to a pre-op and then, have it done (you're home the same day...usually within a couple of hours), it's really nothing to be worried about.  They can even do it with an epidural/block and some good sedation if you're worried about GA...but again...you're NOT at that point right now!  

The word "biopsy" alone scares the crap out of us....but, really...it's just another diagnostic tool that rules out things so that they can figure out what's causing what.  

Hang in there and let us know how you make out with your results.  We're pulling for you.  

(Now, I'm about to propel myself into a lovely period to shed my lining with Provera, starting tonight...ughhh...hate this.  2 weeks on the med, then withdraw and have "The Period From H*ll" )

Hi there, yes, had a TVS a year back which showed a lining of 3.2mm, also a hysteroscopy later which showed most of the lining was atrophic.  My ovaries are asleep apparently and tiny,  FSH level over 100, cervix tight shut and when I say bleed it is just a pin head, I notice it cos I'm looking but most normal, non scaredy cat people wouldn't.

Forgot to add had biopsies done 11 months ago, all clear, not even endometrial hyperplasia.

Thanks you all for your interest!. Well, I did get the results back. I heard from my PCP, who had received the notes from the nurse practioner. I guess I do have a thickened lining. Not the news I was hoping for. Doctor put as much positve spin onto it.Basically, I will need to go to a gyno specialist for a D&C and hysteroscopy. Hopefully  there will not be any abnormal cells. I am very worried as I am in a high risk category due to age,  about 25 -30 pounds overwight, Caucasion, and the most, I was on Tamoxifen therapy for five years that ended ten years ago. At first I felt soothed by my discussion with her, but  after thinking about it and letting it fester, I'm back to worrying.

Thank you so much. Please see the post below. I'm trying to get the hang of the reply function.

I don't know but common sense would suggest that if Tamoxifen was going to cause a problem it would have done so years ago.

I have thought that, too about the Tamoxifen. But I don't know how long it may have an impact on the body. I must be getting some sort of estrogen somewhere. I heard aboutthe  fat cells. I have never been on HRT. I have never had any symptoms of menopause, not even a hot flash.

That's sounding good, Helen.  Sounds like you have no real problems except for, perhaps, some endometrial and possibly some atrophic bleeding.   It doesn't sound like anything at all to worry about.  I wish I could have as good a report!  

I know it sounds frightening, given what your mind is doing to you because of the Tamoxifen therapy situation but, I agree with Helen in that I would also think that *IF* this were to be related to that, it would have likely shown up during or just after its usage...not 10 years later.  I have not used Tamoxifen and have had a thickened lining.  That's what I'm working on right now....taking Provera (medroxyprogesterone) to have a "shed" (period).  And, 25 to 30 lbs overweight, likely isn't the cause of it either...though they love to blame weight for everything and anything.  It may just be your body or...estrogens that are taken in through diet/environment.  Did she say how thick it is?  

Don't worry.  I've had the D&C, hysteroscopy, polypectomy and ablation done, all at the same time and other than the hassle of having to do the pre-op and go for it, it wasn't really anything to be concerned about.  The D&C will clean it out and if you're not producing enough estrogen to re-build it...that will likely be the end of it all right there.  

The results...just wait and see.  You can't do anything else anyways.  

I tend to do the same thing as you are...let in fester, brew, stew and frighten myself into being dysfunctional! 

But, let me just say that no matter what our ages or background or weight or medication usage....they would be doing the same thing as they are doing now with you.  They did it with me and I wasn't taking Tamoxifen and I've heard of a lot of women (in my many "research sessions" to soothe my mind) MUCH younger who have had all fo this done for the same reasons.  It's kind of the "by-the-book" type of procedures that they do.  Take this step...then that....then this one.  It's SO common.  

By the way, my sister-in-law's sister and aunt went on Tamoxifen for breast cancer and they were also concerned about the effects on the uterus.  The doctor told them that the "risk" of it causing endometrial cancer was very small...something like 1.25 out of 1000 women on it would have any issues and the benefits of using it to keep breast cancer at bay were far outweighing any risks for the uterus as it wasn't as common as professionals once thought.  (I hope that helps somewhat).  

