29) Endometrial Hyperplasia: Treatment with the LNG IUD (@dr_dervaitis)

IMPORTANT 2023 UPDATE re: IUD DURATION OF USE- US FDA now approves 52mg levonorgestrel IUD (Mirena, Liletta) for up to 8 YEARS use for contraception. Progesterone levels decline after year 5 and thus extended use for other indications (heavy menstrual bleeding, simple endometrial hyperplasia) may vary.
******
Dr. Kristina Dervaitis, a gynecologist in Newmarket, Ontario (Canada) answers your questions about IUC.
❓WHAT IS ENDOMETRIAL HYPERPLASIA?
❓What are the risk factors?
❓How is it diagnosed?
❓What is the difference between endometrial
hyperplasia with or without atypia?
❓What are the treatment options?
❓What are the advantages of the levonorgestrel
(hormonal) IUD as first line treatment?
❓What is the long term management?
Please note: this channel is provided as a volunteer public health education initiative (not for profit, no industry support, the channel is not monetized with ads). Dr. Dervaitis received her MD in 2000 and completed her OB/Gyn residency training in 2005 at Western Univers ityn

[@veraemarion6697]

Thank you so very much. I’m 62 was treated with Premarin 6 years ago. Now I’m being told I should get a complete hysterectomy Endometrial hyperplasia without atypia. I’m going to consult with my doctor about the iud now that I’ve seen your video. As I am a lot more informed as to my diagnosis. Thank you so very much .

[@aishahussain5045]

Thank you very much very clear information. I'm having alot of these issues found on scan quite scary but I'm staying positive any females going through this I send healing and prayers 🙏 ❤

[@mistytaylor8166]

After experiencing what I have with endometrial hyperplasia I was offered the iud option and I said Nope. I was prescribed medproxyprogesterone 2 times daily and thankfully it is working miracles. Cheers from a fellow Ontarion.

[@Djoanng]

Thank you for explaining this all so clearly.

[@deebelle4318]

Perfect and comprehensive description of this condition. Thank you so much Dr. ...

[@dr.kristinadervaitis789]

You are very welcome! Glad you found it helpful! -Dr. D

[@mohamedhosny5847]

Thank you very very much it was an amazing lecture.

[@cathietonkin5577]

Thank you Dr. Very helpful, I’m due within the month for this surgery!

[@SilviaSanchez-ff3we]

Thank you doctor. I had a biopsy done today, and I was unclear about the next steps. Very clear, and thank you for sharing your knowledge.

[@sheelaabhinaya]

Well explained....thank you

[@chingu1425]

Thank you for this valuable info 🙏🦋🦋

[@firduasmiyanji8930]

Thank you so much.I really appreciate you explaining everything so well, it helps knowing the best way to go for treatment

[@cynthiashesobless7155]

Thank you for sharing

[@SylviaKakai-bm1hc]

Wow, I'm grateful for the clarity in the message.

[@maggiewalshkahlout6364]

Thank you so much for explaining this, makes it so easy to follow.

[@emilybeeman3090]

I just wanted to thank you for putting this together. I have been reading a lot about this and this was by far the most thorough discussion of endometrial hyperplasia. I especially appreciated the explanation of the two different types, with atypia and without. Best regards!

[@dr.kristinadervaitis789]

You are most welcome! So glad you found it helpful. Thanks for watching and for your kind comment. All the best, Dr. Dervaitis

[@mariamkassim9455]

Hii Quies beneficial.. May God bless you. I apreciate your vivid explanation

[@starseed462]

Thank you 😊

[@janelee4961]

Thank you so much for the clear explanation❤❤❤❤

[@dorothywalter7951]

Thank you, Doctor!!! Excellent explanation!!!

[@barbarameehan113]

Thank you Doctor. Wonderful explanation.

[@dr.kristinadervaitis789]

Glad it was helpful!

[@Caress1972]

Thank you for the informative video. I wish we were more educated on what perimenopause means so when our body warns us with irregular bleeding, etc., we know it's time to get an exam and ultrasound STAT.

[@kavithagarimella4413]

A very informative and clear cut explanation on a very complex and confusing symptom of the illness this is the best advice so far I got thank you 🙏

[@dr.kristinadervaitis789]

You are so very welcome! Glad you found the video helpful! -Dr. D

[@MX1.1.]

Same here. Thank you Dr.

[@annr2900]

Thanks for the great videos! At my consultation appt I was told that the IUD may also be helpful for my endometriosis. Would love to see a video with more information about that too.

[@LisaJazz]

im new to your content, however really appreciate them (I am also in Canada). Im about to get an IUD due to high suspicion of endometreosis. Its getting put in next week and watching your videos have helped me prepare. Thank you.

[@rmac2489]

Oh how I wish I had seen your video 2 months ago. I have the endometrial hyperplasia but I am being treated with Medroxyprogesterone Acetate 10mg. The first month (taking pills on days 1-14 of the month) and what followed was the absolute worst bleeding I have ever had. It was so bad I called the Dr after 4 days of this really heavy bleeding because I was so alarmed by the unbelievable volume. The second month has been better but I so wish I knew about this IUD!!! That would have made things so much easier!!! Thank you for your video - so much important information.

