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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 yrs experience, awarding winning educator
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I am 71yrs old and have been on HRT . last

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I am 71yrs old and have been on HRT for 26yrs. For the last 6 months I have had a very small brownish discharge for a couple of days. What can I do I am too scared to see a doctor.
Hi, It's Dr. C. Board certified Ob-gyne with 30+ years of experience. I can help you today. I'm sorry that you have this scary bleeding right now. There are a few possible causes. Most of such light bleeding episodes in older women far into menopause are due to tissue thinning. This causes the blood vessels to come to the surface where they can pop and cause such bleeding. But anytime a woman in your age group has such bleeding, we also need to consider less common causes. These include non-cancrous polyps, cancers and precancers. Some medications and other medical conditions can cause post-menopausal bleeding too. Blood thinners,Tamoxifen and liver disease would be the most common. The way the doctor will figure out the cause is to take more history, examine your tissues for thinning and most likely have an ultrasound done. Nearly all uterine cancers start along the lining ofthe uterus. So we take a measurement there. If the measurement is greater than 4mm, the risk of a cancer or precancer is about 10%. In that case the doctor will want to do a biopsy. If the lining is 4 mm or less, they most likely would treat with a very low dose of estrogen placed vaginally to thicken and improve the health of the tissue. This prevents future tissue tears and future bleeding. This can happen even if a woman is already taking systemic EPT as you are. Risk factors for uterine cancer include obesity, family history of uterine or colon cancer, no childbearing, a history of skipping many periods at younger ages and diabetes. But even with risk factors present, chances are MUCH higher that it's from low estrogen causing blood vessels to pop and tissue tears. So the next step is to call your gynecologist or primary care doctor. An exam and ultrasound are typical next steps. I know it's hard not to worry about it being from cancer or precancer but it's much too soon to say that and statistics are WAY in favor of it not being that. Also if it is, it would likely be caught very early. I know this is scary but I hope my explanation has been somewhat reassuring and helpful. Please reply if I can clarify anything or provide more details.
Customer: replied 2 years ago.
Thank you so much. Said as much as I thought. Just have to bit the bullet and get it seem to.
Yes, usually it turns out not to be serious. I hope that's the case for you. Anything else I can help with today? If nothing more, please leave a rating for my service. I aim for excellent and appreciate your feedback. Thanks.
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