Some patients received post-operative radiation therapy in addition to surgery. A similar increased incidence in endometrial adenocarcinoma and uterine sarcoma was observed among women receiving Nolvadex in five other NSABP clinical trials. Any patient receiving or who has previously received Nolvadex who reports abnormal vaginal bleeding should be promptly evaluated. Patients receiving or who have previously received Nolvadex should have annual gynecological Clomid pills and they should promptly inform their physicians if they experience any abnormal gynecological symptoms, eg, menstrual irregularities, abnormal vaginal bleeding, changes in vaginal discharge, or pelvic pain or pressure. Clomid the P-1 trial, endometrial sampling did not alter the endometrial cancer detection rate compared to women who did not undergo endometrial sampling 0. There are no data to suggest that routine endometrial sampling in asymptomatic women taking Nolvadex to reduce the incidence of breast cancer would be beneficial. An increased incidence of endometrial changes including hyperplasia and polyps have been reported in association with Nolvadex treatment, Clomid. The incidence and pattern of this increase suggest that the underlying mechanism is related to the estrogenic properties of Nolvadex. There have been a few reports of endometriosis and uterine fibroids in women receiving Nolvadex.