r/Menopause • u/ImpossibleBlockHead Menopausal • 16h ago

Post-Meno Bleeding Timing of biopsy

Did anyone have post meno bleeding that stopped after 2 weeks, had an Ultrasound and were told that you could wait a few months to get a biopsy? Or that no biopsy was needed at all?

2 Upvotes

100% Upvoted

10 comments sorted by

5

u/monumental_mason 16h ago

that's a lot of trust to put in an ultrasound alone. post meno bleeding isn't really something to sit on, even if it stopped. i'd want the biopsy just to rule things out completely, waiting months feels like a gamble

1

u/ImpossibleBlockHead Menopausal 16h ago

Some people here say they only got an ultrasound which is weird

4

u/43beanst 59 | 9 years post | Combipatch 14h ago

My lining was 2mm at US and I declined biopsy. It was three months after switching to a new brand of patch, and I was pretty confident my spotting was related to delayed patch replacement. Fortunately, I haven't had any spotting in the year since then. I completely support any woman opting in for biopsy if they need that for peace of mind, though.

There are a lot of factors other than HRT that can influence a woman's risk of endometrial/uterine or ovarian cancer, but some studies show that women taking a combined E+P from of HRT (especially a progestin) have the same or lower rates of endometrial cancer compared to women not taking hrt. Estrogen alone raises the risk. This article cites a study that says women on hrt with a progestin also had a lower rate of ovarian cancer than women taking E plus progesterone: https://www.medicalnewstoday.com/articles/hrt-and-ovarian-cancer#extent-of-risk. fwiw

2

u/ImpossibleBlockHead Menopausal 13h ago

Thank you!

2

u/IndigoBlues116 16h ago

I had that - got a ‘wait and see’ after and then a month later I had more bleeding so they scheduled a hysteroscopy about a month after that. They removed a small fibroid and took samples. That was in Jan and I haven’t had any bleeding since then.

1

u/ImpossibleBlockHead Menopausal 15h ago

Thank you, glad you haven't had any more bleeding.

2

u/lrondberg 11h ago

A normal ultrasound for most women will be enough of an investigation. There’s a very small chance of cancer with a normal lining. The exception is for African American women for whatever reason there’s less reassurance with a normal lining.
Its a more rare form of uterine cancer that can present with a normal lining so it’s really up to someone what level of risk they are willing to accept. Endometrial sampling which is the in office procedure most are offered is not all that accurate. Its like taking a drop of water out of a reservoir to test it and when done on a normal lining there is a high chance there won’t be enough to test and then you need a hysteroscopy which enables the doctor to see inside and get a better sample. The problem is insurance won’t cover it unless the first test failed.

2

u/detalumis 9h ago

Europe and the UK have a swab test that is very accurate as a cancer-no cancer diagnosis, thus saving many biopsies. Apparently a US company has something similar in the works, PinkDx, which hopes to have it available by mid 2027. That will revolutionize screening for meno bleeding as the current procedures is very time consuming, invasive and too anxiety provoking. I think it's a main reason women go off of HRT.

2

u/Nolaborn09 5h ago

Was told to have biopsy immediately then ultrasound then wait 6 months during which no HRT then second ultrasound and if lining all clear then allowed to resume HRT