[@dawnnc27]

Thank you for explaining this so clearly. Loved the fertilizer/mower reference. Now I understand.

[@dr.kristinadervaitis789]

Glad you found the video helpful! -Dr. D

[@JaneSmith-dr4do]

Excellent video. I appreciate your knowledge on the subject of IUD's. 52 y/o dx with endometrial hyperplasia without atypia. Was recommended the Mirena IUD, now I know why. Wish my MD could have taken 15 minutes to explain. Thank you

[@dr.kristinadervaitis789]

You are most welcome Jane! Glad you found the video helpful. -Dr. Dervaitis

[@sugeyalvarado6755]

Great video! So informative! Keep up the good work ❤

[@dr.kristinadervaitis789]

Glad it was helpful!

[@a.s.r.3661]

Great explanation, Dr! Thank you.

[@JohannaRyerson-fg6xp]

Thank you for this video. It so informative. I appreciate your time.

[@dr.kristinadervaitis789]

You are very welcome! Glad it was helpful!

[@rubiejones1897]

Thank you for this thorough and succinct video on endometrial hyperplasia. As a sufferer it is horrible. I really just want a hysterectomy. We have done an ablation and now an iud. I still have painful cysts and am tired. I’m hoping the mirena will stop the cyst formation too.

[@Jules_Jules]

Last year this time, I had extremely painful periods ( happened 6 months after I stopped oral contraception pill ), pain killers couldnt ease the pain. I felt like giving up on life! It was really really painful periods for the whole 7 days every month. Out of desperation, I went to a private gynecologist. She suggested mirena which I agreed to. Just over 1 months after, I experienced no more pain on my periods and not so heavy anymore. Its a life changing for me. And this video helped to be convinced to have mirena which I was sceptical before. Thank you for very helpful info, Doc🙏🙏

[@dr.kristinadervaitis789]

So glad to hear that your situation has improved and that you found the video helpful! All the best, Dr. Dervaitis

[@KreativeKontrolz]

You explained this perfectly

[@alison3776]

Dr Dervaitis, thank you very much for this informative video. I am going for Mirena IUD insertion today as EH treatment. I hope it works for me!

[@dr.kristinadervaitis789]

So glad you found the video helpful Alison! All the best, -Dr. Dervaitis

[@alison3776]

Dr Dervaitis, may I know what is the purpose to do the biopsy periodically after Mirena is inserted and no more heavy bleeding? Many thanks!

[@Apple-ml3rz]

Thank you for explaining this all so clearly & making it easy to understand! I had an endometrial biopsy a week ago as my wall is 15mm & I have bleeding in between periods. I’m still waiting on the results. People need to speak up about symptoms! I had the ultrasound only because I said I have irregular bleeding between periods. Then they found fibroids & a thick endometrial wall. Then they did the biopsy. It’s better to be safe than sorry. Speak up ladies. Hopefully I don’t have cancer. Ugh

[@Apple-ml3rz]

My gynecologist tried putting in an IUD during my biopsy. She couldn’t get it in, she said I have scarring because of the 3 C-sections I’ve had. The biopsy was painful especially because she was trying to put the IUD in. Ouch.

[@courtney4886]

Hope you are well. What was your outcome?

[@Carebearr]

Thank you so much for making this educational video.

[@KatJ3st]

LOVE your glasses!!!

[@umalbaneen3923]

💗

[@rdhami7639]

Thanks so much. You explained so well. I am watching from uk. 🙏

[@dr.kristinadervaitis789]

Glad it was helpful! -Dr. D

[@tyolahughes2279]

Thank you for this in depth explanation. I have hyperplasia without atypia and just had an IUD(Mirena) procedure done as treatment.

[@user-vk1ro2mw8g]

Hello! How are you doing? I hope it’s working out well for you! Did you still get your period or experience any bleeding while in the IUD? Sending healthy vibes your way!

[@briderk]

I appreciated the explanation. Thank you very much

[@cmr6469]

Very helpful information. More than my GYN doctor told me. I'm on the Mirena IUD (after having some post menopausal bleeding due to enlarged endomedtrium lining) but on Mirena IUD i've been spotting now for 3 weeks, i was going to ask my GYN to take it out but after this video i may keep it in for a little longer.

[@mariecrisginez8427]

Thank you so much, it helps a lot were I have Endometrial Hyperplasia vs Endometrial Polyp now.

[@mariecrisginez8427]

Hi Dr. I learned a lot from your video but I am very much worried for my health.. I have a prolonged menstruation at the moment for 3 months from May, June and July monthly period for more than 2 weeks of bleeding. My question is, Is it a sign of minaupausal at my age (47 yrs old)? Thank you.