My bet...you're still producing some type of estrogen stimulation OR...you're getting it from outside souces OR..this is just your body's last hurrah and this D&C will take care of it.  

What I do when I'm like this...I go to "worst case scenario" in my mind and "deal with it"...ie: I'll need a hysterectomy.  Then, I deal with the idea that millions of women go through hysterectomies every year and are walking around, living their lives.  So, if that's what has to happen...darn it...but, hey...doable.  That helps quieten down my overly nosey and negative chattering head some.  

Hang in there and just live today, today and wait and see.  Remember that (as my gynecologists have told me) they are "trained to think it's something until it's proven not to be."  They work opposite to the justice system and put us through hell in the meantime but...better that they're thorough and quick in being thorough than not.  It just drives us nuts in the meantime.  

 

How's this for a theory lol.  The Tamoifen did build up the lining but because they were normal harmless cells they didn't proliferate and because you didn't have periods they didn't go anywhere, then over the course of time your natural estrogen levels gradually built up the lining until it has reached this tipping point and your body is just doing it's job and expelling the surplus.  Main thing is the Tamoxifen clearly did it's number one job.

Thanks for your response. It's given me some thoughts. My nurse practioner said something about a "last Hurrah' when she first attempted the EB, but it seemed very improbable to me. I didn't hear how thick the lining was, but I will probably hear more when the NP returns to the clinic on Tuesday. My breast cancer was a small non-invasive thing, but I have a close relative (sister) with it so they put me on tamoxifen, too. It has been a long time since therapy ended. My last period was eighteen months later and it was a doozy, bled heavily for several days, couldn't even perform my usual duties. Then it just stopped abruptly and I never saw anything else again until this bleeding started. No other menopause symptoms. It's interesting how estrogen could actually be activated now. 

Thanks. From what I have been gathering, our bodies can really surprise us sometines.

Hello ladies, I have been reading this discussion and wondered if you have any advice for me. Two years ago I had an ultrasound for something unrelated to the womb but they found I had a thickened womb lining so had to go see an gynocologist.

I am 55 and not had a period for at least three and a half  years now. The gynocologist told me I had a thickened womb lining of 8-9 mm and a polyp and was scheduled for a hyseroscopy and d and c. They were only able to remove half of the polyp as I am only tiny there and had the hyseroscopy with local anaesthetic. They also put in a Minerva coil and said that would help the lining from getting thicker. They took a biopsy of the polyp and thank the Lord it came back benign, that was January 2013.

three weeks ago I had lower pain not that unsimiliar to a period pain but I thought nothing of it. Last Thursday to my horror I had blood first of all just a bit, so I phoned my doctors and she said she wanted to see me but sadly I couldn't go that day so she said to come see the sister and she would do a swab. On Thursday night I had a lot more blood when I wiped myself and I was so scared. I hardly slept as I know pre menopause bleeding could be cancer. The sister took a swab, and referred back to go see the gynaecologist which I go on the 9th March which seems a life time away. 

I had bleeding for two days then it stopped, i still have lower pain as well. 

The sister did say I had a clear biopsy two years ago and try not to worry which is not easy.

Obviosly the Minerva coil hast done its job?

oh and I used estriol cream once in around August 2013 again last year around September and again I used it three weeks ago, and it was two days after starting it I got the low pelvic pain, not sure this is connected. I continued with the estriol for two weeks then stopped on the Sunday and the bleed was4 days later, als the sister couldn't find the Minerva coil but I had the same trouble the first time I had it checked.

i am so scared it may be cancer and I have another 11 days to wait to see the gynocologist.

has anyone had a similar experience or can offer some advice I would be nosy appreciated

Thanks

 

After two months of tests, I ended up with a 17mm thickened uterus lining. I completed my hysteroscopy yesterday. I had two polyps removed and a general cleaning out. Results came back today. No cancer or precancer. Thanks.

Hi Joyce 

oh thats good news, nothing sinister to worry about ..

Now you should rest up and recover, and put it behind you ...

look after yourself Joyce, take it easy for a while 

big hugs 

jay x