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Thick uterus lining
An_248506 posted:
I am 55, been in menopause 3+ years. Recently began to spot and have minor cramping. Went for my well-woman checkup, pap smear fine.
My mammogram showed enlarged ancillary lymph nodes in armpits and I then had a follow-up bilateral ultrasound of my breasts/armpits -- and other than the enlarged lymph nodes they don't think it is cancer because there is little blood flow to the ancillary lymph nodes. I have since learned that they were comparing the lymph nodes from the previous mammogram from four years before.
CBC bloodwork showed no infections and I am to keep doctor informed if they become larger.
My family history includes a sister who died from Non-Hodgkins Lymphoma so I was and am very concerned about the enlarged lymph nodes.
Doctor said my uterus felt thick and sent me for a transvaginal and abdominal ultrasound. Then went to OB/GYN and had a endometrial biopsy which showed no problems. Still spotted for a few weeks after biopsy but it seems to have all stopped for now. The OB/GYN did bloodwork to confirm that I was indeed in menopause.
So my question is ... why is my uterus thick? If I weren't in menopause, the uterus lining would be normal but because I am in menopause I was told that it should be half as thick.
Could it be from my C-section 25 years ago? I had a long labor (25+ hours) and they had to break my water and I still never dilated past 5 cm. So they finally did a C-section. C-section scar was oozing and took a long time to finally heal. My stomach has never been flat again -- and I seriously think they cut through so much muscle that it never could be.
I also had an occurrence of cervical dysplasia about 22 years ago and the pre-cancerous cells were frozen off. Five years of frequent pap smears until I got the all clear on that scare. No problems since then except that four years ago my pap showed excessive endometrial cells, then I had a very long period and then months with no periods and on and off very, very light periods, and then finally I went into menopause.
This has been a very stressful, emotional and upsetting experience -- not to mention expensive.
My mammogram showed enlarged ancillary lymph nodes in armpits and I then had a follow-up bilateral ultrasound of my breasts/armpits -- and other than the enlarged lymph nodes they don't think it is cancer because there is little blood flow to the ancillary lymph nodes. I have since learned that they were comparing the lymph nodes from the previous mammogram from four years before.
CBC bloodwork showed no infections and I am to keep doctor informed if they become larger.
My family history includes a sister who died from Non-Hodgkins Lymphoma so I was and am very concerned about the enlarged lymph nodes.
Doctor said my uterus felt thick and sent me for a transvaginal and abdominal ultrasound. Then went to OB/GYN and had a endometrial biopsy which showed no problems. Still spotted for a few weeks after biopsy but it seems to have all stopped for now. The OB/GYN did bloodwork to confirm that I was indeed in menopause.
So my question is ... why is my uterus thick? If I weren't in menopause, the uterus lining would be normal but because I am in menopause I was told that it should be half as thick.
Could it be from my C-section 25 years ago? I had a long labor (25+ hours) and they had to break my water and I still never dilated past 5 cm. So they finally did a C-section. C-section scar was oozing and took a long time to finally heal. My stomach has never been flat again -- and I seriously think they cut through so much muscle that it never could be.
I also had an occurrence of cervical dysplasia about 22 years ago and the pre-cancerous cells were frozen off. Five years of frequent pap smears until I got the all clear on that scare. No problems since then except that four years ago my pap showed excessive endometrial cells, then I had a very long period and then months with no periods and on and off very, very light periods, and then finally I went into menopause.
This has been a very stressful, emotional and upsetting experience -- not to mention expensive.
7 Replies |Watch This Discussion | Report This| Share this:Thick uterus liningI am 55, been in menopause 3+ years. Recently began to spot and have minor cramping. Went for my well-woman checkup, pap smear fine. <br /><br />My mammogram showed enlarged ancillary lymph nodes in armpits and I then had a follow-up bilateral ultrasound of my breasts/armpits -- and other than the enlarged lymph nodes they don't think it is cancer because there is little blood flow to the ancillary lymph nodes. I have since learned that they were comparing the lymph nodes from the previous mammogram from four years before.<br /><br />CBC bloodwork showed no infections and I am to keep doctor informed if they become larger. <br /><br />My family history includes a sister who died from Non-Hodgkins Lymphoma so I was and am very concerned about the enlarged lymph nodes.<br /><br />Doctor said my uterus felt thick and sent me for a transvaginal and abdominal ultrasound. Then went to OB/GYN and had a endometrial biopsy which showed no problems. Still spotted for a few weeks after biopsy but it seems to have all stopped for now. The OB/GYN did bloodwork to confirm that I was indeed in menopause. <br /><br />So my question is ... why is my uterus thick? If I weren't in menopause, the uterus lining would be normal but because I am in menopause I was told that it should be half as thick.<br /><br />Could it be from my C-section 25 years ago? I had a long labor (25+ hours) and they had to break my water and I still never dilated past 5 cm. So they finally did a C-section. C-section scar was oozing and took a long time to finally heal. My stomach has never been flat again -- and I seriously think they cut through so much muscle that it never could be. <br /><br />I also had an occurrence of cervical dysplasia about 22 years ago and the pre-cancerous cells were frozen off. Five years of frequent pap smears until I got the all clear on that scare. No problems since then except that four years ago my pap showed excessive endometrial cells, then I had a very long period and then months with no periods and on and off very, very light periods, and then finally I went into menopause.<br /><br />This has been a very stressful, emotional and upsetting experience -- not to mention expensive.
