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Thick endometrium
I am 53 premenopausal, I have had a very heavy but regular period my entire life. The last year and a half to two years I have had a couple instances of anemia. Upon visiting my ob a trans vagina ultrasound was ordered and my endometrium was at 29mm. A biopsy was done and now I wait. My question is, does this thickness automatically mean I have cancer? I have had one instance of spotting longer after my period in December but nothing else? I am ready to just have a hysterectomy and get it over with. I cannot sleep or eat due to the stress and anxiety of waiting? Any response would be appreciated
COMMUNITY LEADER
How long before you get the results of the biopsy? In your shoes, I wouldn't decide on a hysterectomy before hearing what the results are. A thick endometrium does not automatically mean cancer.
Has there been uterine cancer in your family? Do you have diabetes? What's your weight? If the answers are no, no, and not obese, even with a thick endometrium, you have a reduced chance of getting uterine cancer. Also, what time of the month was the visit to your ob/gyn for the ultrasound? Just before your period or just after? If I were your doc, I'd be interested in seeing the thickness of the endometrium right after your period.
Has there been uterine cancer in your family? Do you have diabetes? What's your weight? If the answers are no, no, and not obese, even with a thick endometrium, you have a reduced chance of getting uterine cancer. Also, what time of the month was the visit to your ob/gyn for the ultrasound? Just before your period or just after? If I were your doc, I'd be interested in seeing the thickness of the endometrium right after your period.
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No history, no diabetes, my weight is 152 and I am 5’4” not my ideal, but not bad. I am also a bedside nurse, so I stay active. I was due for my period a few days ago, but two weeks ago the dr put me on norethinedrone and I have not had a period. I have always had very heaving periods with severe cramping, still had three children without any issues. I have not missed a period ever. I just did what I tell my patients not to do researched online and with the thickness I freaked out. I read a lot about endometrial hyperplasia but no one with the same thickness. I appreciate your response by the way. Thank you just so stressed and thinking the worse&
Biopsy results this Friday or Monday
So, all you really know for sure is that this one time, the endometrium was 29mm? Do you have any records noting earlier endometrial thicknesses? What you need are comparative measurements to times in your past. That way you can see if your endometrium is always 29mm at this point in your cycle (if you've ever had one that has gone on so long), or if it has just happened because the norethindrone gave you more time for the endometrium to build up past when it would usually have sloughed off.
Given that your periods have always been consistently heavy and crampy, it does sound pretty standard that your endometrium is somewhat thick every month. It wouldn't be surprising if the norethindrone would account for the difference between what's normal for you and 29mm. When you talk to your doctor, see if you can get him to order a couple more ultrasounds, or maybe one right after your period and one right before it.
Are you on the norethindrone for birth control? Because in your shoes I'd be kind of tempted to get off of it, at least for now to let your period come. Also, and I hate to say it, but be ready for this next period to be a doozie. I'd even consider buying a package of Depends, just in case the flow is extreme and causes you to flood out tampons and pads. (I wore them in the days after I had my son, and they were great.) And, don't forget that Advil or Nuprin, being antiprostaglandins, are great for cramps. I don't envy you dealing with a super heavy period, but of course if everything all comes out (even if it's in a rush) you'll be relieved of the worry that it's hyperplasia or cancer.
Given that your periods have always been consistently heavy and crampy, it does sound pretty standard that your endometrium is somewhat thick every month. It wouldn't be surprising if the norethindrone would account for the difference between what's normal for you and 29mm. When you talk to your doctor, see if you can get him to order a couple more ultrasounds, or maybe one right after your period and one right before it.
Are you on the norethindrone for birth control? Because in your shoes I'd be kind of tempted to get off of it, at least for now to let your period come. Also, and I hate to say it, but be ready for this next period to be a doozie. I'd even consider buying a package of Depends, just in case the flow is extreme and causes you to flood out tampons and pads. (I wore them in the days after I had my son, and they were great.) And, don't forget that Advil or Nuprin, being antiprostaglandins, are great for cramps. I don't envy you dealing with a super heavy period, but of course if everything all comes out (even if it's in a rush) you'll be relieved of the worry that it's hyperplasia or cancer.
Thank you, I actually do not have comparisons because I never believed I had an issue. I just had heavy periods with cramping and lived with it. I am on the hormone recently because I became to anemic, not birth control I actually had a tubal 23 years ago. I did mess the doctor, she messaged back saying yes my endometrium very thick but the positive things are I do not have cancer risk factors and I am still young. She also went to say do not assume the worse and there are other possibilities. Often thirst are pre cancerous and not cancerous. She did say that if there was any cancer of the female reproductive system this would be the one to pick and not to worry yet. I guess because the thickness in mm was so high I freaked out! This makes me feel a little better, I do appreciate you responding to me I have not had anyone to question about this, thank you!!
I agree with your doctor about the risk factors, and your age, and the fact that if one had to have a reproductive-area cancer, this would be the easiest to deal with. But I sure wouldn't rush to a hysterectomy even in your imagination, unless there's evidence you need one. :-)
Regarding the anemia, if I were you and dealing with heavy periods, I wouldn't be enthused about taking anything that might create an even thicker endometrium. Talk to your doc to see what she thinks about whether the norethindrone allowed the uterine lining to build up to that thickness. And while you're talking, ask if you can get at least a couple more ultrasounds to act as baselines for what your uterus looks like right at the end of a period, and on the last day before you expect to begin your next one. If the ultrasound shows that your lining clears all the way out to 0 mm with a period, that would seem significant. (Knowing how thick your lining usually gets before a period might also help explain why you have been anemic. A thick lining binds up a certain amount blood and takes it out when it goes.) Have you been told by your doc to take iron?
Good luck getting this sorted. Write back if you get any unexpected news.
Regarding the anemia, if I were you and dealing with heavy periods, I wouldn't be enthused about taking anything that might create an even thicker endometrium. Talk to your doc to see what she thinks about whether the norethindrone allowed the uterine lining to build up to that thickness. And while you're talking, ask if you can get at least a couple more ultrasounds to act as baselines for what your uterus looks like right at the end of a period, and on the last day before you expect to begin your next one. If the ultrasound shows that your lining clears all the way out to 0 mm with a period, that would seem significant. (Knowing how thick your lining usually gets before a period might also help explain why you have been anemic. A thick lining binds up a certain amount blood and takes it out when it goes.) Have you been told by your doc to take iron?
Good luck getting this sorted. Write back if you get any unexpected news.
Where I said if your lining clears to 0 mm that would be significant, I meant significant good, not significant bad. :-)
Just a heads up! The doctor called and the biopsy is fine!!! She did say we still need to do something because of the heavy bleeding and my blood count dropping so low. She offered to stay on the meds, a d and c, or hysterectomy. I chose the d and c because the us did show a fibroid. What do you think of this or do you have any other suggestions?
I'd go with the D&C. And then get serious about taking iron (plus Vitamin C) all the time. I wouldn't be too keen on trying to use hormones for this. Also, don't forget to have the doctor to do ultrasounds at the beginning and the end of at least one cycle, so you can know for sure how thick your endometrium gets before you bleed, and also if your endometrium drops to 0 mm after you bleed. Good luck! I don't love having a D&C but it's not bad.
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