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    post menopausal spotting
    avatar
    holababy posted:
    Last Sept. I had a little bit of spotting. I have not had a peroid for two years. They did an ultrasound and could not see anything due to fibroids
    I went in for a saline ultrasoung and my cervix was closed
    The doc who did the procedure said that my doc would more than likely just wait and see. Now my doc wants to go in a do a D and C. Is that really necessary?? Or can I wait.
    Reply
     
    avatar
    Jane Harrison Hohner, RN, RNP responded:
    Dear holababy (cool screen name!): It sounds like the fibroids obscured a good look at the lining of your uterus, and that an attempt at saline infused ultrasound was unsuccessful. Hope I am tracking you correctly.

    My best GUESS is that your primary GYN wants to be absolutely sure that there is no pathology (eg precancerous cells) which was the cause of the postmenopausal spotting. If you have a very closed cervix and multiple fibroids I would wonder if they are planning to do a day surgery D&C. If you are asleep it may be easier to use dilators and instruments to examine the inside of your uterus.

    I cannot answer if this is" really necessary". Only the MD who has all your medical history--and the medical liability for the decision can do that. You have a couple of options. First, you can talk with your GYN and explain that you would like to watch and wait a few more months. In this scenario you would defer the D&C to see if any further spotting occurs. Second, you could choose to get a second opinion from another GYN.

    So sorry you are having to go through all this. It would be nice if being menopausal meant no further bleeding. Sometimes spotting does arise in a postmenopausal woman not using hormone therapy. This can represent a number of things: a very thinned out lining of the uterus, unstable lining due to fibroids protruding into the uterine cavity, polyps of the lining, or abnormal/precancerous cells.

    Yours,
    Jane


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