How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Pfeiffer Your Own Question
Dr. Pfeiffer
Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5987
Experience:  Ob/Gyn Doctor
Type Your OB GYN Question Here...
Dr. Pfeiffer is online now
A new question is answered every 9 seconds

I've been on Bio-Identical Pellets for almost two years.

This answer was rated:

I've been on Bio-Identical Pellets for almost two years. Within this last year, at first I started spotting. Now I'm experiencing "period cramps" and bleeding. Not heavy. Problem? I'm a "young 65yr.old. My doctor after learning this, had an ultra sound (negative) and then a cervical biopsy (also negative).He cut the progestrone meds in half. Still no change. Should I be concerned? At first I had no night sweats. Lately I do. I really need an answer. The pellets the first 1 1/2 yr really showed a difference. I have blood work done prior to new pellets. Thank you, Shirlee
Dr. Pfeiffer :

Hello Shirlee

Dr. Pfeiffer :

you mention a cervical biopsy...but what you really need is an endometrial biopsy.

Dr. Pfeiffer :

do you know if that was done?

that typically follow an ultrasound

Dr. Pfeiffer :

also, you mention the ultrasound was negative, but do you know or remember what the thickness of the endometrial lining was?

Dr. Pfeiffer : says you are offline

Dr. Pfeiffer :

so normally the most important part of HRT (either traditional or bioidentical) is the estrogen component..or what's in your pellet.

Dr. Pfeiffer :

when there is persistent night sweats, mood swings, etc..that suggest the estrogen therapy isn't strong enough or is no longer effective.

Dr. Pfeiffer :

this happens even with traditional HRT and sometimes a bump up in the dose helps, but many times it requires a change in the estrogen preparation (ie. where it comes from/how it's made).

Dr. Pfeiffer :

now, as long as you have been on progesterone therapy chances of something serious (ie cancer) is unlikely...

Dr. Pfeiffer :

however, you must ensure you had an endometrial biopsy done to exclude hyperplasia and cancer.

Dr. Pfeiffer :

if the ultrasound showed a endometrial lining thickness of <5mm that has been shown to not represent cancer and is truly a negative ultrasound study in this presentation.

Dr. Pfeiffer :

most post menopausal women will have some type of bleeding episode. Most of the times the cause is not identified. Many times the cause is from something similar to when they were younger...stress, anxiety, illness, medicine, polyps, fibroids...etc. Sometimes there is no identifiable cause. Rarely, the bleeding is from hyperplasia or even cancer.

Because early uterine cancer can be cured with surgery, we ALWAYS recommend any abnormal bleeding in a woman over 35 years old be evaluated to exclude cancer. This is done by an ultrasound and sample of the uterine lining.

Dr. Pfeiffer :

So, this is probably nothing to worry about...but you should touch basis with your doctor to make sure he/she did a endometrial biopsy rather than a cervical biopsy.

Dr. Pfeiffer :

If you have additional questions please ask…I want you to be satisfied with this service.

If you do not have additional question please take the time to rate my service.

We only receive credit for answering your question with a positive rating.

Thank you.
Dr. Pfeiffer


The biopsy was for endometrial. Sorry I did say cervical. Certainly would like to know if there is a brand name for reputable pellets. Thank you.

Dr. Pfeiffer and other OB GYN Specialists are ready to help you

most, if not all, bioidentical hormones are compounded by a pharmacy.

When it comes to bioidentical hormones I would trust your doctor with regards ***** ***** is that's who is most up to date with what products are best.

I prescribe traditional HRT exclusively.

Dr. Pfeiffer