Patient's question:
Endometrial thickening, had two D&C procedures, still having bleeding.Doctor's answer:
Hello: This may be due to endometrial hyperplasia, causing dysfunctional uterine bleeding.Treatment should be planned based on the patient's age, the condition of the endometrium, and her fertility requirements.
For endometrial hyperplasia, if abnormal cells are found (especially in women over 35 who do not wish to have children), surgery to remove the uterus is usually chosen, as abnormal cells may be precancerous lesions.
For endometrial hyperplasia with normal cells but heavy bleeding, high-dose androgens, progesterone, or oral contraceptives can be used. Alternatively, estrogen injections can be administered alone to stop bleeding, followed by oral progesterone. Bleeding usually stops within 12 to 24 hours. Subsequently, low-dose oral contraceptives should be taken cyclically for at least 3 months. For lighter bleeding, oral contraceptives can be used alone cyclically.
For patients who are not suitable for oral contraceptives or estrogen, oral progesterone can be used alone for 10 to 14 days each month.
If hormone treatment is ineffective, a dilation and curettage (D&C) may be performed to remove the endometrium. If the patient wishes to become pregnant, clomiphene can be taken orally to induce ovulation.