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DocPhilMD
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Category: OB GYN
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Experience:  Board Certified Internist trained in OB/GYN
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I am a 51 year old female that went for my check-up 2 weeks

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Hi - I am a 51 year old female that went for my check-up 2 weeks ago. I complained of left ovary pain so dr. scheduled a transvaginal ultrasound which I had last week. Turns out it's merely scar tissue from 2 c-sections 17 and 21 years ago. My periods sporadically stopped starting about 4 years ago... last bleeding (regular period) was about a year ago. I've been through the hot flashes, etc. I take no meds at all. Just quit smoking (29 years) and drinking. Now on a vegan diet. Big change! Anyway she did the ultrasound and inadvertently found that I have endometrial hyperplasia. My lining is 8mm. Now I have no bleeding or pain in the uterus; the only pain I had turned out to be scar tissue. I feel good, and am totally symptomatic. She wants to do camera, biopsy, possible D&C and frankly I can't withstand any of that I would have to be put under general anesthesia. Also I have great insurance and I wonder if that is part of the reason for the "C" scare I am getting from her. I have researched this and found that many doctors do NOT perform biopsy unless there is bleeding unless you are >11 mm. I have decided to totally change my ways and eat to starve any chance of cancer. She's really worried me, and I also don't understand why she hasn't offered natural progesterone cream. So I went and got it myself at the vitamin store. I rub it in my arm 1x a day. It's in a pump. I am also taking dandelion pills, fish oil pills, vitamin C and vitamin D. I am against having procedures done, esp invasive ones, in the name of insurance, and really feel that I'm fine. Should I be alarmed at the 8mm lining? She said if I like I can wait 6 months and do another ultrasound to see where we are at. Are chances high I'm dying and don't know it? I know you can't make the decision for me, but that's all my info and I'm hoping to hear that truly a biopsy given only the 8mm lining is not necessary. Thanks.
JA: Are you in any pain? How regular are your periods?
Customer: My pain is only left ovary, as I stated above, which is intermittent (happens with orgasm as well which again leads to conclusion it is a muscle and scar tissue. Doctor in office already concluded that. Read my paragraph and you will see I'm not having periods.
JA: Anything else in your medical history you think the doctor should know?
Customer: Nothing
Customer: replied 1 month ago.
oh and my pap smear came back negative.
Customer: replied 1 month ago.
Sorry I meant to say I am ASYMPTOMATIC. No symptoms of anything wrong as far as endometrial hyperplasia.
Customer: replied 1 month ago.
Also with the natural progesterone, will I need to worry about bleeding now? ugh! I just want to reverse the endometrial hyperplasia myself because I know it's because I have too much estrogen and I don't want to take anything synthetic (not that she offered me that choice anyhow...) because it increases chance of breast cancer. Really feel this is money-related because I have zero bleeding or symptoms. I went there for left ovary area pain, doc concluded it's just scar tissue, my pap is normal, and now all this...? over 8mm?

Hi, this is Dr Phil, here to assist you. I am Board Certified with over 10 years of experience. I will respond with my answer shortly. Thank you.

still need help?

Customer: replied 1 month ago.
Customer: replied 1 month ago.
No texting is fine. Appreciate your input. I have zero symptoms nothing wrong except dr. accidentally really, found 8mm lining of uterus. Otherwise I have no issues and now this is a big thing. I have no bleeding or symptoms of anything. She wants to forge full speed ahead (I have good insurance.) I don't. Just want to make sure I'm not killing myself by leaving well enough alone. Really don't want my bladder or colon pierced in some accident while she's up in there doing something that is not necessary imo.

I'm sorry this is going on

How can I be of help?

Customer: replied 1 month ago.
You can just answer my question.... if you would. This is the first prelim question I have asked.
Customer: replied 1 month ago.
This is a $5 "first question" site to the best of my understanding. I don't want to add on money until I get a detailed and thorough answer so awaiting that. Thanks...

Most doctors including myself don't really know or care what type of insurance people have.

We do what is appropriate based on the situation.

Perhaps you could check another ultrasound in 3-6 months and monitor the effect of the progesterone?

Customer: replied 1 month ago.
Since I have not had any abnormal spotting or bleeding, now that I am trying this natural progesterone is it normal to expect bleeding even though I no longer get my period?

Yes, if you start taking progesterone you may have some bleeding.

However, the question in my mind would be is this from the progesterone or the hyperplasia?

Customer: replied 1 month ago.
It sounds like you do agree that the 8mm peri-post menopause measurement on the uterine lining is not a cause for alarm, i.e. biopsy, D&C, etc etc etc since I have zero symptoms. I would think that any potential bleeding would be aligned with the use of natural progesterone. The bleeding itself would be the "thick lining" being shed. This to me would be it fixing itself without expensive or invasive procedures.
Customer: replied 1 month ago.
reversing the diagnosis, essentially.

While logically that makes sense and yes, I agree...

There is no way to be sure that it is the progesterone versus the hyperplasia now causing symptoms

If it were me I would hold off on any progesterone and repeat an U/S in 3-6 months to see if there is any change

make sense?

Customer: replied 1 month ago.
It does! Yes perfect sense. My idea of taking natural OTC progesterone cream is to offset and balance the body's making of estrogen, which is causing the thickness. Is there any other natural thing I can do besides take the cream so that a future ultrasound will give good news?
Customer: replied 1 month ago.
really, if bleeding were to begin with progesterone cream usage, then at the ultrasound you'd see a thinner lining, as the bleeding is actually shedding of the too-thick lining. Chances are low in my non-expert opinion, that any bleeding would be caused from a cancer. I would almost expect to bleed with the cream use if it's doing its job.

Nothing that has good data to support it but I am a firm believer that diet and exercise helps quite a few things

A good, clean anti inflammatory diet plus regular exercise can help

Also, baby aspirin has anti inflammatory properties but no evidence it helps endometrial hyperplasia. That is more theoretical

let me know if you have other questions.

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