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Menopause (Expert Forum)
Endometrial thickening, vaginal discharge, fibroids, ovarian cysts
Answered by
Machelle Seibel, MD - Women's Health, menopause, ReproductiveMedicine
University of Massachusetts Medical School
MA
Questions in the Menopause forum are answered by Dr. Machelle Seibel. Topics covered include menopause issues, depression, hormone replacement therapy, hot flashes, joint or muscle problems, memory problems, mood swings, osteoporosis, sexual problems, skin changes, sleeping problems, vaginal problems, and weight problems.
Endometrial thickening, vaginal discharge, fibroids, ovarian cysts
by L.W., Feb 10, 2006 12:00AM
After having periods every 3 mos for about a year, my last full period was in July 2005. Blood tests late 2004 showed signs of early menopause, but by October 2005 showed hormone levels fully menopausal.
I have been experiencing discharge requiring small pad everyday and "anxious bladder." Also have history of fibroids, endometriosis surgery in 1992 with scar tissue attached to duodenal wall "cut" during laprascopic surgery. 3-4 years ago doctor said I could have hysterectomy to alleviate monthly cramping/burning pains thought to be caused by fibroids, but at the time I thought it was too radical. Pain diminished as periods went away, but burning abdominal pains and some cramping, lower back pain and pain in left side have returned.
Now, at 48, my transvaginal ultrasound shows several small ovarian cysts, a 2 1/2cm and a 4cm fibroid and uterine thickness approx twice what they'd like to see. Endometrial biopsy yesterday won't return results for 2 wks. Needless to say, I'm a bit worried, as they are looking for signs of cancer.
What are causes of endometrial thickening? How often does endometriosis return, and can it be a complication after menopause begins? Watery vaginal discharge getting worse in last 5 days. Spotting only Jan 15 and Jan 21 (about 1 tsp) coming at the end of what seemed like "pre-period" cramping, and on recent 3 mo cycle (with the exception of skipping Oct), which is what prompted tests.
Menopause is still new to me, and I'd like to understand if some or all of these symptoms are common.
Thank you.
I have been experiencing discharge requiring small pad everyday and "anxious bladder." Also have history of fibroids, endometriosis surgery in 1992 with scar tissue attached to duodenal wall "cut" during laprascopic surgery. 3-4 years ago doctor said I could have hysterectomy to alleviate monthly cramping/burning pains thought to be caused by fibroids, but at the time I thought it was too radical. Pain diminished as periods went away, but burning abdominal pains and some cramping, lower back pain and pain in left side have returned.
Now, at 48, my transvaginal ultrasound shows several small ovarian cysts, a 2 1/2cm and a 4cm fibroid and uterine thickness approx twice what they'd like to see. Endometrial biopsy yesterday won't return results for 2 wks. Needless to say, I'm a bit worried, as they are looking for signs of cancer.
What are causes of endometrial thickening? How often does endometriosis return, and can it be a complication after menopause begins? Watery vaginal discharge getting worse in last 5 days. Spotting only Jan 15 and Jan 21 (about 1 tsp) coming at the end of what seemed like "pre-period" cramping, and on recent 3 mo cycle (with the exception of skipping Oct), which is what prompted tests.
Menopause is still new to me, and I'd like to understand if some or all of these symptoms are common.
Thank you.
Doctor's Answer
by Machelle Seibel, MD, Feb 14, 2006 12:00AM
, Feb 14, 2006 12:00AM
A. It sounds like you are having a very difficult time and the waiting and worrying are adding to it which is understandable.
Several small ovarian cysts may be very normal at 48 and small fibroids are present in up to 40% of women.
Endometrial thickening can be benign and caused by low levels of estrogen and a lack of progesterone as you transition into menopause. Estrogen builds up the lining and no more progesterone prevents it from leveling off and shedding. Even if there is abnormal endometrial thickening, it takes about 10 years for it to turn into cancer, so it’s good you got a biopsy but it is more likely going to either be benign or premalignant.
Most of what you are describing is fairly common. But it is important that your doctor did the biopsy to exclude cancer from the list of reasons for your symptoms. You might have to take some estrogen and progesterone, or just progesterone for a few months. Your doctor might want to look inside your uterus with a small telescope (hysteroscope) to be sure everything looks normal, or you might have to have a D & C to scrape the lining like a big endometrial biopsy. All these are day procedures done with anesthesia to exclude cancer or other causes of bleeding.
However, in most cases like this, things turn out to be fine, this is normal, and passes as one travels into menopause.
Machelle Seibel, MD
Several small ovarian cysts may be very normal at 48 and small fibroids are present in up to 40% of women.
Endometrial thickening can be benign and caused by low levels of estrogen and a lack of progesterone as you transition into menopause. Estrogen builds up the lining and no more progesterone prevents it from leveling off and shedding. Even if there is abnormal endometrial thickening, it takes about 10 years for it to turn into cancer, so it’s good you got a biopsy but it is more likely going to either be benign or premalignant.
Most of what you are describing is fairly common. But it is important that your doctor did the biopsy to exclude cancer from the list of reasons for your symptoms. You might have to take some estrogen and progesterone, or just progesterone for a few months. Your doctor might want to look inside your uterus with a small telescope (hysteroscope) to be sure everything looks normal, or you might have to have a D & C to scrape the lining like a big endometrial biopsy. All these are day procedures done with anesthesia to exclude cancer or other causes of bleeding.
However, in most cases like this, things turn out to be fine, this is normal, and passes as one travels into menopause.
Machelle Seibel, MD
How did you go with your results ? Hope all is well.
My mum is going in on 18th April for D&C as they have found that she has very thick endometrial lining. She is going through menopause as we speak. We are really worried and are praying that it is nothing serious.