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    Thickening of Endometrium Lining and Cyst
    jamien80 posted:
    I'm just curious, I found out I have a cyst on my ovary which is common I know. I was also told I had a thickening of the endometrium lining. My understanding is that this is not the same as endometriosis, correct? I have extremely bad back pain several weeks before my period. A few times I ended up bed bound. The pain usually comes on gradually and gets worse. Then I start my period. My periods are long about a week and they start then stop, and then start again. They have also been getting later and later. This started occuring for about a year now, however the back pain has always been an issue, it's just been getting worse over the past few years. I've had abnormal paps before but nothing came of them. I am not on the pill. The back pain is pretty bad 800 MG Ibuprofen helps take the edge off. I'm wondering if it's all related and what exactly does a thickening of the endometrium lining mean.
    Jane Harrison Hohner, RN, RNP responded:
    Dear jamien: Excellent question! You are correct, endometriosis is when bits of uterine lining tissue are present outside the uterus (eg stuck to bowel, ovaries, bladder, abdominal lining, or even the lungs). Every month when the lining inside the uterus sheds during a menstrual period, all the other bits of endometriosis begin to shed and bleed at the same time. However, there is no designated place for the small amounts of bleeding to go so they end up creating inflammation inside the abdominal cavity. This is linked to much increased menstruation- time pain and ultimately scar tissue as the body tries to "wall off" the troublesome endo implants.

    The thickening of the uterine lining which is seen on ultrasound does not necessarily mean that someone has endometriosis. A thickening in the muscular walls of the uterus MIGHT suggest that endometriosis is inside the walls. This is called "adenosis".

    More commonly, a thickened uterine lining is either from hormonal influences--or from polyps of the lining of the uterus ("endometrial polyps"). When a woman is making estrogen, but is not ovulating (eg from an ovarian cyst or being overweight or having low thyroid function) the lining can become overly built up. The main problem with a too thickened lining is that abnormal cells can begin to develop. Over a long period of time this can create a focus for uterine cancer.

    Given what you have shared, the back pain MIGHT be linked to endometriosis since endo pain tends to start before flow and can last through the flow. I would suggest that you return to your GYN for follow up on the back pain and the ovarian cyst/thick lining. Hopefully the cyst and lining issue will resolve soon. If the back pain persists your GYN might try using medications which suppress endometriosis--and evaluate if there are other factors which might be responsible for the back pain.

    jamien80 replied to Jane Harrison Hohner, RN, RNP's response:
    Thank you very much. That was very helpful. I see my Gyn on monday to discuss the issue. The back pain is bothersome, it's like sharp stabbing pains in the lower back. I'm just hoping if it's a gyno problem thats causing my back pain, it will be an easy quick fix and I can move on pain free!
    CReneeH replied to Jane Harrison Hohner, RN, RNP's response:
    Ms. Hohner: Thank you for the response. I have a similar issue. The only difference is I no longer have a cycle. I had a hysterectomy about 3 years ago. I learned last week that there is a cyst on my ovaries. Can I still have endometriosis? The Dr. thinks so. It is also a possibility that my bladder is attached to my ovaries from all of the scar tissue. Help, I am not slepping at night because of the bladder pressure and constant urinating. My back hurt as well. I have this sharp pain on my right side that is due to the cyst. I also learned my thyroid levels are low. I am tired no matter how much I sleep. This is driving me crazy. Help, the doctor will repeat the xrays in 3 months with an MRI. I only had an ultrasound performed last week. What can I do in the meantime?
    An_252761 replied to Jane Harrison Hohner, RN, RNP's response:
    I have three cysts on my left ovary (two hemoraghic) and uterine thickening, waiting to find out if I need a hysterectomy but cam I personally recomend Thermacare wraps for the back pain? I get it mid-cycle and every month and having the deep heat makes all the difference. Skip the menstrual wraps and go straight for the back, they are money but the pain relief is worth it. BJs and Costcos sell economy packs of them, I should buy shares! Good luck.
    Anon_6061 replied to An_252761's response:
    Are you waiting on the results of an endometrial biopsy? Uterine thickening oftentimes is nothing serious and if there is hyperplasia, the first line treatment (medication) oftentimes reverses it.

    Hysterectomy is the most overused surgery after c-section. According to ACOG, 76% of hysterectomies don't meet their criteria for the surgery primarily due to lack of adequate diagnostic evaluation and/or failure to try alternative treatments.

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