Re: mENORRHAGIA
From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Sun, 22 Feb 1998 18:02:35 -0600 (CST)
At Sun, 22 Feb 1998, aNASTASIA wrote:
I have a headache from reading your anti-establishment method of typing.
In the future, establishment typing for establishment answers. Deal?
>i HAVE TWO DISTINCT PROBLEMS i'M BATTLING - ONE IS hASHIMOTO'S
>THYROIDITIS, WHICH FLARES UP OCCASIONALLY AND i HAVE SUFFERED WITH SINCE
>AFTER MY SON'S BIRTH (1980).
Are you on thyroid medication to reduce the "flare-ups"?
>i HAVE HAD FIVE PREGNANCIES: TWO MISSES
>AND THREE LIVE BIRTHS VIA C-SECTION. i USED AN iud AFTER MY FIRST
>C-SECTION, BUT HAD IT REMOVED BECAUSE OF THE BLEEDING. aLL LIVE BIRTHS
>WERE FIVE YEARS APART.
>
>i AM CURRENTLY 42 YEARS OLD. i HAVE BEEN BLEEDING HEAVILY SINCE ABOUT
>1986, A YEAR AFTER MY SECOND LIVE BIRTH. iT HAS GOTTEN TO THE POINT
>WHERE i END UP IN THE er WITH PALPITATIONS, LIKE i'M GOING INTO SHOCK.
Were you going inot shock or just felt like it?
>mY PERIOS WERE FREQUENT AND LASTED OVER A WEEK. mY FIRST PERIOD CAME
>WHEN i WAS 10 YEARS OLD. i HAVE ALWAYS HAD BAD CRAMPING, BUT THE
>BLEEDING WAS OK. i DID NOT HAVE SEX UNTIL i MARRIED WHEN i WAS 22, SO i
>HAVE HAD NO stdS.
>
>lAST jUNE, MY gYN GAVE ME THREE LUPRON SHOTS WHICH STOPPED MY PERIODS
>FOR ABOUT SIX MONTHS. dURING THAT TIME, i WAS ABLE TO RECOVER A GREAT
>DEAL OF MY STRENGTH AND MIND. tHEN i HAD MY PERIODS BACK, JUST AS BAD
>IN TERMS OF BLEEDING, BUT NOT AS BAD IN TERMS OF THE OTHER SYMPTOMS
>BECAUSE i HAD HAD A CHANCE TO RECOVER.
>
>i HAVE HAD TRANSABDOMINAL AND TRANSVAGINAL ULTRASOUNDS. i HAVE HAD
>ENDOMETRIAL BIOPSIES AND d&cS. i'VE HAD VARIOUS HORMONAL TESTS DONE AND
>THEY WERE PRETTY MUCH NEGATIVE. i HAVE SOME SMALL FIBROIDS. mY UTERUS
>SEEMS TO BE ENLARGED, LIKE IT NEVER SHRUNK BACK PROPERLY AFTER EACH
>PREGNANCY. mY DOCTOR SAID i HAVE AN UNUSUALLY THICK ENDOMETRIUM.
Possible problems coming to mind are submucous fibroids, adenomyosis,
and my personal favorite, I don't know.
>tO HIS CREDIT, mY DOCTOR HAS TRIED TO AVOID HYSTERECTOMY, BUT i AM AT MY
>WITS' END AND TIRED OF GOING TO THE er FOR THE PALPITATIONS (WHICH, BY
>THE WAY, DISAPPEARED DURING THE TIME i WASN'T MENSTRUATING). hE HAS
>BEEN VERY SUPPORTIVE AND WILLING TO DO THE HYSTERECTOMY OR NOT AS i
>WISH.
I'm confused about this "thick endometrium". It's rather strange to
have a thick endiometrium on sonography and a normal endometrial biopsy.
I'd recommend a sonohysterogram to delineate the actual linig of the
uterus and see if adenomyosis is a possibility. If so, a hysterectomy
might be a good choice. If not, endometrial ablation or uterine balloon
ablation (presuming no submucous fibroids to be removed as the primary
cause) will work in 85% of patients. This is also presuming that you
are euthyroid and that this is not the primary cause.
>iS THERE ANY REASON i CAN'T KEEP HAVING lUPRON SHOTS UNTIL i FINISH WITH
>MENOPAUSE? i REALLY DON'T WANT TO HAVE ANOTHER ABDOMINAL SURGERY. aNY
>SUGGESTIONS YOU CAN GIVE WOULD BE GREATLY APPRECIATED.
--
Harvey S. Marchbein, M.D. FACOG
OBGYN.net U.S. Representative, New York
Great Neck, New York
http://www.obgyn.net/states/bios/marchbein.htm
http://www.obgyn.net/women/advisors/harveym.htm
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