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pstpap posted:
Hi I am a 43 year old mother of 3.. two children which are both all grown up and in the Military and one who is 9. I recently went in for a antoher pap test which came back "abnormal" again, the pap test was taken 6 months apart. I then just had a vaginal ultra sound and was told that the walls of my uterus were "very thick" which has the doctor concerned so I'm scheduled for a biopsy on Friday. What does all of this mean?
1 Replies |Watch This Discussion | Report This| Share this:worriedHi I am a 43 year old mother of 3.. two children which are both all grown up and in the Military and one who is 9. I recently went in for a antoher pap test which came back "abnormal" again, the pap test was taken 6 months apart. I then just had a vaginal ultra sound and was told that the walls of my uterus were "very thick" which has the doctor concerned so I'm scheduled for a biopsy on Friday. What does all of this mean?
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Jane Harrison Hohner, RN, RNP responded:
Dear pstpap: I can understand your concerns, getting informed about two worrisome conditions. Let's take them individually as they are very unlikely to be related, OK?

1..Two abnormal PAP smears six months apart---A lot depends upon how severe the "abnormality" was. The severity ranges from atypical cells of uncertain significance all the way though severe dysplasia and finally cancer in situ. If you had one of the more extremely abnormal PAP smears you would not have had a repeat PAP in six months. You would have been sent for a colposcopy and biopsy of the cervix right away.

Depending upon the exact diagnosis of your recent PAP, the GYN may now want to take a closer look at your cervix using a magnifying machine (colposcope). If they see any abnormal appearing areas a small biopsy of cervical tissue would be taken. If your most recent PAP was still very low grade they may just have you repeat the PAP and/or do HPV (wart virus) testing.

2. Thickened wall of the uterus---It is possible for the muscular walls of the uterus to be thickened. The most common reasons are either multiple small fibroids or adenomyosis (endometriosis in the uterine walls). Both of these are benign.

More commonly we find a thickened uterine lining by ultrasound. This is usually created by missed ovulations or inadequate progesterone production from the ovaries. Frequent triggers for missed ovulations include: being in our 40's, being overweight, low thryoid, and physical/emotional stress. The risk in having a too thick lining is that abnormal (precancerous) cells can develop within the lining.

Lastly there is another, benign, cause of a thick appearing lining. If one has many polyps of the lining (these are like nasal or rectal polyps), those polyps can make the lining look irregularly thickened.

To get the correct diagnosis of a thickened lining of the uterus, a GYN will do an endometrial biopsy to get a sample of the lining for lab analysis.

Pstpap, your own GYN should be able to give you the most accurate answers to your important questions. Be sure to get the exact wording of any results and keep them for your medical records file at home. Feel free to write us back, and put my name in the subject line so I can find you.

Best wishes on your biopsy this Friday. I've had about 30 (for science) and they are painful but mercifully brief.

Yours,
Jane
Report This| Share this:worriedDear pstpap: I can understand your concerns, getting informed about two worrisome conditions. Let's take them individually as they are very unlikely to be related, OK?<br /><br />1..Two abnormal PAP smears six months apart---A lot depends upon how severe the "abnormality" was. The severity ranges from atypical cells of uncertain significance all the way though severe dysplasia and finally cancer in situ. If you had one of the more extremely abnormal PAP smears you would not have had a repeat PAP in six months. You would have been sent for a colposcopy and biopsy of the cervix right away.<br /><br />Depending upon the exact diagnosis of your recent PAP, the GYN may now want to take a closer look at your cervix using a magnifying machine (colposcope). If they see any abnormal appearing areas a small biopsy of cervical tissue would be taken. If your most recent PAP was still very low grade they may just have you repeat the PAP and/or do HPV (wart virus) testing.<br /><br />2. Thickened wall of the uterus---It is possible for the muscular walls of the uterus to be thickened. The most common reasons are either multiple small fibroids or adenomyosis (endometriosis in the uterine walls). Both of these are benign.<br /><br />More commonly we find a thickened uterine lining by ultrasound. This is usually created by missed ovulations or inadequate progesterone production from the ovaries. Frequent triggers for missed ovulations include: being in our 40's, being overweight, low thryoid, and physical/emotional stress. The risk in having a too thick lining is that abnormal (precancerous) cells can develop within the lining.<br /><br />Lastly there is another, benign, cause of a thick appearing lining. If one has many polyps of the lining (these are like nasal or rectal polyps), those polyps can make the lining look irregularly thickened.<br /><br />To get the correct diagnosis of a thickened lining of the uterus, a GYN will do an endometrial biopsy to get a sample of the lining for lab analysis.<br /><br />Pstpap, your own GYN should be able to give you the most accurate answers to your important questions. Be sure to get the exact wording of any results and keep them for your medical records file at home. Feel free to write us back, and put my name in the subject line so I can find you.<br /><br />Best wishes on your biopsy this Friday. I've had about 30 (for science) and they are painful but mercifully brief.<br /><br />Yours,<br />Jane
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