[@dr.kristinadervaitis789]

Hello- Menopause usually presents with irregular or less frequent periods (not prolonged bleeding). Unfortunately I can’t give personalized medical advice over the internet. I’d recommend that you see your doctor for further evaluation. -Dr. Dervaitis

[@arfa8091]

Thank you Dr for the great explanation. Can i know the available medications for second line treatment, examples of the the oral progestogens used with dosages

[@dr.kristinadervaitis789]

This info is beyond the scope of this channel. Talk to your doctor. -Dr. Dervaitis

[@zarzilla392]

Had a biopsy done last year (and was diagnosed with hyperplasia). I had heard a lot of people complain about how painful this procedure was. I made me SO ANXIOUS. I cried the night before because I was terrified. It literally takes only a few seconds. Once my OBGYN was done, I let out an extremely long sigh and started laughing. She asked me if I was ok. I replied "Sorry, it's just that... I had heard this hurt a lot, but quite frankly, I wish my period cramps hurt this little" She looked at me as if I was crazy. Moral of the story: "pain" is a very biased scale. It all depends on what type of pain you are used to deal with.

[@dr.kristinadervaitis789]

Thank you for sharing your experience with the other viewers! I’m glad it wasn’t as uncomfortable as you had anticipated. All the best, Dr. Dervaitis

[@marthasandoval8845]

My daughter has this condition , his doctor place an IUD and did a biopsy, she was doing okay, there was no more cancer cells but they insert another one for 11 years.why?

[@dominic77999]

Great talk, many thanks, from UK :)

[@CLMG714]

Hi everybody. I hope this information helps. I have endometrosis atypia. Currently, I have the IUD Mirena for almost one year. Thankfully, my uterus lining went back to normal. My doctor is going to do surgery to check everything in December. My goal is to get pregnant. I hope the treatment works. My doctor has me taking Prenatal vitamins. Much love 💕 💫 good luck to all the ladies. Don’t loose hope.

[@Baby2890]

Hi Cindy, how did it go with your doctor in December? Everything ok?

[@CLMG714]

Yes, everything well well. My Mirena IUD was removed. I am still taking prenatal vitamins. Also, I am taking progesterone pills. My doctor prescribe me Letrozole.

[@Kakers1288]

🙏🙏🙏🙏

[@meryanndanan3610]

Hi Cindy.how old are u would u mind asking. Coz me iam 44 years old still I want to have Baby but same problem they want to put minera coil how can I get pregnant if I got.coil how long is the treatment takes place.

[@CLMG714]

Hi Mery Ann. I am 35 years old. Update: when they took out the IUD, my body reacted bad. My hip and thigh got uneven. I was in severe pain but now I am fine. And with the IUD you can’t get pregnant.

[@kesaraclark8468]

Thank you very much, doctor!

[@snow8385]

I got mirena inserted two days back only, I took oral progesterone for about 2 months but still my endrometrial lining was 26.4 and this looked too scary and disturbing but finally I consulted another doctor and she said that mirena is the best option for this. Therefore, I got it done. However, it’s so rightly decided and done that IUD should be the first line of treatment. I must have not faced a lot of trouble if that couldn’t be in my case the first line treatment. But I thanks my doctor and god that I am able to get the treatment. And I am fine after it.

[@MATech-yu8gd]

Oh An amazing lecture By an amazing doctor I really enjoyed it dr

[@dr.kristinadervaitis789]

Glad you found the video useful! 🙂

[@sitikhatijahejalawieya5652]

Thank you so much for explanation , its a great video ❤️

[@sharonkowlessar1029]

Exactly what the doctor told me,

[@MissRandom077]

Very informative. I had my 1st biopsy last week, waiting on my results. I’ve been experiencing bleeding for the last month after not having a period for a year. It came on for a full week, disappeared and now I’m experiencing spotting. Before my biopsy I had a vagina l ultrasound. Staying in prayer 🙏🏾.

[@mohanarajesh4035]

Biopsy result?

[@MissRandom077]

Greetings. Well, I had to get an IUD because there was growth growing on my uterus, my Dr. stated that the IUD would stop the growth from growing and turning into cancer, such an ugly word when sitting with your Doctor. Nonetheless, other than bleeding everyday for the last three weeks, all is well. Thanks for asking. @@mohanarajesh4035

[@helenkalognomos]

Thank you for this video Dr. Do you by any chance know what the 1st line of treatment guidelines are in the US? I had a polyp removed last year that was without atypia and in one year it grew back and now has atypia, but my doctor only recommended an IUD recently and not a year ago. A year ago he said we just have to keep an eye on it. i feel like i missed out on a year of treatment that could have prevented the atypia.

[@dr.kristinadervaitis789]

Hello- This channel is not intended to provide personalized medical advice. The management of focal hyperplasia contained within a polyp is a unique and very specific situation. I suggest you pose your questions to your doctor (who has the ability to review all the details of your case, pathology reports, etc). All the best, Dr. Dervaitis

[@KATHLEEN2304]

Thank you very much for this detailed and clear information Dr. I am 65 post menopause and a pelvic ultrasound revealed that I have EH too with a polyp. My OBGYN has recommended a D&C. Have no symptoms whatsoever so no pain, no bleeding nothing. I was living my life as normal until I asked for a routine check to be done as I have never been on any hormone replacement. Never! No one educated me about this. Generally, what would you recommend Doctor for postmenopausal women like me? Thank you.

