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Dr Owen
Dr Owen, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 55754
Experience:  Board certified Ob/Gyn
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I have DUB. I have had an ultrasound and my endometrial lining

Resolved Question:

I have DUB. I have had an ultrasound and my endometrial lining was 2.4mm and smooth. I also have two submucosal fibroids, one high up in the uterous and one in my cervix. Both roughly 25mm. I am interested to know if my constant bleeding is likely to be caused by the thin uterine lining, the fibroids or a combination. I am 47 and premenopausal so I guess there is a chance it could be caused by annovulatory cycles? I would be it interested in your view, particularly in relation to the thin lining. Thanks. Wendy
Submitted: 3 years ago.
Category: OB GYN
Expert:  Dr Owen replied 3 years ago.

Dr Owen :

Hello

Dr Owen :

Well your LINING is absolutely NORMAL - and not the cause of your bleeding.

Dr Owen :

The fibroids are MOST likely the cause of your bleeding given what you ahve said.

Dr Owen :

have said.

Dr Owen :

Also I see you are close to perimenopause - so yes this too can be the cause of the bleeding.

Dr Owen :

NOW, since you have an uterine lining that is less than 4mm - you do Not need an endometrial biopsy since this is not going to be a cancer.

Dr Owen :

hi

Dr Owen :

so to help the bleeding - here are some possible things you can do.

Dr Owen :

1. You can get an Ablation such as the Novasure ablation

Dr Owen :

2. You can try an UAE - Uterine Artery Embolization

Dr Owen :

3. You can also try to use the Mirena IUD.

Dr Owen :

I hope this helps

Dr Owen :

Please if you have more questions ,please ask

Dr Owen :

Please click on EXCELLENT

Dr Owen :

Thank you

Customer: Right, to be clear, the ultrasound was 1 year ago. What are the chances of it growing significantly in this time? I am due another scan tomorrow and am anxious that they might find cancer this time round. The progesterone treatment did nothing but on Agnus Castus my bleeding had settled down to being mostly confined to my cycles but very heavy (twice losing a litre over one night!). I stopped the Agnus Castus and things have got worse again. This month has been constant bleeding bright red and very fluid. (I am on iron pills). Previously I had been clotting. I am trying to reassure myself that even if it was cancer with only less than a year since it started things would be hopeful! I have had a smear test which came back borderline and hpv negative so no further action was taken there.
Dr Owen :

Very Unlikely the Ultrasound will change in a year - but if you want to be 100% sure a simple endometrial biopsy can be biopsy

Dr Owen :

can be done

Dr Owen :

This is very UNLIKELY to be a cancer - given the 2.4mm you had 1 year ago - it really does NOT turn to cancer.

Dr Owen :

And a borderline PAP will not be cancer -

Dr Owen :

so more than likely this is just hormonal - but you CAN do any of the following treatments as I have suggested -

Dr Owen :

The agnus cactus is fine - but the other 3 treatments do work much better

Dr Owen :

Hello

Dr Owen :

Are you there?

Customer: Sorry, yes, I'm just getting used to how this site works! Thanks you for,your answers, prompt and detailed - more than I've got from my G.P or gynaecology dept in two,years! I was wondering if the lining might be too thin atrophy)and that might cause the bleeding? Also is it likely to be significant that the blood is fast flowing and bright red rather than clotting as before?
Dr Owen :

Actually the lining is not too thin.

Dr Owen :

What we don't want to see is an endometrial lining greater than 4.0 mm WITH bleeding - and since you have a lining less than 4.0 mm - you are safe. AND 2.4 mm is PERFECT this is NOT that cause of the bleeding

Dr Owen :

And given you have submucosal fibroids - these are essentially where the blood vessels are located as they supply the fibroids - and hence this is a strong possible cause of your bleeding.

Dr Owen :

But you are 47 - still could be perimenopausal - hence what we call hormonal bleeding - and hence why the Agnus worked a bit - as this is a weak estrogen product - I would NOT continue to use this all the time.

Dr Owen :

Blood is blood - does not matter if bright red, brown, purple, fast or slow or clotting or not - so nothing really significant other than you have more blood than you are usual and what you need to do is stop the blood flow.

Dr Owen :

I wish you well

Dr Owen :

Please click on EXCELLENT

Dr Owen :

Thank you

Dr Owen :

I wish you well

Dr Owen :

Have a good day

Dr Owen :

Please click on EXCELLENT for helping you

Dr Owen :

Thank you

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