Thickening of the Uterine Lining

[Moe690]

Hello

I am 45 years old and I have not had my period for 5 years.  I have always had very irregular periods all my life.  I have recently lost 40 lbs and a couple of months ago I experience spotting for one day and stopped.  I went to the OB and had a PAP and HPV test.  All came back normal and negative.  I then took a Pelvic utra sound which also looked very good but showed that my uterine wall was thick 5.6mm.  She now wants me to have an Endometrial Biospy because she would like my lining to be under 4mm.  I feel GREAT with my new weigh lose.  Is this something I should be concerned about?  I keep putting off this test.  I had complete blood work-up (all good).  I feel like I am being picked apart.   Is this something that should be done?

A lot concern...

[PerimenoWorried]

By the way, one thing that I wanted to mention....IF you truly feel that you do not need this test or want it and are uncertain as to the necessity of it, why not try a second opinion and see what they have to say about it?  This doc may be being overly cautious and another may say..."let's wait another 6 months or a year and do another ultrasound at that point to see where you're at".  That would be being conservative in treatment options.  It takes approximately 10 years of a thickened endometrium for it to become cancerous apparently (from reading other info).   So, waiting another 6 months or so and a repeat ultrasound may be a very viable avenue to take for you!  Why not see what another doc has to say first then? :)

[PerimenoWorried]

Tell you what....we'll both be here as cyber hands for each other, ok? :)  

I know what you mean about making that phonecall.  It's one of the easiest things to do to bypass that phone and say, "tomorrow" and go on with what is essentially, a nice day.  I've done that as well...MANY TIMES over different things.  

If I may put this into a bit of perspective, the word "biopsy" simply means..."we want to see what this is made up of to know how to help you".  Believe it or not, they do this very same thing for women who are trying to conceive children and are having trouble with infertility.  It's still called biopsy! LOL  They are actually sampling the utering lining in this case to see what it's composed of and what hormones are lacking or in abundance in that lining so that they can correct the balance to help the woman become pregnant.  This very same biopsy is done for all kinds of reasons!  We just connotate the word with cancer.  I once had a biopsy done on a skin rash.  Not because they felt it was cancerous but, because they didn't know what it was so, they didn't know how to treat it. :)  I wish that they'd use the words "cell sampling" rather than biopsy because we generally tend to leap to conclusions of..."they must be suspecting cancer!" when that word is used.  In reality, the thing that they're looking for is "what type of cells are there so we know how to treat it or whether to just leave it alone."  Make that call when you're ready.  The waiting and wondering can be far worse than anything else.  And, to add a bit more perspective to things here....IF...and, I'm using that very lightly here, there were to be anything that needs attention, it's best to take care of it while it's a small concern and you're feeling great than to let it get to the point where it's full blown, you're feeling miserable/horrible physically, mentally and emotionally and have to go through far more to try to correct it, right?  You likely don't need this test.  Your doc is following protocol according to set out guidelines and erring on the side of caution.  But, on the same hand, once you've done this and gotten a clean bill of health...think how great you'll feel then! :)  Then, there's nothing in the back of your mind at all anymore.  At worst, you likely need some progesterone to thin out that lining just a bit more.  At best....nothing needs to be done but let your body go through the process normally.  We're in this together! :)

And, congrats on your method of losing weight!  My doc has always said...1 lb per week loss maximum.....do it slowly because it's got to be a lifestyle change rather than a "diet" otherwise, we'll fall off the proverbial wagon and be right back where we started from months down the road again.  Sure enough, that's what I did.  I lost 60 lbs (had 20 more to go) and gained it all back again because it was something that I couldn't keep up with.  I lost that amount in about 4 months.  I worked out for an hour or more per day, ate very little and ended up injuring myself with working out.  I had to lay off the workouts for over 6 months and then some and of course, my drive and determination went down hill after that.  I've now got to climb back onto that wagon and get moving again on both my eating style and my exercise (which will be back at square one again after having built up over time).  WW's is a GREAT program!  I became a Lifetime Member years ago but, like you, I got tired of the meetings and the weigh-ins and the lectures and the cost and want to go it on my own this time.  I should join up just to get the newest program and then, work on it on my own and at my own pace like you are doing.  You've just re-inspired me! :)

So, keep in touch and I'm here!  Thank you for your words of encouragement for my own situation.  I'm rather scared and worried to put it mildly as I may have to go through surgery but, again, I'm doing what I'm being told to do and that's all that I can do.  I'm helping them to help me by going through what I need to do.  I know what you feel as I'm there with you in it.  