[@dr.kristinadervaitis789]

This channel is not intended to provide personalized medical advice. Talk to your doctor.

[@mdtrk370]

Great work. Love from India.

[@ang7156]

Thanks Dr.D for this informative video… it is clear and easy to understand 😊… I was diagnosed with endometrial hyperplasia without atypia and had my mirena insertion and it has been successfully treated.

[@dr.kristinadervaitis789]

Glad you found the video helpful, and glad to hear you’ve been treated successfully! All the best, Dr. Dervaitis

[@rudet79]

Hi @Ang, how long was your treatment before you saw results in treatment?

[@ur_43vaqueen29]

This is great news! How long were u on the mirena before it work? Are u still on mirena?

[@ang7156]

@@rudet79 hi Ruiz sorry for my late reply. I had my mirena insertion back in Dec 2021. It had an immediate good effect after the insertion, the bleeding has been reduced tremendously, completely agreed with with Dr D that this is an extremely effective treatment for endometrium hyperplasia. After 6 months the cell test result returned good.

[@ang7156]

@@ur_43vaqueen29 hi… the abnormal bleeding stopped right after the mirena IUD insertion and the endo thickness was back to normal after 2-3 months if not mistaken (can’t recall the exact timeline). Though the cell test result returned good but I didn’t remove my mirena, just leave there since it can last for up to five years, just continue to receive the benefit of it and also to prevent future development of endometrial hyperplasia.

[@LobstahLovah523]

Very helpful, thank you

[@Franciscosincorporated]

Hi Dr I am here in Kentucky and I have been going to the OBGYN for a quite a while now but haven't been since 2014 but just now had went back couple months ago for a pap and was prescribed medicine to take like normally as always😀..there for just went back on Sept 2nd and they did a ultrasound on my uterus and ovaries and everything on my results came back normal and my ovaries looked good and I'm not going through no pre-meanapause except for my uterus they said I had endometriosis hysplasia all because of a polyp on my uterus and but the main thing is that I have a very thick lining on my uterus as well ..so I go back on September 28th to see another DR from out of Louisville KY and get to know the Dr and see what there gonna say wether and what there gonna do , but I'm praying no hysterectomy unless otherwise .But the main reason why I have been going and having all these test done is because we're I haven't had a regular period since I was 13 but my last period was when in 2018 so there for I have irregular periods ,so what is your suggestion should I have a hysterectomy 😁 just want to get a second opinion before I see her on September 28th

[@dr.kristinadervaitis789]

This channel is not intended to provide personalized medical advice. Please discuss your treatment plan with your doctor. -Dr. Dervaitis

[@laughsbeauty7152]

This video is amazing! Easy to understand! So if you have this with atypia, beginning stages, no children but would like children, what are treatment options?

[@dr.kristinadervaitis789]

Glad you found the video helpful. This channel is not intended to provide personalized medical advice, and management of hyperplasia with atypia is beyond the scope of this video. Talk to your doctor. All the best, -Dr. Dervaitis

[@bienaimeedwine]

I was prescribed megestrol acetate 80 mg. I will look into it. What are side effects after removal?

[@shunwilliams6180]

Thank you so much for sharing 🥰🥰🥰

[@thegreysgul8949]

I am 27 years old with no kid’s . I have uterine hyperplasia and Doctor said he will be putting a iud for a year ..

[@melaniepanimdim3744]

Thank you.very informative. Question dr Person had this endometrium hyperplasia is it possible to conceive a baby

[@dr.kristinadervaitis789]

Hi Melanie- Yes, after successful medical treatment of endometrial hyperplasia, there is no impact on fertility (ie pregnancy is still possible). -Dr. Dervaitis

[@venuscabasis912]

Thank you for this informative video! Just wanna know if endometrial hyperplasia is the same with hyperplastic endometrial polyp? We just got my mother-in-law's biopsy result and it doesn't indicate whether it's with or without atypia.

[@dr.kristinadervaitis789]

Hello- Generally this information would also apply to hyperplasia contained within a polyp, but each case is individualized (please consult your mother-in-law’s doctor for further guidance). Not having read the reports or reviewed the biopsy myself, I cannot comment on the issue of whether atypia is present or not in her case (which is a key issue in determining appropriate treatment, as I discussed in the video). -Dr. Dervaitis

[@DrKazAstro]

There’s a new paper on using he4 as a bio marker for success on Mirena for aeh. a 2016 paper as well. Will be very interesting if it becomes part of the protocol because some of us will have a better chance to keep our ovaries and their benefits into our later years if the data hold up. Also, Remission rates are high though aren’t they for cessation of iud treatment in aeh.

