Tamoxifen - endometrial thickness
Tamoxifen - endometrial thickness HI
I am pre-menopausal and still getting very heavy periods - albeit the gap between them is now about 6 weeks.
I have had three womb scans over the last 8 months and my endometrial lining has gone from 11mm to 6mm and on Monday was 9.5mm. I’ve tried to do research on the net and have only found details about the thickness on of the endometrial lining for post-menopausal people on tamoxifen. My lining is definitely high for that category.
My gynae has now recommended endometrial ablation (although 2 years ago he said I couldn’t have that on tamoxifen). He has also said that he wants to take biopsies of my endoemtrial lining. He kept saying he would do both procedures at the same time. I just don’t know what to do. I can’t work out if he thinks biopsies are necessary and whilst he is at it he might as well do endometrial ablation - or the other way round.
I know tamoxifen increases the risk of endometrial cancer. My Mum died of bowel cancer and I had a pre-cancerous bowel polyp removed 3 years ago - my gynae thinks I am at increased risk because of this.
I think he might be being over-cautious - but I don’t know. Not sure that I want to be “messed around” with.
Anyone else had similar problems?
Love
bjj
eek I’m also getting very heavy periods and I was taking tamoxifen, and had a mirena coil fitted in 2004 which was meant to reduce them. I have stopped taking tamoxifen because I ended up with severe constipation, and other side effects which I didn’t think were worth having for five years.
Anyway I now have a gynaecologist and she is recommending hysteroscopy and a biopsy but under general anaesthetic. She says pain will be like bad period pain. I hope that is all. I am now bleeding heavily for seven or eight days with 19 days between meaning I seem to be bleeding constantly.
I was worried about uterine cancer. My G referred me for a non urgent scan which has taken three months to arrange, yet I had an urgent gynae referral so basically the tests will have to follow my visit to the gynaecologist. In addition to the hysteoscopy I am now having a trans vaginal scan which sounds a bit awkward, as they stick the probe bit in the vagina to improve picture quality but embarrass you more in the process. I shall just have to remember dignity, always dignity
Mole
Message for Mole… I had trouble with heavy periods prior to being diagnosed with bc. Like you, I would bleed for 7 or 8 days every couple of weeks. It turned out in the end that I had fibroids. My GP prescribed Tranexamic Acid which I took for the first three days of my period. It certainly reduced the amount of blood loss but I don’t know if you could take it with a diagnosis of bc - it might be worth mentioning.
I also had a hysteroscopy and biopsy but it was done by my GP in the surgery!! (She specialises in Gynae problems). Certainly no general anaesthetic. It wasn’t pleasant by any means but was just about bearable. Had a couple of trans vaginal scans at the time - again, unpleasant but bearable and certainly no worse than a smear test!
Soon after all these probs. I went into the menopause at the age of 52 when I had my last period. I was on Tamoxifen but changed to Arimidex last November and have felt much better in myself since then.
Hope you get sorted soon.
Jo
bjj I can’t understand why you are still on Tam when there are other hormonals which do the job without the endometrium probs. Have you asked about changing?
Time for a heart to heart with your onc. Remember that the alternatives cost more so if your PCT is cash strapped you may have to do a bit of pushing.
Also it’s well worth googling the aromatase inhibitore so you are informed enough to ask the right questions.
Best wishes, dilly
Thank you Thanks everyone for your responses.
Dilly - I can’t have aromatase inhibitors as I am definitely pre-menopausal. I have seen my onc many times as I feel so ill on tamoxifen and the only alternatives she can offer me is either to take it or not to take it. I don’t feel happy coming off it so at the moment I’m sticking with it.
Helen - thanks for your comments. I’ve also got a cyst - apparently tamoxifen can cause these - yet another side effect that you are not warned about. I’ve heard the biopsy procedure is really painful - not looking forward to that.
Mole - your periods sound a lot worse than mine. I’m frightened to leave the house for the first couple of days because it pours out. I found a really helpful website about menstrual loss and mine is way beyond what they call heavy. Lots of graphic pictures and even a warning on the home page for the squeamish - it did make me realise though that I am not exaggerating my problems.
I have had several trans vaginal scans - they really are ok. I was a bit surprised when they put a condom on the probe! I had a female radiologist for all of them apart from one. The man was ok and used a blanket to preserve my modesty but I did feel slightly embarrassed. My partner came in with me and he was very pleasantly surprised at how discrete the whole thing was. One huge advantage is that you don’t have to have a full bladder and the pictures are great - found them really interesting. All in all I would definitely chose this kind of scan over the one over the outside. Far better!
Josie - I don’t know about Tranexamic Acid whilst on tamoxifen and with breast cancer. I was prescribed it years and years ago but on reading the list of side effects - I didn’t take it. I think (but I’m not sure now) that the side effect that most concerned me was the possibility of strokes. I have a strong family history of these and didn’t think it was worth increasing my risk. Have since found out I have “sticky” blood which is much more likely to clot. I have to take a daily aspirin to counter the effects of tamoxifen.
