# Tell Me All You Know About Endometrial Thickening



## PaytinandAvarysMom (Apr 19, 2006)

because I just got a calll from the nurse saying thats whats going on...not the worst thing so I am pretty relieved I think







They want to schedual a d and c, soon...
Do you have to be put out for a d and c? I hate being put out because my family has reactions with what they use...
Thanks!!!!!!!


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## kate3 (May 4, 2007)

Endometrial hyperplasia is an abnormal thickening or build up of the uterine lining. It is most often seen in women with chronic amenorrhea (ie skip months between periods) and women with PCOS.

I can't really tell you much more without knowing things like your history, age, measurement of the endometrial stripe, etc. Endometrial hyperplasia is a major risk for endometrial cancer. The D&C will remove the excess lining (and be sent to pathology). The focus will then be on regulating your menstrual cycle and preventing this from happening again. D&Cs are most often done under general, but with a documented severe reaction (something like malignant hyperthermia), it could be done under spinal.

Good luck.


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## PaytinandAvarysMom (Apr 19, 2006)

Quote:

I can't really tell you much more without knowing things like your history, age, measurement of the endometrial stripe, etc. Endometrial hyperplasia is a major risk for endometrial cancer. The D&C will remove the excess lining (and be sent to pathology). The focus will then be on regulating your menstrual cycle and preventing this from happening again. D&Cs are most often done under general, but with a documented severe reaction (something like malignant hyperthermia), it could be done under spinal.
My history: I've always had normal periods up until August of '07. I have "missed" periods because of breast-feeding with my second baby. From The time she was born in June of 2006 until January of 2007.

I do not know the measurement of the endometrial stripe; I will call in the morning and find out though.

It is a risk for endometrial cancer in someone my age? (25)????? Wrong person to tell that, as I am a chronic worrier!!!!!!!!









I have never had a bad reaction to general but I have only been under it once when I was three...my mom and all her sisters have a TERRIBLE time with it, and both of her sisters almost never came back...so I am more afraid of general anesthesia then the D&C!!!!!!!!!

And now I am confused is endometrial hyperplasia the same thing as endometrial thickening?????


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## KMK_Mama (Jan 29, 2006)

All I can tell you is MY experience.

I was diagnosed with a "thickened endometrial stripe" a few years ago after years "woman problems." I was bleeding all the time. I'd have my period and then it would stop for a few days to a week and then DH and I would have sex and we'd end up in a puddle of blood and then I would spot again until it was time for my next period. It was awful. I also had really bad cramps during AF. I was finally diagnosed with the thickened endometrial stripe, and they wanted me to either go on progesterone (artificial/man made progesterone) for 2 weeks to give me a really bad period and shed the lining or they wanted me to get the D&C. The decision was mine. I took some time to decide and I found out I was pregnant with Keegan about 2-3 weeks later, so I'm glad I hadn't made a decision at that point. By the time he weaned, the problems started to come back and they did another u/s and said it was the thickening again....I didn't feel comfortable with the options they had so I did nothing. When I went to a naturopath for an unrelated problem, he wanted my complete medical history so I told him about my period/bleeding problems. At this point, my periods were 2-3 weeks long and I was starting to bleed during sex again. He checked my hormones and VOILA, the problem was solved. My hormones are completely out of whack. My estrogens were off the chart high and my progesterone was VERY low. He put me on DIM (a supplement at the health food store to reduce estrogens) and a natural progesterone cream to be used on day 14-28 of my cycle. On month 3 of this, I had the WORST period. I was leaking through tampons every 30 minutes or so, but ever since then my problems have been solved. My periods are a NORMAL 5-7 days and I don't bleed during sex anymore and I hardly ever get cramps. He said that my really bad period was when my thick lining shed itself due to the change/balancing of my hormones. I must also add that my family doctor had checked my hormones and said they were fine. The way the ND explained this discrepancy was that both my estrogen and my progesterone were within normal range, but the progesterone is supposed to be higher than the estrogen and my estrogen was significantly higher than my progesterone. Basically they were flip-flopped. I'm NOT saying this is what is wrong with you, but it's worth looking into. It was an easy fix.


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## kate3 (May 4, 2007)

Quote:

It is a risk for endometrial cancer in someone my age? (25)????? Wrong person to tell that, as I am a chronic worrier!!!!!!!!
It's a risk if you do nothing about it.
Endometrial thickening is hyperplasia (thickening is just a more understandable term).


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## tylerdylan (Aug 29, 2007)

Quote:


Originally Posted by *kate3* 
It's a risk if you do nothing about it.
Endometrial thickening is hyperplasia (thickening is just a more understandable term).

