My Mother Aged 47 Has Irregular Periods , Heavy Bleeding That Is Long Duration 10 Days And Twice In A Month And Uterus Bulky In Size Can Explain Clearly What Further Treatment Is Best Option To Recover?

Posted on Wed, 1 Feb 2023

Question: hello doctor. this is for my mother query. age 47. irregular periods , heavy bleeding that is long duration 10 days and twice in a month. like once the periods had stooped after 5 days again came. so 2 times in a single month . there is no spot (bleeding)between the periods. consulted doctor said that get biopsy, then we consulted another doctor but before take biopsy she took scan . in the reports uterus bulky in size, measures 81*50*60 mm. Endometrium is 14mm. Left ovary show 25*25 mm follicile. i'm attaching all the reports which first doctor as well as second doctors prescribed including lab reports . could you see and explain clearly what further treatment is best option to recover

Answered by Dr. Deepti Verma (2 hours later)

Brief Answer:
Endometrial biopsy recommended

Detailed Answer:
Hi dear,
I have gone through your question and understand the concerns.
I have reviewed the reports and the prescription.
The irregular bleeding your mother is having is most likely due to the hormonal changes in the perimenopausal period, and the disturbances caused in the uterine lining due to these changes.
The ultrasound shows thickened endometrial lining.
Hence, an endometrial biopsy is recommended to confirm the diagnosis and further treatment should be done accordingly.
If it is due to hormonal disturbance, then hormonal medication like medroxyprogesterone acetate is given to cure the situation.
Small follicular cyst in the ovary is unlikely to cause any problem.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Deepti Verma (7 hours later)

Thank you mam.my doctor has given two options 1)hysterectomy 2) get biopsy then proceed further but she prefers hysterectomy. May I know why? She said that if get biopsy wait till results come like 10 days and again we might to get surgery that too your mother age is 47. She may not tolerate biopsy test so hysterectomy is my choice she said. But I’m not satisfied her advice is it correct advice? Is Hysterectomy permanent solution for all these type of uterus , endometrial problems irrespective of biopsy reports. Mam could you tell me that what to know biopsy reports according to my knowledge diagnose whether cancer or not. Is there anything else to know through biopsy plz explain. And if biopsy reports say not cancer generally what further procedures will take place like again perform any surgery or some tablets is enough . But why doctor suggested hysterectomy Is this situation any danger at this age 47. plz explain in detail madam we are so worrying.

Answered by Dr. Deepti Verma (13 hours later)

Brief Answer:
Endometrial pathology should be ruled out

Detailed Answer:
Hi dear,
In cases of irregular bleeding beyond 40 years of age, it is always recommended to get biopsy done and plan further treatment accordingly.
Biopsy will diagnose cancer, hormonal disturbances or endometrial hyperplasia.
Cancer is rare, however the treatment is completely different and is not cured by simple hysterectomy.
Hormonal disturbances and hyperplasia are first treated by medical manangement.
If it fails, then hysterectomy is done.
Endometrial biopsy is an office procedure, and if done properly with mild sedation, patient tolerates it very well.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepti Verma (9 hours later)

Okay mam. How would we give biopsy test .fast samples or with food and does she take hypertension (BP) , diabetic tablets . If give without food , after test done immediately does she take food or shall we wait. How long we will be in hospital? Could you explain mam?

Answered by Dr. Deepti Verma (6 hours later)

Brief Answer:
Office procedure

Detailed Answer:
Hi dear,
Endometrial biopsy is an office procedure.
She can have light meal before the procedure.
Generally, it is advisable to wait for at least 2 hours in the clinic or hospital after the procedure.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepti Verma (44 minutes later)

Mam does pap smear test also simple procedure? can we get this test with food ? and i have general doubt mam. does these tests MBBS MS Obstetrics & Gynaecology DGO only performs or MBBS, MD - Obstetrics & Gynaecology, DGO, MBBS DGO, MBBS, DNB - Obstetrics & Gynecology, these doctors also perform? Could you explain

Answered by Dr. Deepti Verma (3 hours later)

Brief Answer:
Pap smear is a simple procedure

Detailed Answer:
Hi dear,
Pap smear is a simple investigation of the cervical cells and can be taken anytime, irrespective of the food intake.
Any person having degree or diploma in gynecology can perform these procedures.
Regards
Dr Deepti Verma

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Above answer was peer-reviewed by : Dr. Nagamani Ng