[@dr.kristinadervaitis789]

Hello Karen- I wasn’t aware of that research- it sounds very interesting and I will definitely look into it further. Currently I am only treating EH patients WITHOUT atypia with the levonorgestrel IUD- if there is any decision to use the LNG IUD (or any other hormonal treatment rather than surgery...) for patients with atypia, it would need to be at the discretion and close supervision of a gyne oncologist (subspecialist). Thanks for watching and for your comments! -Dr. Dervaitis

[@charlietzizar4568]

thank you so much for this video. Doc, is endometrium thickness ( 1.0 CM ) in secretory phase pre cancerous? I have suffered heavy bleeding for 3 months. I had 2 D&C and one hysteroscopy. If I have Mirena IUD inserted, can I also possibly take oral progesterone at same time? Thank you so much

[@dr.kristinadervaitis789]

Hello- There is no “normal” value for endometrial thickness on ultrasound in women who are still menstruating (the 5mm cutoff applies only to post menopausal women). It’s possible to take oral progesterone simultaneously with a levonorgestrel IUD in place (but wound be considered “off label” use, we do sometimes use both in specific situations- talk to your doctor for advice on this issue). Dr. Dervaitis

[@SarahMerritt15]

I bled for 392 days straight, suffered a hemorrhage and lost half of my blood (didn’t have insurance so couldn’t get checked earlier)… I had 5oz of endometrium removed and an IUD placed and I’ve been doing great since! I was leery about getting the IUD at first, but it was an emergency situation and I had no choice, but I’m glad I got it!

[@dr.kristinadervaitis789]

So sorry to hear about your experience, but glad to know that things are better with your hormonal IUD! Thanks for sharing your story other viewers. -Dr. Dervaitis

[@JohannaRyerson-fg6xp]

I'm kind of going through the same thing. I'm so happy that you're feeling better

[@6jruu4]

Im. Bleeding continues. For4. Months now...veey heavy bleeding. 2 days ago the obgyne put in in depo shot.... Soooi hope it will. Stop. Im. Sooo. Tired. Of bleeding..

[@tinkerbell3594]

Hello Dr. It is amazing to listen this video.. drs i am visiting are not as informative as you. I live in Ontario how can i come see you... I would like to discuss my special case. Please advise

[@dr.kristinadervaitis789]

Hello- I’m so glad that you found the video helpful! Although I am always accepting new patients (via family doctor referral) my practice is mostly focused on contraception, with also (non-surgical) Gynecology. I am not an endometrial hyperplasia or cancer “specialist”. Your family doctor will help you decide which specialist in your area to best refer you to. All the best, Dr. Dervaitis

[@tinkerbell3594]

Dr. Kristina Dervaitis thanks for replying honestly

[@MrNewjk]

First of all, thank you so much for this perfect video!! Just some general questions.. (1) does iud (mirena) likely to not reduce but just maintain the thickness one has? and (2) performing d&c before inserting an iud is a common practice? I'd really appreciate any comments you could provide. Thank you again!

[@dr.kristinadervaitis789]

Hello- Glad you found the video helpful! This channel is not intended to provide personalized medical advice, I don’t have the details of your case and so can’t comment on the D&C issue (speaking generally, it is not always done if the hyperplasia diagnosis is well established and the gynecologist is confident that they have adequately sampled the uterine lining). Mirena is likely to THIN the lining (in most patients). -Dr. Dervaitis

[@maicasalomon6224]

Just had my biopsy done today and praying it’s without atypia. Doctor tried to “scrape” it as they were soft. Anyone experienced this?

[@rodacabigting8282]

Hello I just want to ask I I was diagnosed with EIN recently started to take megace,why do I have chronic pelvic pain ever since I start taking the medicine

[@dr.kristinadervaitis789]

Hello- Unfortunately I can’t give personalized medical advice over the internet. If you are having problems with pain I’d recommend that you see your doctor. -Dr. Dervaitis

[@casperfarva4824]

About a month I found out I have 1 mm of complex hyperplasia with atypia. Due to me being younger I’m getting a D&C and they are putting a hormonal IUD in me. Thankfully I went in to check to see why I had heavy irregular bleeding and bleeding in between. The biopsy I was given wasn’t even that bad!

[@Kinsken]

Hi, is the iud working out

[@casperfarva4824]

@@Kinsken for the most part it is. It’s a slow process though. In the mean time I’ve been following the doctors orders like eating healthy and trying to lose weight.

[@zahrazafreen1960]

Thank u. I have a question. How much thickened endometrium is considered to be endometrium cancer. I have 29mm endometrium thickness

[@cml1179]

Hi Thank you so much for such a informative video! I had hysteroscopy last wk and result was not great. I have endometrial polyps with complex atypical hypertropy. When I had hysteroscopy with D/C, doctor inserted mirena IUD as well. I feel much better after procedure, but my specialist saying that hystrectomy is the answer. What shall I do? I am so worried. (I am 47 years old) I am seeking your professional advice. Thank you so much!!! Lee

[@dr.kristinadervaitis789]

This channel is not intended to provide personalized medical advice. Talk to your doctor.

