Aa
Other than cancer what could it be?
Recently I had a pelvic exam at my drs after experiencing itching, burning, and pain in lower abdomen. My dr said she felt what she thought was fibroids and ordered an ultra sound. The ultra sound results are as follows:
Uterus measures 10.7 x 5.4 x 6.6 cm. Cervical nabothian cysts. Endometrium measures 2.5 cm and is slightly heterogeneous. Myometrium is heterogeneous. No dominant fibroid. Right ovary measures 3.5 x 2.4 x 2.5 cm and left ovary measures 2.3 x 1.8 x 2.2 cm . No adnexal mass or free fluid.
My question is she now ordered a endometrial biopsy, besides cancer what other conditions could cause this?
Uterus measures 10.7 x 5.4 x 6.6 cm. Cervical nabothian cysts. Endometrium measures 2.5 cm and is slightly heterogeneous. Myometrium is heterogeneous. No dominant fibroid. Right ovary measures 3.5 x 2.4 x 2.5 cm and left ovary measures 2.3 x 1.8 x 2.2 cm . No adnexal mass or free fluid.
My question is she now ordered a endometrial biopsy, besides cancer what other conditions could cause this?
You're absolutely right; if there was an infection in the uterus, it could cause the thicker lining. However, one would usually not biopsy someone if there was a suspicion of a uterine infection/endometritis.
I still wouldn't consider it unusually abnormally thickened,though. I guess this is why we ask our patients not to look things up on the internet :) I've done it too, I'm a real person too, but learned my lesson that way, too. :)
A polyp would not necessarily be picked up on ultrasound. I have found many of them in a situation just like yours. To find a polyp, you would have a special test called a sonohysterogram, which is where there is a thin catheter put through your cervix into the uterus, some water is put into the uterus, and you have an ultrasound while the catheter is still in there. It shows the lining of the uterus and can show if there is a little fibroid on the inside of your uterus or if there is a polyp. It's less uncomfortable than the biopsy you had yesterday.
As for endometriosis, that doesn't show up with a thick endometrium. It shows up as progressively more painful periods which then progress to daily pelvic pain. It has nothing to do with endometrial lining or frequency/heaviness of periods. There is no test to show endometriosis, short of having a surgery called a laparoscopy where they look around in your belly and see it with your eyes. No ultrasound, MRI, CT scan, etc will ever show endometriosis.
I hope you did well with your biopsy; I know they can be quite uncomfortable for some people. If it was uncomfortable, you're probably feeling better by now, anyway.
Keep me posted as to the results. I take it she ordered the ultrasound in response to your describing your periods as heavier for 1-2 days, because if you're not bothered by either of them, there would have been no reason to order the test and cause this mess. If you're bothered by your periods, maybe you want to consider treatment. If you're 100% sure you're done with babies, I have seen some excellent results for this problem after a NovaSure ablation procedure. About 30-60% of women don't get periods after the procedure (yay!) and those who do get SIGNIFICANTLY lighter bleeding, sometimes just spotting. It destroys the inside of your uterus so that you can't bleed like you used to. It doesn't make you menopausal and involves no hormones (again, yay!).
Let me know how you make out....take care!
wendy
I still wouldn't consider it unusually abnormally thickened,though. I guess this is why we ask our patients not to look things up on the internet :) I've done it too, I'm a real person too, but learned my lesson that way, too. :)
A polyp would not necessarily be picked up on ultrasound. I have found many of them in a situation just like yours. To find a polyp, you would have a special test called a sonohysterogram, which is where there is a thin catheter put through your cervix into the uterus, some water is put into the uterus, and you have an ultrasound while the catheter is still in there. It shows the lining of the uterus and can show if there is a little fibroid on the inside of your uterus or if there is a polyp. It's less uncomfortable than the biopsy you had yesterday.
As for endometriosis, that doesn't show up with a thick endometrium. It shows up as progressively more painful periods which then progress to daily pelvic pain. It has nothing to do with endometrial lining or frequency/heaviness of periods. There is no test to show endometriosis, short of having a surgery called a laparoscopy where they look around in your belly and see it with your eyes. No ultrasound, MRI, CT scan, etc will ever show endometriosis.
I hope you did well with your biopsy; I know they can be quite uncomfortable for some people. If it was uncomfortable, you're probably feeling better by now, anyway.
Keep me posted as to the results. I take it she ordered the ultrasound in response to your describing your periods as heavier for 1-2 days, because if you're not bothered by either of them, there would have been no reason to order the test and cause this mess. If you're bothered by your periods, maybe you want to consider treatment. If you're 100% sure you're done with babies, I have seen some excellent results for this problem after a NovaSure ablation procedure. About 30-60% of women don't get periods after the procedure (yay!) and those who do get SIGNIFICANTLY lighter bleeding, sometimes just spotting. It destroys the inside of your uterus so that you can't bleed like you used to. It doesn't make you menopausal and involves no hormones (again, yay!).
Let me know how you make out....take care!
wendy
Thank You for your reply!! Just very worried everything I have looked up points to cancer. It said that normal range for endo thickness if still having menstrual cycle is 10-15mm and mine was 25mm.I am 38 and still get my period about every 32-36 days and it usually lasts 5-7 days with 1-2 days of really heavy bleeding. If it were a polyp wouldn't the ultasound have picked it up? Also the reason I saw my gyn was for burning and itching she said I had a mild case of BV lot of white blood cells in the vagina and discharge from my uterus as well.Could it just be my uterus is infected? what is the chance of endometriosis (which both my younger sisters have) ? What other things could make it heterogeneous?
Your doctor thought you had fibroids, but it was just the size of your uterus (normal, especially after having children) that set her off to get the ultrasound. The "thicker" endometrium was an incidental finding.
Other conditions that can cause a thicker endometrium depend on your age and what your bleeding pattern is like. If you're not menopausal and have regular periods, it is probably normal. If your period seems to go on spotting for days longer than usual, it could be a polyp in the uterus (very rarely cancerous), which also might be found with the endometrial biopsy. It all could be hormonal change, as well. If you're under 40, the likelihood of it being cancer is quite slim. I'd still go ahead with the biopsy, anyway. I usually don't do an endometrial biopsy as long as you're not done with menopause and have a normal menstrual cycle. I'm a PA in gynecology.
Other conditions that can cause a thicker endometrium depend on your age and what your bleeding pattern is like. If you're not menopausal and have regular periods, it is probably normal. If your period seems to go on spotting for days longer than usual, it could be a polyp in the uterus (very rarely cancerous), which also might be found with the endometrial biopsy. It all could be hormonal change, as well. If you're under 40, the likelihood of it being cancer is quite slim. I'd still go ahead with the biopsy, anyway. I usually don't do an endometrial biopsy as long as you're not done with menopause and have a normal menstrual cycle. I'm a PA in gynecology.
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