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Re: Postmenopausal bleeding From: Garry E. Siegel, M.D. (garrys@mindspring.com) Thu Dec 29 19:01:50 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: Cesarean on Demand" Previous message: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Re: Cesarean on Demand" In reply to: art fougner, md: "Re: Postmenopausal bleeding" Art: You are right that I've not excluded a polyp, but I think I've explained the bleeding. FWIW, I don't feel compelled to do a SIS or H-scope. I'm going to treat with Provera, and see what happens/maybe do an endometrial thickness scan. Garry At Thu, 29 Dec 2005, art fougner, md wrote: > >Garry > >you haven't excluded a polyp, a not uncommon finding made less likely by >a "thin" EM on TVS. And if you are really compulsive, either saline >sonohysterogram or office hysteroscopy would be diagnostic. > >Barring a polyp, since the biopsy did not show CA would observe response >off estrogen. > >Just my opinion, I could be wrong. > >Art > >At Wed, 28 Dec 2005, Larry Glazerman wrote: >> >>I'd consider a TVUS, and if endometrium not significantly thickened, >>probably nothing else. Your idea for Provera makes sense, as well >> >>-- >>Larry R. Glazerman, MD >>Ob-Gyn at Trexlertown, PC >>610-402-0161 >>l.glazerman@rcn.com >> >>-----Original Message----- >>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. >>Siegel, M.D. >>Sent: Wednesday, December 28, 2005 7:26 PM >>To: Multiple recipients of list OB-GYN-L >>Subject: Gyn: Postmenopausal bleeding >> >>74 YO on unopposed estogen (despite our protestations) presents with >>postmenopausal bleeding. >> >>Her exam is unremarkable, and the biopsy shows proliferative endometrium >>with stromal and glandular breakdown. >> >>She stopped estrogen once the bleeding started and will not resume. >> >>Would you: >> >>1. Do and D and C/hysteroscopy to further define and exclude >>malignancy? >>2. Give a short course of a Progestin (Provera 10 mg. for 10 days)? >>3. Do nothing and see what happens? >>4. Other? >> >>Garry >> >>-- >>Garry E. Siegel, M.D. >>Private Practice >>Roswell, GA >> >-- >art fougner, md > >"I knew I was going to take the wrong train, so I left early." >Lawrence Peter Berra > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Garry E. Siegel, M.D.: "Re: Cesarean on Demand" Previous message: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Re: Cesarean on Demand" In reply to: art fougner, md: "Re: Postmenopausal bleeding"

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