[@emmarie7352]

Is it harder for a patient with a thickened endometrium to get pregnant? Great video I got a scan and haven’t spoken to my Dr yet but my results show 13.2mm endometrium thickness 🥺

[@dr.kristinadervaitis789]

Hello- The “normal” values for endometrial thickness apply ONLY to patients who are menopausal (ie, there is no “normal” or “abnormal” value or range for women who are still menstruating). The thickness of the lining varies throughout the menstrual cycle. Reported ultrasound endometrial thickness would have no bearing on evaluating fertility potential. -Dr. Dervaitis

[@anjumshaikh9885]

Hi please advise if someone's report have atypical endometrial hypothesis should they do laparoscopic hysterectomy or they can wait finding out ather treatment please respond need advice

[@dr.kristinadervaitis789]

Hello- This channel is not intended to provide personalized medical advice, please discuss your question with your doctor. -Dr. Dervaitis

[@luisepalma3189]

Hi Dr! I had been diagnosed of endo w/o atypia last year. I had been constantly seeing my doctor until before the pandemic. But now I am scared to go to hospital bec of the increase of covid cases. As of now I am on my 7th month of taking YAZ pills thou my doc advised to take the pills for 6months. I would just like to ask if the pills im taking is still safe to continue for a year. Thank you for your helpful video😊

[@dr.kristinadervaitis789]

Hello- Unfortunately I can’t give personalized medical advice over the internet. Generally speaking, the standard of care for treatment of hyperplasia without atypia is PROGESTERONE. There is not a specific time frame or limit with respect to safe duration of use. It has not been my practice to prescribe a pill with both estrogen and progesterone for someone with this diagnosis, and so I cannot comment on your current treatment regimen. -Dr. Dervaitis

[@cherylepp780]

Hi I have been post menopausal for over 10 years and started spotting/bleeding about 2 years ago. I have had 3 endometrial Biopsies, 2 pelvic ultrasounds ( First ~7, second 8-9) and finally a hysteroscopy/ D &C in August of this year This procedure showed 1 0.8 x 0.6 x 0.3 cm polyp negative for atypia. It also showed a cystic atrophic endometrium. Gynocologist decided best course of action was insertion of Mirena IUD. Very light spotting for first couple of days, getting heavier and heavier daily. Am now soaking 2 pads a day and have some cramping all the time. Not foul smelling. Bright red blood. It has now been 6 weeks and do not have a follow up appointment for another month. Is this normal to have this kind of bleeding if post menopausal? Thanks

[@dr.kristinadervaitis789]

Hello- This channel is not intended to provide personalized medical advice. If you are concerned about your bleeding, talk to your doctor. For general information about bleeding after IUD insertion, see video #7: kzbin.info/www/bejne/gX-sYaiAiMx_rNU -Dr. Dervaitis

[@glennameade2043]

Thank you for your detailed information. My question concerns balancing hormones in the case of postmenopausal GSM. Is there a product or multiple products that could be considered to treat GSM locally using a balance of low dose estrogen and progesterone (e.g. Estring & Mirena)?

[@dr.kristinadervaitis789]

Generally, low dose LOCALIZED treatment of GSM does not require concurrent progesterone therapy. For SYSTEMIC (higher dose) HRT, Mirena can be used to provide endometrial progesterone protection (concurrent with an oral or transdermal estrogen). Talk to your doctor. -Dr. Dervaitis

[@MK-Hogan]

Thank you for this thorough video. Since I’m 43 and have simple EH without atypia, I don’t understand why my doctor seems to be eager for me to resign myself to hysterectomy without further treatment options. My only other risk factor is that my maternal grandma had some kind of uterine cancer in her 40’s. I’m trying the 3 months of Progesterone with 14 days on, 14 days off. However, on the days I’m not taking it, my bleeding is extremely heavy. Instead of offering any kind of constant progesterone treatment instead though, so I won’t bleed, my doc is advising I basically just give up on treatment and have the surgery. It seems like I’d be a good candidate for an IUD as method of treatment now, or at least some kind of consistent progesterone to prevent the bleeding, then biopsy again in a few months. She told me I can’t have an IUD until I complete this 3 month course of oral progesterone and have another biopsy because we can’t biopsy with an IUD already in place. However, in speaking to other women with EH, I’ve learned that many of them were given an IUD right away and then biopsied with it in place later to determine the status of hyperplasia. I feel pressured or like my doc just doesn’t want to bother with me because it seems like there are other options available. She basically said the 3 month oral progesterone cycles are the only treatment for me to try and if it works, then I get can get an IUD. But if I can’t tolerate the 14 day bleeding in between progesterone cycles, why not at least try something else before hysterectomy? 🤦🏻‍♀️

[@dr.kristinadervaitis789]

It’s good that you’ve done your research! Trust your instincts. Keep in mind that the information I provide in this video is not simply my “opinion”- it is based on national guidelines for EH management. The levonorgestrel IUD is considered a first line management option for EH without atypia, and often has the advantage of diminished bleeding. And yes, it is indeed possible to do an endometrial biopsy with an IUD already in place. -Dr. Dervaitis

[@Laura-sn7mh]

I was just diagnosed with same as you. I am 50. My dr recommend checking my thyroid. Well low and behold it’s super high. So she recommended getting that back to normal ans see if it helps with my periods. Sorry your dr is going to surgery right away. I also got put on same med as you. I’m only on day 2 so we shall next week when I’m get my period if it helps.

