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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11231
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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I am post menopausal with vaginal bleeding...I had an endometrial

Customer Question

I am post menopausal with vaginal bleeding...I had an endometrial biopsy done that states "weakly proliferative endometrial epithelium with scant stroma." Can you tell me what this means and if I should be worried?
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. Norm S. replied 2 years ago.
Do you use any hormones?Was an ultrasound done? If so, what was the thickness of the endometrium? How long ago was your last period? Thank you.
Customer: replied 2 years ago.
I had my ovaries removed surgically 7 years ago but still have uterus. I am 48 years old and my last sonogram was done about 13 months ago at which time the endometrium was thick (around 11m I think?), which resulted in a DNC done one year ago which showed benign polyp removed. I take .3 Prempro for hormone therapy. I just had in office biopsy done due to cramping, bloating and bleeding which started about four weeks ago. I don't understand the Pathology Report and hoping it does not suggest cancer. Thank you.
Expert:  Dr. Norm S. replied 2 years ago.
The report does not suggest cancer. Weakly proliferative endometrium means that the Prempro is causing some buildup of your uterine lining, which has led to the bleeding. If you stopped the Prempro, the buildup would disappear, and the bleeding would go away.
If you wish to continue HRT, I would discuss it with your doctor. Possibly the bleeding would go away if you continue the same dose of Prempro, which is a low dose. Or you could switch to a different estrogen/progesterone combination, or you could try taking the estrogen daily and take the progesterone for about 10 days each month, in which case you may get periods.
Mild bleeding on Prempro is not too unusual, and there is no suggestion of cancer. It's now a matter of figuring out how to deal with the bleeding. Best wishes.
Customer: replied 2 years ago.
Thanks so much for your response. Since it stated "weakly proliferative endometrial epithelium with scant stroma", what does the" scant stroma" mean and how do you know if the bleeding is from the low dose of prempro and not a sign of cancer? Just want to make sure that this report does not suggest a pre-cancerous condition? Do you think a sonogram is required? Thank you. p.s. I have had thyroid cancer and a history of ovarian cancer in my family so I am a little anxious, but already feel better that you do not believe the report suggests cancer. Thanks.
Expert:  Dr. Norm S. replied 2 years ago.
Scant stroma just means that not very much of the supportive tissue between the glands was seen. It doesn't mean very much.
Since an endometrial biopsy isn't as complete as a D&C or hysteroscopy, there is a slight possibility that the biopsy missed a cancer. However, when endometrial cancer develops, it usually develops in overactive tissue, or where there are pre-cancerous changes. There is no suggestion here of overactive tissue or pre-cancerous changes. So I think that it's safe to assume that the bleeding is from the Prempro.
Customer: replied 2 years ago.
Thanks so much for your detailed and helpful response.
Expert:  Dr. Norm S. replied 2 years ago.
You're welcome.