Endometrial cancer is very rare in someone before menopause. A biopsy would have to be done to see if there are any atypical cells, but given your age it is unlikely.
I am an ultrasound tech and have seen too many woman in your age group with endometrial hyperplasia. The most common causes are:
1. hormones - requires hormone treatment (ie think progestrone but I could be wrong on that)
2. polyp - very common even in young patients. Diagnosis can be made with special ultrasound called a hysterosonogram. It can be painful, but you are awake and unmedicated for it. It might be a good place to start for you.

I don't think that a D&C is the first choice in treatment. Infact, if the cause is hormonal having the D&C would not have any benefit/cure since a D&C simply scrapes the innermost layer clean and hyperplasia is a thickening of all layers of the endo (the D&C would help if there was a polyp, but they usually need to know the polyps location to be sure they do a thorough job and get it out). Also, there are risks with having a D&C which include developing adhesions in the endometrial canal which can make getting pregnant difficult or impossible in the future (if that is something you would want).

I think you need more information. I think maybe hormone tests would be beneficial too to see if something is simply off there. If the hormone tests are normal I would have the hysterosonogram. If that is normal than maybe a D&C could be considered though I really don't think it will change anything.


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## PaytinandAvarysMom (Apr 19, 2006)

tylerdylan, thank you for your post! I dont know how to explain it but when I heard d&c I just thought to myself, yeah sure like that will help...







I know that in August of 2007 my testosterone was flagged as being high, not really high but higher then normal in women (I cant remember the exact number) I'm gonna call back up there in a few minutes and ask some questions!







Thanks!


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## CorbinsMama (Jun 29, 2003)

Well, whaddaya know. I was just coming here to post about this. I had heavy bleeding in August (had a baby in April), so my OB put me on Provera for 10 days and did a biopsy (negative). It's stopped the bleeding and gave me a heavy period, and then I had practically no period (just a little spotting) for months. In January it all started again. I went to the OB again this past Tuesday for the same thing. I've been on Provera again since then, but the bleeding has not stopped. My cramps feel like the kind you have after birth when your babe starts nursing.

So, the bleeding has not stopped, I'm supposed to have a pelvic ultrasound in 2 weeks, and I'm afraid of what happens if this doesn't go away. I know that uterine cancer is the issue, but if my estrogen doesn't get straightened out, if my bleeding doesn't stop, and the u/s shows nothing, I'm afraid that they will start talking hysterectomy.

Is that a possibility?

I'm calling my doc Monday if the bleeding hasn't stopped by then.


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## JaneSmith1010 (Apr 22, 2007)

I have always had abnormal cycles and have been having some extra severe pain in my ovarian/kidney regions since October. Haven't menstruated in about 2 1/2 years due to pregnancy, BFing and some other factor I think. Could this be a cause of my pain then too?


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## PaytinandAvarysMom (Apr 19, 2006)

So i called up to check on my results closer and come to find out that she did not even test my hormones!??!!!!!!!!!! I'm ready to go get my own O.B./GYN behind my name so i can fix myself...in the long run i think it would be cheeper! This is so frustrating...I really feel as though i am knocking my head against a wall!







I tell these people that i really really really to the depth of my being think that this all goes back to my thyroid (hello I have every thyroid symptom, except one, that you can check off the list) In turn I think I have PCOS. Every doctor just says nope, nope, nope, no possible way it can be any of that! I'm so done! I have one last hope, his name is Dr. Hilgers at the pope john paul institute in Omaha (maybe you have heard of the Creighton method) he's suppose to be so good he actually want to get to the bottom of what it causing your symptoms







From what I heard he will test you until there is nothing else left to test...sounds good to me, I'm calling on Monday


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## CorbinsMama (Jun 29, 2003)

I, too, have thyroid problems, hypothyroid. But I also am iodine deficient and I suspect that I have PCOS.

Here is an article on iodine deficiency from my homeopath's website: http://drshevin.com/patient_educatio...deficiency.php

You definitely need a new doctor who will listen to you!


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## PaytinandAvarysMom (Apr 19, 2006)

Corbinsmama and jhaw32000 did you guys find anything out on Monday? I put off calling until today...I'm good a procrastinating!


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## CorbinsMama (Jun 29, 2003)

My bleeding has slowed, but has not stopped completely. I spoke to my OB today, and she wants me to stay on the Provera for 4 more days to see if we can get it to stop. I'm going to have my u/s hopefully next week. Then next month, I'll take Provera for 12 days and 12 the month after. By that time I will have my annual on June 9, so we will see what is happening then.