[@wildorchidxxx2644]

The same here that is why I went to another obgyne to get another opinion.

[@lynnpoag8173]

@@Laura-sn7mh Any updates? I’m going in for the biopsy soon and I had heard that it could be caused by thyroid issues, but Dr never mentioned that to me.

[@Laura-sn7mh]

@@lynnpoag8173 no clue if my thyroid issues were related or not. But dr put me on a med that now I have NO periods. It’s been amazing

[@fashionfanatic6507]

I have a thickened endometrium of 1.1 cm currently and it was previously in April 2020, 5.0mm I have had two ablations. Would I be a candidate for this IUD

[@dr.kristinadervaitis789]

This channel is not intended to provide personalized medical advice. If you have questions about your candidacy for an IUD, see your doctor. -Dr. Dervaitis

[@Gangapriya0815]

hi, dr what kind of exams do we need to find out our endometrial issues? blood test or camera insert to see? how to see or find out about the endometrial issues? I have heavy bleeding non stop prolonged bleeding.... not sure why...

[@dr.kristinadervaitis789]

This question is beyond the scope of this channel about IUC. This channel is not intended to provide personalized medical advice. Talk to your doctor. -Dr. Dervaitis

[@cherylhobbie7252]

To those of you who have hyperplasia with atipia and without cancer, the first thing the doctor seems to say is hysterectomy. I found a new doctor, an oncological gynecologist, at a major well known medical/research hospital. I have an appointment set to have an IUD with progesterone placed. I am placing this comment for informational purposes to let you know you should get a second opinion or more if you wish to pursue an alternative treatment. All of the videos I have found do not mention this, so I am advocating for you.

[@brendame]

Cheryl Hobie Thank you for sharing !!! May I please know, how are you doing ?

[@cherylhobbie3595]

@@brendame Thank-you for asking! I am glad I touched someone and they are interested, possibly for yourself? If just one person does what I did that was my hope in posting. I am 66 so instead of treatment, the only recommendation from the first doctor was hysterectomy. I did not even have cancer. I had the IUD placed Jan. 3, 2022. March biopsy was hyperplasia no atypia. June biopsy was no hyperplasia, no atypia. Sept. biopsy not quite so good, detection of hyperplasia with atypia. Recommendation is to add progesterone oral pill. Not so excited at this as I have lost 30 pounds, one of the recommendations is to lose weight. The Megace is prescribed to increase progesterone to treat hyperplasia. It is also prescribed to HIV patients to INCREASE appetite, promoting weight gain. It was just prescribed and the pharmacy had to order it in, so I have not started it yet. We will see how that goes. My current doctor did say hysterectomy is an option. I replied it IS NOT an option. I hope this helps you! If you care to share your story with me, I am interested.

[@user-ye6kh4tt3t]

❤

[@teacherabegailgorospe4718]

I am diagnosed with endometrial hyperplasia with atypia. I still don't have a child. But my Doctor really recommended me to have a hysterectomy. It's really depressing, but I need to accept .

[@dr.kristinadervaitis789]

Hello- Sorry to hear this. This channel is not intended to provide personalized medical advice. Complex hyperplasia with atypia is beyond the scope of this video and so I won’t comment further about fertility sparing options in this situation. I’d recommend that you discuss your future fertility concerns/ desires directly with your doctor. -Dr. Dervaitis

[@brendame]

Teacher Abegail Gorospe Thank you for sharing !!! May I please know how you are doing ?

[@cindykrueger9456]

I had Mirena iud put in a month ago. Since then, I’ve read that a higher than expected number of reports with Mirena. There is risk of pseudo tumor cerebri which means “false brain tumor. Is there a better option? Thank you!

[@dr.kristinadervaitis789]

As per the Bayer product monograph, there is not consistent or clear evidence to substantiate a causal link between Mirena and pseudotumour cerebri. Isolated case and anecdotal reports do not equate with evidence, and do not control for confounding variables. Some of this issue has been exaggerated in the media and online due to medico-legal opportunism. -Dr. Dervaitis

[@maureenloonam6468]

Hi I went for a ultra sound at USA vein clinics to check for fibroids 7 months ago. The doctor said no fibroids but my uterine lining was thick. I am anxious that I may have hyperplasia but never got it treated. I have an appointment coming up soon with my gyn. I am experiencing bleeding in between my peripd ,I'm 41 and I'm wondering if 7 moths is too long to wait and if I now have a bigger problem?

[@dr.kristinadervaitis789]

Abnormal/ unscheduled bleeding requires investigation. Talk to your doctor.

[@reesycasi]

Very informative!!

[@dr.kristinadervaitis789]

Glad it was helpful!

[@haryfairy]

Thank you so much for this video! I’m 43 and have endometrial hyperplasia and doc has recommended I get the D&C and have the Mirena put in at the same time. I suspect I’m perimenopausing and have no plans to conceive. Does this mean I won’t have any more periods until I menopause say at 50?

