Uterine Thickening

Hello and thank you for taking my question. I do apologize in advance if this is posted to
the wrong area.

For the most part I have always had normal menstrual cycles until this past July. I had two
which lasted 10 days each and is not normal for me. I also had/have vaginal discharge and
odor. In August I had a normal cycle and this month (Sept) I had another lengthy cycle.
Since, approx. two weeks ago, I started having dark bloody spotting, bloating, cramps
and a back ache. Last week I had symptoms of a bladder infection too so made an appointment
to see my GYN.

Cultures were taken to check for vaginal and bladder infections and an utra sound was
scheduled for what appeared to be an enlarged uterus and possibly fibroids. Culture for
bladder infection was contaminated, so no results, but I've been taking a sub for Bactim
(and drinking a lot of pure cranberry juice) and am no longer experiencing the frequent
urge to empty my bladder nor the pain associated with that. The culture for the vaginal
infection came back negative. Ultra sound results revealed a thickening of the uterus
and cysts (one on the left ovary which I understand to be normal), no fibroids. I'm scheduled
for a biopsy at the end of the week. (A D&C was also mentioned.)

My question is this, infection has been ruled out, if this isn't peri-menopause
(I'm assuming these symptoms could be attributed to it) nor normal thickening
during the menstrual cycle does that mean it is probably cancer? Or are there
other possible causes for this thickening and at my age.


Thank you,
Gen

[Dennis MD]

Hi.
How old are you?  Are you presently on any medication?
The causes of abnormal uterine bleeding include endometrial cancer, myoma uteri, functioning ovarian tumor, adenomyosis, or secondary to oral contraceptive pills intake or depot medroxyprogesterone acetate (dmpa) injection.
I agree with the plan of doing a biopsy, hysteroscopy guided or dilatation and curettage.  This will help determine the cause of the endometrial thickening.      
Good luck.  

[GenJ]

Thank you.

I apologize for having forgotten to add my age, I'm 49. The only medication I'm taking is the Bactrim for what I believe was a bladder infection and was prescribed before learning the culture was contaminated, but it has relieved the frequency urge and most of the discomfort associated with emptying the bladder. Having said that, and not knowing definitively whether or not it was a bladder infection, is it possible the symptoms could be attributed to any of the diseases you mention? Could a bladder infection be secondary to any of them? Could the vaginal discharge be related to any of them?

Thank you in advance.

[GenJ]

Sorry, one more question - does thickening normal during the onset of menopause? I checked a list of sign and I have many of them. Have been losing a lot of hair for the past year, irritability, depression, unable to focus, memory deficit, etc. and I'm tired all the time.

[Dennis MD]

Hi.
Cotrimoxazole (Bactrim) is an antibiotic that can be given in patients with genitourinary tract infection.  Women are especially prone to urinary tract infection because of the anatomy of the urinary tract.  
The symptoms you are experiencing may be attributed to any of the disease conditions I mentioned, including the vaginal discharge you had.  A patient with genital tract infection can also develop urinary tract infection.  
Menopausal women have small, atrophic uterus.  The uterine lining is also thin.
Please do post the result of your biopsy.
Stay positive.      

[GenJ]

Thank you for your time and kind words. The biopsy report is due back in a little over a week, I'll be sure to post the results then.

Thank you again.