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D&C Question


Posted by colleen777

Hello. I am 40 years old and starting in January, I started having irregular bleeding. I had a period from January 13-January 16th, period started again January 24th and ended January 27th. Then on February 12th, period started again only heavier and did not end until I visited a doctor on February 24th.

 At that time, i was given a manual exam - told i had what he thought was a small fibroid tumor above my cervix. I was given blood work, put on provera to stop the bleeding, scheduled and had a transvaginal/pelvic ultrasound and was told the doctor's office would call in the next few days to make an appointment for a D&C.

 I was a little stunned because i thought I would be told that I was going into menopause. Since the 24th, this doctor's office has not called once to give me results of bloodwork, ultrasound results or to schedule D&C. My Provera prescription runs out in 3 days and I figure I will start bleeding again, but am not sure.

 I have not had abnormal bleeding until this past January. My regular periods were lighter than usual (my normal period was about 4 days, and had recently gone to maybe 1-3).

Would a D&C be recommended prior to even seeing blood results? Ultrasound results? Could this be a hormone imbalance due to menopause?

 I am not sure if i should seek a second opinion (I guess I should since the doctor's office is not calling me - and, by the way - I've called and left messages for the doctor now four times and still no call).

I guess I just feel like D&C would be recommended if I had a history of heavy bleeding/prolonged bleeding, which I don't.

 Thanks for your response!

 
Answers (1)
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Dear Colleen

You are right to question.  You?ve had the appropriate tests to determine if something is seriously wrong vs just beginning perimenopause.  Hormonal levels - saliva or blood would also be helpful.

First, you should get a response from your physician?s office about your test results.  Don?t take no for an answer.  Some physicians want you to come in for a visit to discuss test results, but you?ve not even had that response.

A D&C should not be recommended without determining necessity and checking less invasive tests such as those you have had.  It is important to find out if something other than hormone fluctuations is causing your bleeding, of course.  Indeed, I would find another physician - one who will work WITH you as a health care partner.  Sad to say, it took me 3 tries to find such a gynecologist when I was bleeding heavily in perimenopause.

if indeed, you are bleeding due to perimenopause, and no other serious conditions exist, then increasing your intake of iron or red meat should keep you from getting anemic.  Interestingly enough, fibroids often show up in perimenopause, only to shrink or disappear when in full menopause.  (That happened in my case.)  

You are also right that your bleeding has not been heavy or prolonged.  Even if you should experience heavy bleeding or prolonged bleeding as part of perimenopause, a D&C should not necessarily be the first answer.  It is an invasive procedure with all the attendant risks of general anesthesia.  Again, you?ll want to determine with your physician/health care partner if your bleeding is due to perimenopause or a more serious condition.  Also, if or when you make an appointment with a new physician, have your previous test results sent over to him/her.  They are part of your medical record and they belong to you.

Below is a recent blog I wrote about heavy bleeding in perimenopause in response to another Wellsphere member - you might find some of it helpful.  Good luck and let us know how it goes.

Lynette Sheppard RN
Health Maven
www.menopausegoddessblog.org

Recently on one of the health websites where I am privileged to be an ?expert? on Menopause, www. wellsphere. com,
a member raised a question about bleeding for over a month solid. Of peri- menopausal age, she was under- standably worried. Most of us think of menopause as a time of skipping or diminishing periods until they cease altogether. Because this question comes up frequently and because it was the case in my perimenopausal transition, I?m reprinting my answer to her for all concerned goddesses.

?Actually, it CAN be normal. Heavy and/or prolonged bleeding during perimenopause can be a normal variant. I had my period every other week (and heavy flows) for a little over a year. Because prolonged bleeding (called dysfunctional uterine bleeding) can be a symptom of more serious conditions, it is important to be checked out by a physician. A pelvic ultrasound and/or endometrial biopsy can rule out pathology. Even if no serious condition is found, you must be monitored for anemia. Regular red blood cell and hemoglobin counts are recommended. I simply increased my intake of red meat and took iron supplements and was never anemic.

Even in the absence of disease, if bleeding persists, your MD may recommend a ?simple? D & C (dilation and curettage) or even hysterectomy. I?d get a second opinion or even a third. Remember that NO surgical procedure is simple - each has risks, including that of general anesthesia. A good rule of thumb is to always try the least interventional remedy first.

It took me three tries to find an enlightened gynecologist who felt that heavy bleeding was a normal variant. After ultrasounds and an endometrial biopsy (performed in her office) returned as ?normal with menopausal thickening of uterine lining), together we monitored me for anemia and eventually I began skipping periods as I continued on my menopause journey.

Hope this helps - let me know if you have further questions. For more info - check out our blogsite at www.menopausegoddessblog.org. Good luck. Lynette Sheppard RN.?

On a further note: I cannot tell you how many of my nurse-friends had D & C?s or hysterectomies after three weeks of bleeding. When they went to their OB-GYN?s, understandably a little freaked out, those were usually the only recommendations. While a surgical procedure may end up being the right choice for you, it is not necessarily the only or best one. I?ve said it before and I?ll say it again. You MUST be in charge of your own health care education and decisions. Still have questions? Click on the ?Contact Us? button at the top right of the page or visit me at www.wellsphere.com in the Menopause Community.

?The Big M?, the long awaited chronicle of the real-life adventures, musings, wit, and wisdom of the Venus group of Menopause Goddesses is available now. Check out our girlfriend?s special: buy one at regular price and get the second for HALF PRICE. To buy or for free download of Chapter One The Big M, visit thebigmwebsite.com
NOTICE: The information provided on this site is not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified health provider because of something you have read on Wellsphere. If you have a medical emergency, call your doctor or 911 immediately.
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