Jane Harrison Hohner, RN, RNP responded:
Dear An: If your uterus felt "thick" on pelvic exam that likely meant that the size felt larger than expected. An overly thickened uterine lining cannot be felt on exam. That diagnosis only comes after an ultrasound scan measures the "endometrial stripe" or "echo" in millimeters--so its an accurate number. A thickened lining is associated with abnormal bleeding patterns and the potential development of abnormal, precancerous cells. In your specific case you had an endometrial biopsy which did not apparently find abnormal cells. Sometimes a woman just past menopause will still have some erratic production of estrogen (eg conversion of adrenal hormones into estrone via body fat, or less commonly an estrogen producing tumor). Any additional source of estrogen can cause uterine lining to proliferate and grow thicker.
By contrast an enlarged, "thick" uterus can be caused by a number of things:
1. Multitudes of very small fibroids can distend the contours of the muscular walls of the uterus. A single very large fibroid can enlarge the uterus, often making irregular contours.
2. Endometriosis withing the walls of the uterus ("adenomyosis") can make a uterus feel enlarged, boggy, and even tender.
3. Having had many full term pregnancies can create a slightly enlarged uterus. A C-section scar would not contribute to this, unless there was a large twin or triplet birth.
4. There is a very uncommon cancer (sarcoma) which can arise in the muscular wall of the uterus. Here is a link to more information on diagnosis from the American Cancer Society:
http://www.cancer.org/cancer/uterinesarcoma/detailedguide/uterine-sarcoma-diagnosis
Bottom line, I'm not totally clear if it was the lining or the body of the uterus that was thickened. You deserve the most accurate answer from either your primary care MD or the GYN who did your ultrasound and endometrial lining biopsy. Please ask them for clarification as they have access to your GYN evaluations. You are asking the right questions!
In Support,
Jane
By contrast an enlarged, "thick" uterus can be caused by a number of things:
1. Multitudes of very small fibroids can distend the contours of the muscular walls of the uterus. A single very large fibroid can enlarge the uterus, often making irregular contours.
2. Endometriosis withing the walls of the uterus ("adenomyosis") can make a uterus feel enlarged, boggy, and even tender.
3. Having had many full term pregnancies can create a slightly enlarged uterus. A C-section scar would not contribute to this, unless there was a large twin or triplet birth.
4. There is a very uncommon cancer (sarcoma) which can arise in the muscular wall of the uterus. Here is a link to more information on diagnosis from the American Cancer Society:
http://www.cancer.org/cancer/uterinesarcoma/detailedguide/uterine-sarcoma-diagnosis
Bottom line, I'm not totally clear if it was the lining or the body of the uterus that was thickened. You deserve the most accurate answer from either your primary care MD or the GYN who did your ultrasound and endometrial lining biopsy. Please ask them for clarification as they have access to your GYN evaluations. You are asking the right questions!
