menopause and thickening of the uterus lining

[MALIBU CINDY]

Does thickening of the uterus lining have anything to do with menopause? Is it just part of the process? My uterus lining measured 3mm 6 months ago, and now measures 9mm. I am 49 years old, and had a blood test that my doctor said showed no signs of menopause. He wants to do a biopsy, but I hate to have surgery and I want to know if this is just normal for my age possibly getting close to menopause? I have a history of fibroids, but have posed no problems for me. My periods have become irregular for the first time in my life.

[Machelle Seibel, MD]

A. Uterine lining thickens each month during the reproductive years due to an increase in estrogen. With ovulation and the release of the egg, the ovary also starts to produce progesterone in the second half of the cycle which levels off the height of the buildup. If pregnancy doesn’t occur, the lining sheds as a period and the process starts over again.

In perimenopause, there is estrogen but since there isn’t always an ovulation, there isn’t always progesterone to stop the lining from thickening and it just builds up until it begins to shed irregularly rather than as an anticipated period. Over time, this buildup can turn into uterine cancer, but it usually takes years, up to a decade.

The biopsy is an office procedure that involves placing a thin instrument into the uterus and scraping off a few cells to be looked at under the microscope. While it is uncomfortable, it usually lasts only a few minutes and the discomfort wears off over the next half hour or less. Taking an over the counter pain pill such as Motrin or advil or Tylenol an hour before can help. The biopsy can tell most of the time if there is any change in the tissue that is worrisome and this is a routine office procedure.  While your symptoms are likely to be normal, the best way to find out is to have a biopsy of the uterine lining.
Machelle M. Seibel, MD