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    Worried about Upcoming Saline Sonogram
    AnimalFriendly posted:
    Hello - this is my first post. I turned 52 in August and have had intermittent bleeding/short periods throughout 2012. I thought these were normal as it has never been anywhere near 12 months at a time since I've gone without a period, at least a short one over 1-3 days. My GYN sent me for a transvaginal ultrasound last Friday and now she wants me to have a saline sonogram which isn't scheduled until January. She said she couldn't tell from the ultrasound whether the lining of my uterus was thickened, etc. although I may have a few small fibroids. She said my pelvic exam, also last Friday, felt normal. Although I don't have the results of last Friday's PAP smear, I have never had an abnormal pap. [br>[br>I think my worry is mostly that my blood work last Friday showed me to be in menopause even though I know it has been nowhere near a year since my periods fully stopped. My GYN said it was sometimes difficult to determine whether one is still in perimenopause or menopause - but why does my blood work indicate the latter? I also had a period of at least 2 months of hot flashes earlier this year - I had never had them before. And the other day I thought I had another. I had what I THOUGHT was a short period lasting 2 days on November 2nd, some more bleeding (period?) on December 2nd & 3rd and then today, some more spotting. Both today & on November 2nd I saw some actual dark, red bloody tissue. [br>[br>I'm just worried about having this spotting/bleeding, etc. despite supposedly being in menopause. This has all got me very worried, thinking I have endometrial cancer or something worse. If anybody else has been through something similar and has any insight to share, it would be very much appreciated.
    Anon_6061 responded:
    When uterine fibroids or polyps are present, it can be hard to differentiate between those and a thickened lining. But additionally, the lining can thicken during perimenopause due to the lack of ovulations and irregular periods. This thickening usually resolves on its own by the time you go into menopause. But even once in menopause, spotting isn't necessarily cause for alarm although has to be investigated. Sometimes the lining gets too thin which can lead to spotting. Or sporadic ovarian activity can cause bleeding (this seems to be more likely in the early post-menopausal timeframe).

    The tests for menopause aren't accurate until you've gone a full year without a period. Since ovarian hormones fluctuate wildly during the perimenopausal years, FSH can be elevated (and estradiol low) during this time. Dr. Minkin has posted about this a number of times. Here's one of her posts - You can find others via a search for "FSH".

    "Menopausal" symptoms usually start during the peri years. In fact, many women say that they're worse during this time and improve shortly after becoming menopausal. But symptoms vary widely by individual.

    Let us know what you find out from the sonogram.
    AnimalFriendly replied to Anon_6061's response:
    Thanks very much for this great information! I will advise re: the sonogram in January - AF.
    Mary Jane Minkin, MD replied to AnimalFriendly's response:
    Dear AnimalFriendly,
    You did receive excellent info from Anon_6061; she is quite correct that the bleeding usually is not from a worrisome source, but a saline sonogram can give you additional information.
    As far as the hot flashes: indeed, many women find the perimenopause to be more problematic than the postmenopausal time frame. There is a large study being done in this country, called the SWAN study (Study of Women Across the Nation)-and indeed, the researchers have found this to be true, across women of many ethnic backgrounds.
    So hopefully you'll get some very reassuring news in January-and enjoy the upcoming holidays!
    Good luck,
    Mary Jane
    a2stylist responded:
    Hi AnimalFriendly,
    I am 35 and have had two sonohysterograms in the past two years. I have a 20 year history of Endometriosis leading us to believe I have Adenomyosis as well. I had heavier than normal bleeding with large clots and menopausal symptoms like hot flashes and more than those terrible night sweats leading up to the tests.However, it was discovered in the last two shg's that I had endometrial polyps in my uterus. I've had two surgeries to remove them, D&Cs and in May I had uterine ablation which has helped immensly! (however, if I truly have Adeno, the bleeding will come back)
    For me, the menopause like symptoms were definately related to the polyps growing and totally throwing my hormones off course. I had longer periods, in between bleeding, passing gel like clots that I could feel come out(gold ball of larger size) hot flashes, night sweats and all of the other menopause stuff. I was at first told it was just perimenopause and nothting to worry about.I most recently developed ovarian cysts and had my left ovary and both tubes removed a week ago. I"m now experiencing those same symptoms, but in relation to the lack of ovary
    I've not had fibroids before, so for that I cannot say. However, from what you are describing it sounds like your doctor is on the right path with the shg being done. It basically "outlines" any abnormal structure in the uterus. In my case the polyps. I'll be thinking positive thoughts for you! keep us updated.
    AnimalFriendly replied to a2stylist's response:
    Hello a2stylist, Dr. Minkin & Anon_6061 - I just wanted to let you know that I did get the saline sonogram done on Thursday, 1/10 which included a endometrium biopsy. I just heard this a.m. from my doctor's nurse who told me that the biopsy results were negative for any cancer so that was wonderful news to get!

    When I had the sonogram, my GYN said that she was "leaning toward" doing a hysteroscopy, no matter the biopsy results, which I assume would be to remove the fibriod(s) and/or polyps that have been causing my intermittent spotting. But the nurse didn't mention that my doctor wanted to get that scheduled so I asked her to get back with my GYN for clarification. It may just be that I need to keep a careful watch on the bleeding/spotting for awhile and note any more changes, etc. I think I also remember my GYN saying that I probably had a "degenerating" fibroid.

    My bloodwork was not repeated on 1/10 (it was originally done on 12/7/12) which I almost wish it had been as I would have been interested to see what my hormone levels were last week. I am still very surprised that my 12/7/12 bloodwork showed me to be menapausal since I'd had what must have been an actual period, albeit only for 36-48 hours, back starting November 1, 2012.
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    Anon_6061 replied to AnimalFriendly's response:
    Glad to hear the biopsy was negative! Since lab results can fluctuate quite a bit during perimenopause, doing another set of labs wouldn't have provided any benefit.

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