HUGS

[Moe690]

Thank you soooooo much!  I truly appreciate the positive words and advice.  I think I have been racking my brains of what I should do.  I know that having the test is the right thing to do.  But I feel wonderful and any bad news would truly be a kill joy:-{.  Every day I say I am going to set up the appointment and I don't - fear kicks in.  Believe me I know it is better safe then sorry.  I will have it done.  It's making the phone call that is hard.  I think it is the word BIOPSY.  Yuck!

Weel, I am sure that your test results are going to be nothing for you to worried about...Stay positive!  I know what it is like to be a nervous reck.  

And as for my weigh lose, it was just cutting down my calorie and fat intake.  I use Weight Watchers guidelines and stuck with it.  I went to Weight Watchers many times and had great success but this time I wanted to try it on my own.  I have 15 pounds to go...I started on Jan 1st. so it took me 8 months to lose 40 pounds.  I wanted to take my time and try to stay focused.  I walk alot, drink lots of water, eat fruits and veggies....I wish I can say its easy - its not!  But the results are wonderful...

I am sure your results will be fine..please keep me updated.  I will also let you know when I make my appointment.  I may need a cyber hand to hold..  I truly appreciate the information, it gave me alot to think about.  I know I am on my way to a happier healthier me,  and so are you :-}

[PerimenoWorried]

I know what you are feeling and going through.  It does feel like being "invaded" when there are so many tests being done on us, doesn't it?  

I don't think that you need to panic.  It's pretty standard stuff for them to want to do these testings, including the biopsy.  When you're post menopausal, anything over 4 or 5 mm thickness is considered an automatic "screening" by biopsy.  I've had one done and it's quick, done in the office and you're on your way home or wherever.  Just take some Advil an hour prior to your appointment to diminish cramping from the test.  It's done like a PAP.  You're in the same position etc..  A small, thin plastic tube is inserted in through the cervix (you'll feel a slight pinch) then, a small amount of uterine tissue will be withdrawn through suction (you'll feel either pressure or a cramping sensation during this portion which only lasts a couple of seconds).  That's it.  You're done and out.  

Now, as to the endometrial thickening.  Well, as I once had it explained to me, fat cells trap/hold estrogen.  When you are losing weight...especially if it is rapid or done quickly, the estrogen becomes freed up into the system.  When estrogen is freed up into the system, it causes an "excess" of estrogen because when in perimenopause and especially, menopause, we have little progesterone by comparison to keep it thinned.  So, this may be why your endometrium has become a LITTLE (it's very little) thickened.  The fact that you had even one spotting episode on top of this thickening is enough for your doc to follow "standard guideline procedures/testings".  Nothing more.  

By the way, the average age for uterine cancer is 60 to 70 years of age.  You're 45 :)  However, it's best to check to make sure that there's no "pre-cancerous" changes going on because that can be corrected through meds like progesterone to thin the lining back out again.  

It's likely all harmless stuff and nothing at all to worry about but, best to follow through with that few minutes of testing to be sure.  That's all that it really is....just a few minutes.  

I'm waiting for the results of my biopsy.  My endometrial thickening was at 16 mm!!!! (I'm 53)  I'm not post menopausal yet or, at least, they don't think so but, it needs to be looked at seriously.  I'm a nervous wreck but, I know that this needs to be looked at and taken care of.  

Be safe.  You've gone through this much and I know it's frightening but, better safe than sorry.  I'm sure you're fine and at most, may need some progesterone to clean out that lining.  

Congrats on the weight loss!!!  Keep it up!  That's fantastic!!!!  :)  Let me know how you did it.  I really need to lose weight healthfully to be healthier too. :)