Brief Answer:
Hormonal imbalance

Detailed Answer:
Hi,

Thanks for your query.

The endometrium, in a normal cycle, has two phases of growth namely, the proliferative and secretory. While the proliferative phase is before ovulation and is under the influence of estrogen, the secretory phase is post-ovulation and is under the influence of the hormone progesterone.

When ovulation does not occur and the periods that are seen are due to the withdrawal bleeding, only the proliferative phase is seen. Sometimes, due to excessive formation of the endometrial tissue due to excess estrogen, polyp (a protrusion of tissue into a knob-like or pear-shaped swelling) formation is seen in the endometrium.

Your endometrial tissue shows evidence of excess estrogen as there is proliferative tissue seen (presuming it is taken in the later half of the cycle ). Also, the sample of tissue taken shows formation of an endometrial polyp which is degenerating. Your pathology report should be correlated with hormonal studies and trans-vaginal sonogram to come to a conclusion for further management.

While anovulatory cycles are painless, presence of pain in your cycles points to other causes like endometriosis or pelvic inflammation. If you are overweight, please try to maintain a healthy BMI and do some regular exercise. Eating plenty of fresh fruit, vegetables and having plenty of liquids is a must.

Pain during the cycles can be controlled with NSAIDs along with the anti-spasmodic, Dicyclomine. You did not mention how irregular your cycles are. There is a normal range of one week of 28-35 days for a regular normal cycle; for some people, cycle span is 40-45 days.

Hope I have answered your query. Please feel free to contact for further information. I will be happy to help.

regards,
Shanti.V.

---

Brief Answer:
Mefenamic acid is a better alternative

Detailed Answer:
Hello,

Thanks for writing back.

Mefenamic acid, which has a good anti-prostaglandin effect, is a better alternative. Larger doses of NSAIDs are to be avoided as they can impair renal function. Also, progestin-only pills may be tried to regress the hyper-estrogenic state with good effect. Please discuss with your consultant n the possibilities. Likewise, any infection should be treated. Stress also should be controlled through meditation and medication if needed.

Hope you received the necessary information. Please contact for more clarifications. I will be ready to help.

regards,
Shanti.V.

---