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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11295
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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I am 45 and have had uterine bleeding and pain a

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I am 45 and have had uterine bleeding and pain for over a month, heavily for 3 weeks. My GP prescribed numerous meds to stop the bleeding but these made no difference. I have recently had abdominal and vaginal scans. The sonographer said there were glandular changes to my uterus but she could not say anymore and I would have to wait for her full report to be sent to my GP. That was nearly a week ago and I have another week before my GP appointment. What I want to know is: Other than uterine cancer is there anything else this could be? If I need a hysterectomy will I need to have a biopsy to confirm cancer first of are they likely to just get on with it? I am also sweating profusely at nights which is getting worse every night, is this likely to be due to blood loss, cancer or hormonal changes? The waiting is torturous.

I am in the UK and need info based on this

How regular were your periods before this bleeding started a month ago?What meds has your GP tried?Do you use anything for birth control? Thank you.
Customer: replied 2 years ago.

Always regular apart from cycle getting 1-2 days shorter over the last 2-3 years.

The GP first gave me norethisterone, then added tranexamic acid along with mefanamic acid for pain. None of this worked and I was also passing large pieces of 'tissue'.

He then prescribed microgynon which I have stopped taking now after 5 days as it didn't make any difference and as it contains oestrogen I am concerned it may increase cancer.

I think that the chance of uterine cancer is low. Usually it requires years of fairly irregular bleeding for uterine cancer to develop. Uterine cancer develops when the uterine lining builds up too much over time (due to hormonal changes), and that buildup gradually changes to cancer.You may have precancer changes, but they can usually be treated with progesterone hormone pills.You will probably need an endometrial biopsy (thin tube through the cervix to sample the uterine lining) or a D&C. Since your bleeding has continued in spite of progesterone, perhaps the best solution would be the D&C. That would usually stop the bleeding plus make the diagnosis.That might be the only treatment you would need.
A hysterectomy would not be done without a biopsy first.The night sweats are due to hormonal changes, and are common at age 45.Since you've been bleeding heavily for 3 weeks, I would recommend taking iron pills once or twice daily to help your body to re-build the blood cells.
Dr. Norm S. and other OB GYN Specialists are ready to help you
Microgynon would likely help your bleeding, but it takes time to work. The progesterone in it will help cause the changes that cause the built up lining to clean off. The estrogen usually will help to decrease the bleeding while those changes are occurring. You could even take a pill twice daily. I'd be surprised if that didn't help.The "glandular changes" suggested by the ultrasound may be a polyp or polyps inside the uterus, which may be why the bleeding hasn't gotten better with the northisterone. If that's the case, then the D&C (with hysteroscopy) will clean them out.
Customer: replied 2 years ago.

The sonographer said no fibroids or polyps. The scan showed multiple spots highlighted with yellow and red colours.

I thought that the main cause of uterine cancer was oestrogen which is why I was reluctant to continue with the pill.

I'm don't think they can always identify polyps on a scan.Uterine cancer is caused by estrogen not countered by progesterone. As long as there is progesterone (produced each month after ovulation), cancer doesn't develop.Thank you for your payment and rating.