[@dr.kristinadervaitis789]

Glad you found the video helpful! Only around 30% of women using Mirena stop having periods (the D&C does not stop menstruation long term). -Dr. Dervaitis

[@sheetal5thakur]

I am in my mid 30s and I was diagnosed with Endometrial hyperplasia with Atypia last year in November 2022 , initially I was advised oral progesterone for 3 months ( megace -160mg) , my condition started reversing , one of the doctors suggested mirena coil as first line of treatment and today just after 3 months of mirena insertion my reports came back negative. Mirena definitely works better, there are some side effects like spotting and cramps and some people can develop candida but as my doctor said to me that benefits outweighs the risk and she was right. I have to wait for another 3 months in order to get second negative results.

[@dr.kristinadervaitis789]

Glad to hear this! Just as a point of clarification, there has not been any study evidence to prove a link to IUD use and candida (yeast). Good luck with the rest of your treatment! -Dr. Dervaitis

[@Gangapriya0815]

is the overgrowth lining of uterus same as endometriosis?

[@dr.kristinadervaitis789]

No. They are different conditions.

[@kimesch9698]

Thank you, thank you, thank you!💐

[@dr.kristinadervaitis789]

You are most welcome! Glad you found the video helpful! -Dr. D

[@BlushingUnseen]

If precancerous endometrial hyperplasia with atypia (EIN) is successfully treated with progesterone treatment in a women of child bearing years, what is the percentage rate of it coming back once treatment is stopped? Do you feel hysterectomy is inevitable? And if obesity is the root cause of this problem and patient loses the weight could that factor into it returning or not, again providing it was successfully treated with progesterone treatment? Sorry I hope those questions made sense!

[@dr.kristinadervaitis789]

Hello- The answers to your questions depend on the individual situation, and aren’t really generalizable. Unfortunately I can’t give personal/individual medical advice over the internet. I’d recommend that you discuss these questions with your doctor. All the best, -Dr. Dervaitis

[@lizandro3454]

Is Lileta okay in treating Complex Hyperplasia or should Mirena be the main one to use?

[@dr.kristinadervaitis789]

Please note that this video discusses the treatment of SIMPLE endometrial hyperplasia without atypia. The treatment of complex endometrial hyperplasia, and hyperplasia with atypia, is beyond the scope of this video. Speak to your doctor. (Re: Liletta versus Mirena- both contain 52mg of levonorgestrel and are equivalent). -Dr. Dervaitis

[@kanenayugap6281]

Hello just wanna ask how much milligram needed of progesterone intake in a day if diagnose of hyperplasia with atypia?

[@dr.kristinadervaitis789]

The dosage varies depending on what type of progesterone is prescribed. Talk to your doctor.

[@mitchtemporosa2304]

Hi dra can i ask its posible the iud can expelled while pooping?

[@dr.kristinadervaitis789]

There are various risk factors for expulsion. Sometimes it happens without any obvious trigger. Essentially the answer is “no” - defecation would not cause an IUD to be expelled, it would be extremely unlikely for expulsion to occur due to a bowel movement. -Dr. Dervaitis

[@LucidLuuu]

wondering if you have a video talking about the zinc deficiency when we insert a copper IUD and the dangers when there is too much copper and what we can do about it. Thank you =)

[@dr.kristinadervaitis789]

There is no scientific evidence to support the concept of zinc deficiency in this scenario. Similarly, there is no scientific evidence to support the concept of copper toxicity (or “too much copper”) from copper IUD use. -Dr. Dervaitis

[@DAGY29]

Thank you Dr. For this information but now I have doubts My MRI showed Adenomaiosis (they found 2 little lumps ) totally diferent of endometriosis but he didn't do a Biopsy to certified it was 100% but right way he recommended the IUD Mirena, Does this will help? Or should talk to my Dr. I do the biopsy ?

[@dr.kristinadervaitis789]

This channel is not intended to provide personalized medical advice. Talk to your doctor.

[@matthewlee3819]

What’s the best treatment for with atypia she as iud over two years now she wants to take it out can atypia come back normal

[@dr.kristinadervaitis789]

Hello- Your question is beyond the scope of this video. This channel is not intended to provide personalized medical advice. I suggest you talk to your (your partner’s) doctor. -Dr. Dervaitis

[@petronaloftman7731]

Am 40 years old and i have done a ultrasound and that was found on my uterus can i get pain from it

[@salma_techie]

Thank you Doc

[@LadyM24]

I just had Mirena IUD with hyperplasia without atypia last week. Is it normal to get period a week after I thought period gets lighter having iud inserted? Should I be concern?

[@dr.kristinadervaitis789]

See video #7.

[@iqm2031]

Hello doctor, thanks for this very informative video! Is the first line treatment 52 mg levonorgestrel IUD also considered in woman diagnosed with endometrial hyperplasia without atypia, which are not post menopausal and have a pregnancy wish?

[@dr.kristinadervaitis789]

Yes.