I hope this will fix everything!


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## PaytinandAvarysMom (Apr 19, 2006)

I called the office again today to get more info. I talked to a nurse about my ultra sound results and asked if we could test my hormones first. She said we can but since I have a moderate thickening the doctor would really rather get it out quickley since it can lead to edometrial cancer. I explained to her that I know it can lead to that but for someone at my age with a normal PAP, I would really rather try to get my hormones in order first. Her responce was well we could end up messing with your hormones for months, it better just to have the D&C and get it "cured." Is it me or do they just want to do a D&C for the quick fix????!!! I feel like this is really being pushed on me all the while I know my hormones are out of wack! I'm getting a second opinion. I want to have more babies and although the risks of a D&C preventing that are low they are sitll there. Plus I want to feel like a normal human being with energy and I want to stop packing on 30 pounds a year just from looking at food! Just thought I would update!


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## CorbinsMama (Jun 29, 2003)

Quote:


Originally Posted by *PaytinandAvarysMom* 
I called the office again today to get more info. I talked to a nurse about my ultra sound results and asked if we could test my hormones first. She said we can but since I have a moderate thickening the doctor would really rather get it out quickley since it can lead to edometrial cancer. I explained to her that I know it can lead to that but for someone at my age with a normal PAP, I would really rather try to get my hormones in order first. Her responce was well we could end up messing with your hormones for months, it better just to have the D&C and get it "cured." Is it me or do they just want to do a D&C for the quick fix????!!!

Yes, I believe they think it will be a quick fix, but the thing is, you are right that it won't fix the hormonal issue. My aunt had two D&Cs for this very thing. When I mentioned it to my OB on the phone yesterday, she said yeah, it cleans you out, but it doesn't take care of the underlying hormonal issue. From what my OB said, it's not just the thickening of the lining that can cause cancer, it's the high estrogen that is causing the thickening in the first place that can cause cancer. So if you thin the lining, that's fine, but you'll still have high estrogen which will make it happen over and over again.

So, I agree that you should go to another Dr.


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## PaytinandAvarysMom (Apr 19, 2006)

I'm calling in the morning to get my second opinion. I'm confused can you have high estrogen along with high testosterone? I've never had my estrogen tested but I know that I was at a 90 for testosterone. (The normal for women I think is 30-60) My second question is if I get my hormones straightened out will I be able to shed the thickened endometrial layer or am I going to have to go ahead with the D&C anyway? I'll do the D&C if I have to I just don't really want to, but what I do want to do is get on the ball and get pregnant with #3!


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *PaytinandAvarysMom* 
I'm calling in the morning to get my second opinion. I'm confused can you have high estrogen along with high testosterone? I've never had my estrogen tested but I know that I was at a 90 for testosterone. (The normal for women I think is 30-60) My second question is if I get my hormones straightened out will I be able to shed the thickened endometrial layer or am I going to have to go ahead with the D&C anyway? I'll do the D&C if I have to I just don't really want to, but what I do want to do is get on the ball and get pregnant with #3!









You can have a d&c with conscious sedation and a local block. It's painful, but very short.

Yes, you can have elevated estrogen along with testosterone. Both are converted from prohormones into sex steroids in the fat tissue. Endometrial hyperplasia and elevated testosterone are almost diagnostic for PCOS for most providers, though they don't meet the Rotterdam criteria for diagnosis.

The doc may try to induce a progesterone withdrawal bleed, which will thin the endometrium but not address any underlying disorder. If it is PCOS, you will likely be much more successful at conceiving if the PCOS is treated, and less likely to miscarry if metformin is used in the first trimester.

The d&c is diagnostic as well. You can't do pathology on a withdrawal bleed, and you can path samples from a d&c.


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## PaytinandAvarysMom (Apr 19, 2006)

maxmama thank you so much...much less







: now! Yeah I've said from the beging I think I have PCOS, but I'm just wondering were on earth you find a doctor who is willing to say someone with out cysts on her ovaries has PCOS! Frustrating! Thanks Though...


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *PaytinandAvarysMom* 
maxmama thank you so much...much less







: now! Yeah I've said from the beging I think I have PCOS, but I'm just wondering were on earth you find a doctor who is willing to say someone with out cysts on her ovaries has PCOS! Frustrating! Thanks Though...

Only about half of women with PCOS have cysts on their ovaries, and many women without PCOS have cysts. The old name, Stein-Leventhal syndrome, is probably less misleading, since it doesn't mention cysts at all.

FWIW, I do have PCOS and have no ovarian cysts, nor have I ever had them.


