Ask the Nurse

I am 61 and went through menopause at age 50-51. On a routine check-up, I had a vaginal ultrasound which indicated a thickened endometrium - the doctor said about 7mm. The endometrium biopsy is "benign endometrial hyperplasia". The pap smear was negative and I have no symptoms, I am not overweight, and I have never been on any estrogen or any type of hormone therapy. I’ve had 5 normal vaginal births and 1 miscarriage (at 3 weeks) due to the flu. My doctor wants to do a D&C next, but I do not understand why I cannot try treatment with progestin first. He became agitated when I brought up that option. This is a new doctor to me; I had to switch due to insurance, and I am not confident with him.

You need to seek out an OB-GYN that you are comfortable with. You will need another endometrial biopsy within 3 months after treatment with high-dose progestin. You can also request another pathologist to review the slides.

If there is any atypia, a hysterectomy would be recommended. Endometrial hyperplasia can be a precursor to endometrial cancer, so you need close follow up.

All My Best,
Speaking of Women’s Health Nurse

March 19, 2018 at 2:33pm