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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Treated Pelvic Infection With Antibiotics. Going Through Perimenopause. Increasing Endometrial Lining. Cancer?

I am 42. Been in peri menopause phase for 5 years. In 2010 I went 11 months without a period. In 2011 I had 3 periods and went from Sept 2011 to August 2012 without a period. I recently had a pelvic infection and was treated with antibiotics. No std s and no idea how. Regardless at that time my endometrial lining was 12 mm and I got my period 2 weeks later for the first time in 11 months. Went back for follow up yesterday and it was 16mm. My dr wants to do a biopsy and I m worried because I m supposed to be moving in 2 weeks. Besides cancer what else can cause this? Can it be hormonal and all the changes happening? I ve always had problems starting with endometriosis 24 years ago. Please help
Fri, 28 Sep 2012
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OBGYN,  's  Response
Hello

Perimenopausal irregularity of menstrual cycles for 5years should be taken seriously and its better to get it investigated with an endometrial biopsy as the earlier a diagnosis is made the better it is. Incase your report is normal, you can be relaxed and wait for your menopause.
As you mentioned that you had a bleeding episode after a gap of 11months which is almost like a postmenopausal bleeding and any kind of postmenopausal bleeding should be investigated. Menoapuse is considered when there are no menses for a period of 12mnths in any female of your age.
Also you have mentioned you have an endometrial thickness of 16mm which is definitely more than what should be at your age. As after menopause endometrial thickness of more than 4mm with irregular bleeding should be investigated. You also have history of endometriosis which is a hyperestrogenic state and can cause endometrial hyperplasia (thickened endometrium ) as well.
Its not necessary your bleeding is due to cancer, it can be due to endometrial hyperplasia which can be simple, complex or atypical. Only the atypical ones have to be surgically managed. Simple hyperplasia can be treated with drugs like meprate (progesterone).
But i would definitely advise you to go ahead for an endometrial biopsy. Also get a PAP's smear done if you dont have one as yet.
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Treated Pelvic Infection With Antibiotics. Going Through Perimenopause. Increasing Endometrial Lining. Cancer?

Hello Perimenopausal irregularity of menstrual cycles for 5years should be taken seriously and its better to get it investigated with an endometrial biopsy as the earlier a diagnosis is made the better it is. Incase your report is normal, you can be relaxed and wait for your menopause. As you mentioned that you had a bleeding episode after a gap of 11months which is almost like a postmenopausal bleeding and any kind of postmenopausal bleeding should be investigated. Menoapuse is considered when there are no menses for a period of 12mnths in any female of your age. Also you have mentioned you have an endometrial thickness of 16mm which is definitely more than what should be at your age. As after menopause endometrial thickness of more than 4mm with irregular bleeding should be investigated. You also have history of endometriosis which is a hyperestrogenic state and can cause endometrial hyperplasia (thickened endometrium ) as well. Its not necessary your bleeding is due to cancer, it can be due to endometrial hyperplasia which can be simple, complex or atypical. Only the atypical ones have to be surgically managed. Simple hyperplasia can be treated with drugs like meprate (progesterone). But i would definitely advise you to go ahead for an endometrial biopsy. Also get a PAP s smear done if you dont have one as yet.