HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Suggest Treatment For Endometrial Hyperplasia

Posted on Tue, 9 Sep 2014

Question: I'm going to a new gynecologist on Monday. I was diagnosed by a nurse practioner with endometrial hyperplasia, with 3 Fibroids, one of which is pressing against my bladder. I had a uterine ablation about 14 years ago, with no periods until about 3 years ago when they started up again. Do you have any insight as to what to expect as a possible treatment? And do you have any suggestions as to what I should ask the gynecologist, other than what tests and treatments he might order? I'm 52 and I suspect I'm near menopause, with an unknown family history, and have had abnormal paps for the most part since the ablation, with colposcopies coming back negative. I've already had a colposcopy, and endometial biopsy, and two vaginal ultrasounds. I'm just nervous that there might be a more serious underlying cause than hyperplasia.

Answered by Dr. Soumya (58 minutes later)

Brief Answer:
Fibroids

Detailed Answer:
Hello

Welcome to healthcare magic.

1. Endometrial hyperplasia might be a simple hyperplasia that is causing bleeding after 3 years post ablation.

2. Since this has been evaluated by endometrial biopsy probably this ia the best investigation and rules out cancer as a cause for Endometrial hyperplasia.

3. But with presence of 3 fibroids and one pressing against bladder the probable treatment advice would be to get uterus removed. Its called hysterectomy.

4. Since you are nearing menopause hysterectomy would be best possible solution in view of fibroids, endometrial hyperplasia and abnormal pap smears.

Let me know if you have any more questions.

Regards
Dr. Soumya

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Soumya (9 hours later)

I know that a hysterectomy could cause mood swings among other things. In your opinion, would my tendency to have problems with major depression put me in a higher risk for suicidal ideation or self-injury? I am just now coming out of my latest episode of such thinking. And, yes, I am under a psychiatrists care. Some of my other health issues have been chalked up to anxiety - spastic colon, headaches, chest pains, etc. I'd like to stay "safe", so I could really use some insight on this. I don't have any plans to have more children, and I don't have a partner, nor do I anticipate having one, so losing my uterus for those reasons isn't really an issue. It's the hormonal side of things that I'd like addressed.

Answered by Dr. Soumya (34 minutes later)

Brief Answer:
ovary

Detailed Answer:
Hi

Along with uterus there are 2 ovaries in every woman.

Ovaries are responsible for releasing an egg as well as other hormones which are necessary for mood and might lead to mood swings if removed.

Hence I suggest not to get ovaries removed and get only the uterus removed which is creating trouble with fibroids and other things. Ovaries need not be touched so that hormones remain normal and no mood swings.

The procedure is called as hysterectomy without ovary removal (also called as oophorectomy in medical terms).

Regards

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

Follow up: Dr. Soumya (3 hours later)

Last question: The fibroids are about 1", 2", and a little over 2". What size of fibroids is considered "large"? And, just to clarify, with my age, et al, if you were the deciding doctor, you would suggest a hysterectomy over a myomectomy? From what I've read, a hysterectomy is what my thinking would be.

Thank you for answering my questions. I hope your weekend goes well for you.

Answered by Dr. Soumya (7 minutes later)

Brief Answer:
Hysterectomy

Detailed Answer:
Hi

Your size is large(more than an inch is considered to be large). That too multiple fibroids.

If I were your treating doctor I would have advised hysterectomy definitely.

Regards

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. Ashwin Bhandari