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## PaytinandAvarysMom (Apr 19, 2006)

Soooooo....I treated myself with peroxide and water for bacterial vaginitis. The doctor had originally prescribed flagal (I think thats what it was called) but after reading up on it I decided trying peroxide sounded allot safer! I am 99% sure it cured it.







I started the treatment last Tuesday, and I ended today. My question is, ever since about Sunday my bleeding has REALLY increased and it looks normal now, not so pink and no puss. (It is now deep dark red) Could it be that the reason I had a medium thickened endometrial lining was because of Bacterial Vaginites and is it possible now that I treated it, I am able to release the thickened layer? Maybe I am just wishful thinking as I don't want a D&C, but truly I am no longer just spotting I am going through a pad about every 3 hours. Crossing my fingers someone will have an idea!


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## PaytinandAvarysMom (Apr 19, 2006)

Anyone? I know it is an odd question but really, its like the bleeding you have right after giving birth. I searched online but couldnt find anything saying that bactiral vaginitis could effect your cycles. Anyone know of a midwife or nurse here at mothering I could direct this question too, I really dont feel like calling the obs office I went to, they pretty much just want me to do the d&c end of story. Thanks


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## maxmama (May 5, 2006)

No. BV isn't an infection; it's a disruption in the normal ecology of the vagina. It has nothing to do with the uterus. It has nothing to do with the endometrium. It's jsut coincidence that your bleeding increased after treating the BV.


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## tylerdylan (Aug 29, 2007)

Quote:


Originally Posted by *PaytinandAvarysMom* 
maxmama thank you so much...much less







: now! Yeah I've said from the beging I think I have PCOS, but I'm just wondering were on earth you find a doctor who is willing to say someone with out cysts on her ovaries has PCOS! Frustrating! Thanks Though...


Actually only about 30% of people with PCOS will have cysts on their ovaries (it's been awhile since I studied it, but I am pretty sure 30% is right). The diagnosis is made based on hormone levels and symptoms only. If your doctor doesn't know this than it is time to find a new doctor!!!!


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## PaytinandAvarysMom (Apr 19, 2006)

My Ultrasound Results!!!???

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I finally was able to get my results sent over to me. I have posted before that this doctor I saw really wants me to do a D and C. I would rather try progesterone first so I went to see Dr. Keefe at Pope Paul in Omaha. She told me to chart for 2 months and come back. But I have been bleeding since August of last year and while bleeding for another 2 months would be same old same old...I would really like to get this taken care of before the end of the summer. I'm just sick to death of bleeding! Neither of these to doctors took any hormone levels but I know they have to be off because they were off a year ago when I had them tested. So here are my results of my ultrasound any advice you guys could give would be great!

ULTRASOUND PELVIS/GYN + TRANSVAGINAL

Transabdominal study shows the uterus to measure 9.2 cm in length and 5 cm in the AP dimension x 5.2 cm in width. The endometrium appeared prominent at 1.8 cm. No uterine mass was seen. The ovaries were not well visualized. Transvaginal study will be performed to further evalutate the study. No other pelvic fluid collection or mass. Transvaginal sudy showed endometrial to measure 2.1 cm. With small amount of fluid withen the uterin cavity. Two small nobothian cysts were seen. No uterine mass. The uterus measured 8.2x4.8x6.2 cm. No other pelvic fluid collections. The ovaries were visulated measuring 4.1x2.2x3.3 cm on the right and 3.1x2.2x2.2 cm on the left. Color flow doppler evaluation of the ovaries showed symetrical appearing blood flow. No other abnormality.

IMPRESSION:
Moderate endometrial thickening with small ammount of free fluid in the uterine cavity. These changes probabley represent hyperplasia given patients age but endometrial neoplasma cannot be totally excluded.

So is it even worth trying progesterone...has anyone had that work for a moderate thickening?


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## CorbinsMama (Jun 29, 2003)

I have been on progesterone for three months for (IIRC) about the same amount of thickening. I took it for 14 days the first month and 12 days for the next two months. I'm having a heavy period right now and then I go back to the doc on June 9. We will see then if it makes my body start having regular periods instead of two months of nothing and then two weeks of spotting and two weeks of heavy bleeding.


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## PaytinandAvarysMom (Apr 19, 2006)

CorbinsMommy
did you have to figure out/know were your cycles are to get on progesterone or did you just start taking it? I'm asking because I have no idea were mine are...


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## CorbinsMama (Jun 29, 2003)

I was bleeding constantly, so they just started the prog immediately. i had no idea when mine were either.


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