11 Comments
Aug 8Liked by Dr. Jen Gunter

This was very helpful and informative as always. The comments helped me understand why my OBGYN is investigating my situation

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So for this particular article women are adult human females? How refreshing not to have to read about "bleeders"! I hope this means that you have reconsidered your opinion, Dr. Gunter, that an individual can simply declare their biological sex and that the rest of the world must uncritically accept that as fact .

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Would being on progesterone mask cancer as it prevents bleeding if on a daily dose? And what if your lining is thicker, say in the 6mm-9 mm range? How often and what kind testing is indicated in that circumstance? Would it be safer to just have a hysterectomy vs risking a missed cancer?

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Progesterone prevents the primary type of endometrial cancer, but taking progesterone is not a guarantee that someone won't get cancer. For example, if the estrogen dose is too high relative to the progesterone or if someone is at high risk for endometrial cancer. A 6-9 mm lining for someone in menopause needs to be evaluated with a tissue sample from the lining, but how this is done depends on several factors.

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The uterine lining comment refers to if someone is bleeding. How it should be evaluated when there are no symptoms depends on many factors.

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Thank you, once again. ~3yrs post menopause found a great menopause GYN practice & after better education, started HRT. In the 4 yrs since, infrequent, but recurrent bleeding. After 2 U/S <4mm, then biopsy (neg), increased progest. from 100mg to 200mg. Many months later, another few, spread out, minor bleeding episodes. U/S 5mm, another biopsy - neg. Originally, progesterone gave a HUGE improvement to sleep, but am nervous about 200mg after mult fibroadenomas & other benign breast changes (biopsies, add'l diagnostics, etc.). Under consideration: return to 100mg oral progest but add Mirena IUD to try to balance sleep, breast health, & uterine protection. Thoughts? Again, thank you for giving access to so much useful research & expertise (infuriating the lack of info & expertise on menopause even when one is savvy & motivated re: medical research & health.... on a topic impacting overall & lifelong health. Hoping advocates like you are moving the needle on this. You're making such a positive impact.)

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Thank you, Dr. Gunter. May I ask - what is a "normal" rage for uterine lining thickness if you are perimenopausal but on MHT (transdermal estradiol and oral progesterone) for treatment of hot flashes irritability and brain fog? I still get my period but my periods got heavier with MHT and my last TV US showed my lining at 4.4. is it less concerning if you are still in peri? Thank you for all you do!

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There isn't a normal range before menopause, we only use it to screen for endometrial cancer after menopause

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Thank you for this - very thought-provoking about the findings for Black women. Is there any data for Asian women?

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Interesting facts, thank you for this information. Vaginal bleeding after menopause can also be from dryness is that correct?

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It can be, that is why a work up is indicated

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