progesterone or not for endometrial hyperplasia

Women's health
1

just wondering what the procedure was for you lot who thought they were post-menopause (i had  no period for 18 months at 55 years old) then a slight bleed and all the usual ovulating symptoms.

I had all the usual tests....ultrasound, lining 7mm......too thick so a  biopsy and hysteroscopy. 

The results came back saying endometrial hyperplasia, nothing more so i was told to take oral progesterone for 3 months and then come back for another biopsy.  I didn't take the tablets because i was so worried they would make me more anxious and depressed than i already am.

Today i went for my appointment (6 months) after the last one, i was expecting another biopsy as i was told i would but they didnt do one. I explained to the gyno that i saw about my fear of the tablets and he said that it didn't really matter if i take them or not as the biopsy was normal....just endometrial hyperplasia.....he gave me the option of either having the coil fitted or doing nothing at all.

Im a bit confused as to why the first gyno was concerned enough for me to take a strong dose of progesterone but this gyno was giving me the option of doing nothing.....he said the only time i need to see him again is if i have another bleed a year or more after the last bleed.

I was wondering what other post.....but not quite woman have gone through.

 

2

Hi Jacky, I had a thickened lining like you so had the biopsy and hysteroscopy. Results of biopsy came back negative so nothing further has even been mentioned. no one offered any progesterone or a follow up appointment. Unless I have symptoms again I'm just glad to be off the whole procedure/panic merry-go-round. x

3

thanks Jane ....its just a bit confusing as to why docs have different procedures. Im happy to just leave things and wait. glad all was ok for you.x

4

Jacky, I know I'm probably not hitting your specific question.   But I will mention that I've known women who have had bleeding past menopause.  Nothing wrong, just was what it was. 

What's important is our defination of menopause.  For the medical community, it simply means one full year without periods.  But what we rarely think about is that women continue to produce hormones, even though we aren't producing enough to stimulate the uterus on a monthly basis.  I'm 60, and yet at my last uterine ultrsound, ovaries were there, normal sized, and follicules were even visable inside the ovaries.  So even at this age, 7 years past final periods, my ovaries haven't turned into prunes, shriveled up and died.  

There are many women who aren't having periods, yet will still produce a decent level (possibly as high as 50pg/ml) of estradiol.  Not enough to produce periods, but plenty to keep things looking and feeling ok.  These are normally the women who don't get hot flashes and night sweats.  But over time, the levels continue to decline.

So while a menopausal lining is normally <5mm, your lining of 7mm isn't horrible and will get smaller the further you get into menopause.  You are only 18 months out.  What is apparent, is that your body is doing a good job of still giving you some estrogen, hence, the thickness of your lining.  And estrogen comes from internal glands, as well as diet, and enviornmental sources.  

Just guessing here, but I bet you feel pretty good.  Not sure I disagree with your decision to avoid the progesterone, as some women do have problems with it.  Especially emotional/depression issues.  The coil would be providing synthetic progesterone to the area, and therefore, reduce the lining thickness.  But again, some woman have felt a systemic effect from the coil and don't like it.  

I get it, that they want to keep an eye on your lining, and any unusual bleeding which could indicate cancer of the uterus.  But this just sounds like a woman who is producing a decent amount of estrogen, at this point in time.  Most woman never have anything looked at.  They just stop periods, don't have any bleeding, so no one ever looks at all this.  While your body just hasn't given up the TOTAL GHOST quite yet.  And have you ever heard of the light bulb burning brightest, right before it burns out?  Possibly this was your last hoorraaaaa, before your ovaries tank.  

Hope this helps, but with the information you've been given from your doctors, it doesn't sound like you have anything to worry about.  So I hope you aren't.          

5

Thankyou gailannie ....you explained things so much better than the doc todaybiggrin on the sames lines as him but easier for me to understand. I suppose my concern is that if the lining keeps increasing without shedding then could it turn into cancer, i forgot to ask him this. Im not really concerned about the situation im in now but obvously i dont want it to progress into something bad....thanks again

6

You are very welcome Jacky and glad to hear it helped. 

So for your next issue, all I would tell you is have another uterine ultrasound in 6 months, or a year.  You can keep tabs on lining.  It will change over time.  I have been using hrt to help with menopause symptoms.  Before I started my lining was 3mm.  With estrogen patches, even though I was also using progesterone 14 days per month, my lining was 12mm.  Did a uterine biopsy and things were fine.  Reduced my estrogen and as of February 3rd, my lining is now back to 5mm.  

So just keep in mind that even every month your lining can and will change.  In fact, I was told by the tech during the ultrasound,  they check the lining twice, because as you relax the lining can change in thickness. Sounds obsurb doesn't it, but that's what she told me.  And mine was 5mm for the first and second measurement.  

So here's the thing, obviously you are still producing estrogen from your ovaries.  But remember that will change month to month.  Just watch for bleeding, and do an ultrasound every once and a while to put your mind at rest.  Progesterone is an option if you are really concerned.   

7

i will have a chat with my gp to see what he thinks about it all, he will be the one fitting the coil if i decide to go ahead with it. Im still a bit worried that the extra progesterone  will increase my anxiety....but there again it may reduce it if im more balanced.

I feel like im going to have another period as im getting the same symptoms as i did before the last bleed, the gyno said that its ok if i do as long as its not over a year.

I will keep an eye on things though as you suggested...Thank-you

 

8

hey Jackie, just thought I should mention that the coil isn't your only option for progesterone.  There are plenty of things you could do instead.  I will mention that I'm one of those women who had difficulty with oral progesterone.  what I've always found is I do better with the vaginal route.  You could try using a FDA approved vaginal progesterone Crinone. This is a every other day vaginal, premeasured syringe.  Studies have shown it is protective for the uterine lining.  And the good thing is, you could get, try it, and unlike the coil, quit if it's awful or too much for your system.  You can also use Prometrium (FDA approved pill) both orally or vaginally.  Just remember that orally, our livers chew up and spit out a bunch, where vaginally it is more direct route and bypasses the liver.  So you need less with vaginal routes, than when you swallow the pill.  

And the of course, you could have something coumpounded.  I got some progestesterone vaginal capsules, that were in olive oil that I really liked.  Your doctor would have to order it.  

So even if you have some concerns about using the coil, just know that isn't your only option.  Just the one thing the doctor has suggested.  

9

I went from 7mm to 11mm in two and a half years. Now I am on hormones. And looking to get this out of my body soon. My test were all OK. But not going to risk my life.