My gynae recommended endometrial ablation at the same time as taking the biopsies to reduce the bleeding. I have now done a lot of reading up about this and I’m not at all sure this is the way to go. The procedure (whichever way it is done) sounds quite barbaric. It only has about 85% success rate - I know which side I would fall in! What concerns me more than anything though that once you have had this procedure taking endometrial biopsies in the future is impossilbe. Any problem will mean an immediate hysterectomy. Also because of my history and my family history I am concerned about getting cancer in another place and I think to rule out being able to check a susceptible part of my body could be a bit stupid. Also if the ablation stopped my bleeding altogether then symptoms of odd breakthrough bleeding etc may not happen and the endometrial cancer could creep up unknown on me. Sounds like I am getting a bit paranoid.
Think I might ask to have a another consultation with my gynae and go in armed with questions - her’s going to love me! Maybe just having the biopsies done is the way to go and I’ll just put up with the heavy periods.
Thanks again.
Love
bjj
bjj my daughter was put on Arimidex when premenopausal because she’d had a leg thrombosis when on the pill so couldn’t take Tam. Still worth asking? Best wishes, dilly
thanks Thanks dilly.
Last time I asked my oncologist - about 18 months ago she told me that I couldn’t swtich. I’m seeing her sometime in the next couple of months so will ask her again - things do change. Who knows my hormone level might even be heading towards the menopause by now and that might make a difference.
Thanks
Love
bjj
bjj should have also said that daughter was put on Zoladex injections so that both sources of oestrogen are covered. Best wishes, dilly
I am sure you cannot have anything but tamoxifen when pre-menopausal.
You would have to have zolodex to beable to have the other drugs as this switches off yoru ovaries.
Rx
R however certain you may be my daughter [at 46] was premeno and put on Arimidex with Zoladex in 2004 [read previous post for reason why] and is doing well on it -except for the worries about Zoladex being only for 3 years. dilly
Yeah Dilly i said that think you misread it if you have zolodex you can have things other than tamoxifen.
Rx
R thanks for clearing that up.
It looks lunatic to continue with treatment that worries and endangers.
So why aren’t the ladies with thickening emdometria put onto other hormonals plus Zoladex instead of being left on Tam?
Anyone have the answer? dilly
Hi bjj My sister has had endometriosis for several years. The docs weren’t much help, they recommended a historectomy with no guarantee of clearing it. Being 29 at the time, she declined.
She researched on the net and found that cutting out wheat and dairy might help her. Subsequently, she has cut out wheat and all dairy ‘cow’ products and her endo has cleared. If she lapses at anytime, it returns. It’s not an easy diet to follow but she does it most of the time and it works for her.
I would say though, that before you thouht about trying this diet, that you research it and speak to your doctor/consultant, and then make up your mind.
Al the best
Saffire xx
Thanks Thanks everyone for all your input - all very much appreciated.
I’ve got an appointment with my gynae on Monday and I shall go in armed with a list of questions (he’s going to love me!) and I’ve got an appointment with my oncologist at the beginning of June - so again I shall go in armed with questions.
It’s been really useful to read your comments and I am very grateful.
Love
bjj xx
results of my investigations I have two fibroids 2 cm each, a polyp and the IUD strings have disappeared and the IUD itself is too low to have an effect on the lining of the womb. So basically I have to have the IUD taken out (mirena) then a camera looks at the inside of the womb, and they take off the polyp and do a few biopsies to see if there is anything untoward. At an unspecified period I have another IUD put in
So much for the mirena. I didn’t notice the strings going up the swanneee
Hi Mole I didn’t know that IUD strings could disappear - yet another delightful thing we have to go through.
I saw my gynae on Monday and he is now insisting on a hysteroscopy and endometrial biopsies - the procedure doesn’t sound like a bundle of fun. He agrees that endometrial ablation is not the best option for me because of the impossibility of taking future biopsies so is now strongly recommending a hysterectomy. Think I will wait for the results of the biopsies before making a decision - the last thing I feel like at the moment is major surgery.
Did you have mirena to reduce your periods? Mine are becoming virtually unmanageable now but still don’t fancy a hysterectomy…
bjj
Hi Have just been reading your post and have been through similar thing myself. After hysteroscopies etc I did end up having endometrial ablation due to excessive bleeding etc and it did lighten the flow but did not shorten the length so it still lasts for around ten days. It was not a bad experience and I was back to work after two days.
When they did the ablation they did a D&C which showed changes in some cells in the lining which did not show up on any of the earlier biopsies. So 6 months down the line I have just had another biopsy which there seemed no problem with even after the ablation.
I have now been advised to have a hysterectomy .
Good luck with whatever you dicide
Suex
A womb with a view wasn’t that a novel by Virginia Woolf?
But I digress. I am not sure I want my womb removed as well as a quarter of my bosom.
Anyway I fly to the US next Tuesday. needless to say I can’t get any insurance for the period problem and I have just started bleeding again just in time for it to be happening when I go on holiday.
Mole