Menopause, On Elleste. Had Bleeding, Test Showed Bulky Cervix. Had Loop Incision And Smear. Have Back And Pelvis Pain

Posted on Mon, 23 Sep 2013

Question: i have been well into the menopause and have not had a period for 5 years . i am on elleste 2mg and still have no periods . Last week i started to bleed , on visiting my Gp he examined me and said i had a bulky cervix . Five years ago i had abnormal cells burnt away , i think it was called loop incision and have had yearly smears since . although i missed my smear this july . My gp has has done an urgent "2to his surgery for week referral and phoned asking me to return to him for bloods tomorrow . I am so tired and listless and in pain in my back and pelvis for some months

Answered by Dr. Dr. ARIF N K (1 hour later)

Brief Answer:
Kindly rule out malignancy.

Detailed Answer:
Hi XXXXXXX
Thank you for choosing XXXXXXX Post menopausal bleeding is a serious thing and it needs urgent evaluation. Because of following reasons, as you are on estrogen replacement, history of abnormal PAP smear which was treated conservatively and on examination your cervix is bulky. You have not mentioned your previous loop excision histopathology report ( if it is taken), and I presume it to be normal.
Once there is post menopausal bleeding, every doctor has one intention mainly to rule out malignancy. Currently you need an ultrasound pelvis to check if there is any abnormal growth in uterus or there is endometrial thicknening, then you need to undergo endometrial biopsy to rule out malignancy, later a COLPOSCOPY will rule out any abnormal areas in cervix, which needs to be biosied. Type of procedure depends on your treating doctor.
But, kindly do not worry as the most common cause for post menopausal bleeding is endometrial atrophy due to estrogen deficiency.
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it.
Thank you,
Wish you good health.
Regards,
Dr Arif
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Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Dr. ARIF N K (3 hours later)

i also forgot to mention that i had a thermal eblasion several years ago , my pap smears since i had the loop incision have been clear x

Answered by Dr. Dr. ARIF N K (17 hours later)

Brief Answer:
ultrasound scan uterus, ovary and colposcopy

Detailed Answer:
Hi,
Thanks for the further information, even though you have undergone thermal ablation its not a end procedure, some women do develop endometrial growth, hence I advised you to get a scan done to rule out any uterus and ovary pathology. It will clear most of the doubt, then further a colposcopy can fine out any abnormal areas in the cervix which needs to be biopsied to rule out any cervical pathology. Till you get investigated further, kindly stop oestrogen replacement. If you have any post menopausal symptoms there are non-hormonal treatments, kindly speak with your doctor regarding this.
If you do not have any further clarification you can close the discussion. Kindly rate & review my answer. Wish you good health.
Regards,
Dr Arif
You can consult me again directly through my profile
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Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E