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What Causes High Libido While On Tamoxifen?
Posted on
Thu, 3 Dec 2015
Thu, 3 Dec 2015
Answered on
Wed, 23 Dec 2015
Last reviewed on
Question : Hello Dr XXXXXXX
I started to have a very light bleeding (the same I had in September and October when you said was ok after the transvaginal ultrasounds was fine)
This seems more like a light period than bleeding because I have the same symptoms that I had when I had period. My doctor says that I am in menopausal, after my chemio and tamoxifen for 5 years, but it appears that I have a normal period and very strong increase of libido. It appears that I develope a lot of hormones especially ( I think) estrogen and testosterone, and sometime I wake up at night. I have intercourse with my husband regularly, once a week, and I heard that sometime having a tick uterus walls (like mine) may determine the bleeding. Please tell me my options because I am really not available to perform useless test that can result false positive and determine an useless and unnecessary hysterectomy.
There is any specific test where I can find out if such light bleeding depends from my hormone imbalance and an increased libido? Or may be from the thickness of my uterus? Thank you so much! XXXX
I started to have a very light bleeding (the same I had in September and October when you said was ok after the transvaginal ultrasounds was fine)
This seems more like a light period than bleeding because I have the same symptoms that I had when I had period. My doctor says that I am in menopausal, after my chemio and tamoxifen for 5 years, but it appears that I have a normal period and very strong increase of libido. It appears that I develope a lot of hormones especially ( I think) estrogen and testosterone, and sometime I wake up at night. I have intercourse with my husband regularly, once a week, and I heard that sometime having a tick uterus walls (like mine) may determine the bleeding. Please tell me my options because I am really not available to perform useless test that can result false positive and determine an useless and unnecessary hysterectomy.
There is any specific test where I can find out if such light bleeding depends from my hormone imbalance and an increased libido? Or may be from the thickness of my uterus? Thank you so much! XXXX
Brief Answer:
Endometrial biopsy is recommended
Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
I have reviewed your discussion with Dr XXXXXXX in October 2015.
Tamoxifen increases the risk of endometrial hyperplasia and carcinoma due to the estrogenic effects on the uterine endometrium.
If you are having spotting and bleeding intermittently , you should undergo a endometrial biopsy , which is a simple office procedure, to ascertain the cause.
Endometrial thickness of more than 4 mm in postmenopausal female needs endometrial evaluation. Since the ultrasound thickness is just borderline and you are having such symptoms, an endometrial biopsy is recommended in your case.
The false positive rate of this biopsy is extremely low, and you need not worry about the sensitivity of this test in making an accurate diagnosis.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards
Dr Deepti Verma
Endometrial biopsy is recommended
Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
I have reviewed your discussion with Dr XXXXXXX in October 2015.
Tamoxifen increases the risk of endometrial hyperplasia and carcinoma due to the estrogenic effects on the uterine endometrium.
If you are having spotting and bleeding intermittently , you should undergo a endometrial biopsy , which is a simple office procedure, to ascertain the cause.
Endometrial thickness of more than 4 mm in postmenopausal female needs endometrial evaluation. Since the ultrasound thickness is just borderline and you are having such symptoms, an endometrial biopsy is recommended in your case.
The false positive rate of this biopsy is extremely low, and you need not worry about the sensitivity of this test in making an accurate diagnosis.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
is there any hormonal test I can perform in addition to the Endometrial biopsy if they can be useful?
Thanks
XXXX
Please note: my Endometrial thickness is 5 mm since years (not 4)
Thanks
XXXX
Please note: my Endometrial thickness is 5 mm since years (not 4)
Brief Answer:
Serum estradiol can be done
Detailed Answer:
Hi dear, you can get serum estradiol done to assess the estrogenic activity in the body.
Yes dear, I have noted that the endometrial thickness is 5 mm.
Chences of endometrial hyperplasia or carcinoma are very low at this thickness, but it is always advisable to rule them out by pathological diagnosis before labelling it as normal postmenopausal spotting due to atrophied or aged endometrium.
Regards
Dr Deepti Verma
Serum estradiol can be done
Detailed Answer:
Hi dear, you can get serum estradiol done to assess the estrogenic activity in the body.
Yes dear, I have noted that the endometrial thickness is 5 mm.
Chences of endometrial hyperplasia or carcinoma are very low at this thickness, but it is always advisable to rule them out by pathological diagnosis before labelling it as normal postmenopausal spotting due to atrophied or aged endometrium.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
If I will decide to not to perform the biopsy can I still perform the transvaginal ultrasounds every 6 months plus any other tests except a biopsy? I really want to avoid a biopsy because in my past I had false positive result and now I am scared to go though the same procedure that may request unnecessary, surgery, chemiotherapy, radiotherapy, hormontherapy and so on.
Thank you
Regards
XXXX
If I will decide to not to perform the biopsy can I still perform the transvaginal ultrasounds every 6 months plus any other tests except a biopsy? I really want to avoid a biopsy because in my past I had false positive result and now I am scared to go though the same procedure that may request unnecessary, surgery, chemiotherapy, radiotherapy, hormontherapy and so on.
Thank you
Regards
XXXX
Brief Answer:
Can follow up with ultrasounds
Detailed Answer:
Hi dear,
You can observe for any further vaginal spotting and bleeding in coming days.
If there is none, then you can follow up with transvaginal ultrasound every6 monthly.
However, if there are repeated such bleeding or spotting episodes, then I will strongly suggest you to get a biopsy done.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Can follow up with ultrasounds
Detailed Answer:
Hi dear,
You can observe for any further vaginal spotting and bleeding in coming days.
If there is none, then you can follow up with transvaginal ultrasound every6 monthly.
However, if there are repeated such bleeding or spotting episodes, then I will strongly suggest you to get a biopsy done.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Dr. Deepti Verma
OBGYN, Maternal and Fetal Medicine
Practicing since :2009
Answered : 5064 Questions
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