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Endometrial Biopsy - help!
br350 posted:
I had an episode of 3 week bleeding last month (sometimes normal flow, mostly spotting of various degrees - sometimes brownish, pinkish, sometimes red but lasted all in all, for 21 days). I'm 46 and my periods are quite regular (every 28-33 days).

My doctor ordered a transvaginal ultrasound which was normal. This was done a week after the bleeding/spotting had stopped. However, for where we think I am in my cycle, he thinks the endometrium is thick - 13mm - it IS within normal limits but more like what it would look like if I was about to get my period. He did say it is likely a perimenopausal anovulatory cycle that I experienced.

I did have a benign uterine polyp a few years ago which was removed via fractional D&C in 2010 and all tissue was normal. So he is having me come in for an endometrial biopsy, I guess this is their normal protocol for 'abnormal' bleeding.

I'm scared. I know that if I have hyperplasia, it can lead to to uterine cancer. Has anyone had anything like this or been treated for hyperplasia diagnosed by endometrial biopsy? It would really help to know and have some info. Thank you for reading this.
br350 responded:
Jane, if you are there I'd really love to hear from you.
Anon_6061 responded:
Jane will probably come along when she gets some time from her busy schedule. But in the meantime, I thought I'd give my 2 cents since you sound so worried.

As your doctor said, it could very well be a "perimenopausal anovulatory cycle." Reduced production of progesterone (and resulting sporadic ovulations) during peri can cause the lining to get extra thick hence the irregular cycles. It usually isn't anything serious and the lining generally thins out by the time you reach menopause. Also, I believe polyps can sometimes make the lining appear thick on u/s. A biopsy will give you peace of mind. If it shows hyperplasia, most cases regress with meds -

I don't know if your doctor recommended any meds before the biopsy but some women have taken an OTC painkiller and/or some sort of anti-anxiety med. Hope the biopsy goes well and it's nothing serious!

An_244031 replied to Anon_6061's response:
Thank you so much for taking the time to respond. I really appreciate it. I had the biopsy Friday. It was uncomfortable but I would have had him spend 10 minutes in there if it meant getting a proper sample. The pain was not my worry. I did end up getting a period about 2 days later (which I was expecting) and it seemed normal. I want to call the office to see if the results are in but I think I may be jumping the gun. He said to call Wed but as it gets closer, the anticipation is really getting to me. My doctor did say exactly what you said, as well, that a thicker looking lining can occlude polyps. I believe he said if the endo biopsy came back with abnormal cells, they would move onto a hysteroscopy w/fractional D&C to get more tissue samples and visualize the uterine interior to see if there might be an polyps.

Thank you so much for your response, again, I appreciate it as I know we are all busy.
briz350 replied to An_244031's response:
This br350 - don't know why this is showing my response as anonymous but it was me responding.
briz350 replied to briz350's response:
Well, I called the doctor's office this morning to get the results. The nurse kindly looked them up for me and said it read 'negative with probably polyp'. I didn't realize that an endometrial biopsy could even determine that, but I'm guessing maybe he snagged a piece of a polyp and it must look distinct on pathology. I don't know. The doctor was with another patient so I could not speak to him right then but they'll have him call me back.

I had a polyp before (in 2010) which was removed via hysteroscopy and D&C but with a different doctor who was a specialist in endometriosis. The polyp removal was done at the same time I was having a laparoscopy to remove endometriosis. I remember the specialist telling me, at that time, that polyps do tend to recur.

I am guessing that my gyn may want to do the hysteroscopy/D&C route. Any questions or advice about things I should ask him when he calls me back? In my health anxiety, I am kind of paranoid to leave anything in there that is not 'normal' but yet don't want to have to have another procedure. I'm usually on the side of getting something removed rather than a wait and watch, but I guess I will have to see what his suggestion is.

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