In Support,
Jane
Report This| Share this:Thick uterus liningDear An: If your uterus felt "thick" on pelvic exam that likely meant that the size felt larger than expected. An overly thickened uterine lining cannot be felt on exam. That diagnosis only comes after an ultrasound scan measures the "endometrial stripe" or "echo" in millimeters--so its an accurate number. A thickened lining is associated with abnormal bleeding patterns and the potential development of abnormal, precancerous cells. In your specific case you had an endometrial biopsy which did not apparently find abnormal cells. Sometimes a woman just past menopause will still have some erratic production of estrogen (eg conversion of adrenal hormones into estrone via body fat, or less commonly an estrogen producing tumor). Any additional source of estrogen can cause uterine lining to proliferate and grow thicker.<br /><br />By contrast an enlarged, "thick" uterus can be caused by a number of things:<br /><br />1. Multitudes of very small fibroids can distend the contours of the muscular walls of the uterus. A single very large fibroid can enlarge the uterus, often making irregular contours.<br /><br />2. Endometriosis withing the walls of the uterus ("adenomyosis") can make a uterus feel enlarged, boggy, and even tender.<br /><br />3. Having had many full term pregnancies can create a slightly enlarged uterus. A C-section scar would not contribute to this, unless there was a large twin or triplet birth.<br /><br />4. There is a very uncommon cancer (sarcoma) which can arise in the muscular wall of the uterus. Here is a link to more information on diagnosis from the American Cancer Society:<br /><br /><a rel="nofollow" href="http://www.cancer.org/cancer/uterinesarcoma/detailedguide/uterine-sarcoma-diagnosis ">http://www.cancer.org/cancer/uterinesarcoma/detailedguide/uterine-sarcoma-diagnosis</a> <br /><br />Bottom line, I'm not totally clear if it was the lining or the body of the uterus that was thickened. You deserve the most accurate answer from either your primary care MD or the GYN who did your ultrasound and endometrial lining biopsy. Please ask them for clarification as they have access to your GYN evaluations. You are asking the right questions!<br /><br />In Support,<br />Jane
dmm2cats replied to Jane Harrison Hohner, RN, RNP's response:
Jane,
Thanks for the reply. I haven't had any bleeding for two weeks and have a follow-up appointment with the OB/GYN who did the biopsy tomorrow morning -- which I had been thinking of canceling.
Now I am going to keep the appointment and take the info from that website along with me. I am making a list of questions and appreciate your reply.
As a non-medical person, it is helpful to have the insight of a medical person who can think of what needs to be asked.
I will let you know how it goes!
Thanks again,
Dawn
Thanks for the reply. I haven't had any bleeding for two weeks and have a follow-up appointment with the OB/GYN who did the biopsy tomorrow morning -- which I had been thinking of canceling.
Now I am going to keep the appointment and take the info from that website along with me. I am making a list of questions and appreciate your reply.
As a non-medical person, it is helpful to have the insight of a medical person who can think of what needs to be asked.
I will let you know how it goes!
Thanks again,
Dawn
Report This| Share this:Thick uterus liningJane,<br /><br />Thanks for the reply. I haven't had any bleeding for two weeks and have a follow-up appointment with the OB/GYN who did the biopsy tomorrow morning -- which I had been thinking of canceling. <br /><br />Now I am going to keep the appointment and take the info from that website along with me. I am making a list of questions and appreciate your reply.<br /><br />As a non-medical person, it is helpful to have the insight of a medical person who can think of what needs to be asked.<br /><br />I will let you know how it goes!<br /><br />Thanks again,<br />Dawn
Dear Dawn: Wow, if it was the lining that was thickened (not the muscular walls of the uterus) I'm so glad that you decided to keep the appointment for the biopsy of your uterine lining. Please do write us back when you get the results of your biopsy. Through the magic of the internet another woman will find your story through your descriptive subject line "thick uterus lining" and learn from your experiences. Please add your follow up to this same thread so I can find you.
In Gratitude,
Jane
In Gratitude,
Jane
Report This| Share this:Thick uterus liningDear Dawn: Wow, if it was the lining that was thickened (not the muscular walls of the uterus) I'm so glad that you decided to keep the appointment for the biopsy of your uterine lining. Please do write us back when you get the results of your biopsy. Through the magic of the internet another woman will find your story through your descriptive subject line "thick uterus lining" and learn from your experiences. Please add your follow up to this same thread so I can find you.<br /><br />In Gratitude,<br />Jane
dmm2cats replied to Jane Harrison Hohner, RN, RNP's response:
Jane,
At my most recent OB/GYN appointment I discussed my concerns with him and asked about what our next step was as I am still concerned about the thick uterus lining. We are scheduling a D&C so he can get a better sample to biopsy than just the endometrial biopsy which did not show any cancerous cells. So now I will wait until that is scheduled and will let you know what the results of the D&C show.
Dawn
At my most recent OB/GYN appointment I discussed my concerns with him and asked about what our next step was as I am still concerned about the thick uterus lining. We are scheduling a D&C so he can get a better sample to biopsy than just the endometrial biopsy which did not show any cancerous cells. So now I will wait until that is scheduled and will let you know what the results of the D&C show.
Dawn
Report This| Share this:Thick uterus liningJane,<br /><br />At my most recent OB/GYN appointment I discussed my concerns with him and asked about what our next step was as I am still concerned about the thick uterus lining. We are scheduling a D&C so he can get a better sample to biopsy than just the endometrial biopsy which did not show any cancerous cells. So now I will wait until that is scheduled and will let you know what the results of the D&C show.<br /><br />Dawn
Dear Dawn: Yes, a full D&C can usually get more tissue for examination by the pathology lab. If it's any reassurance, when the current endometrial biopsy procedures were being developed there were MANY randomized clinical studies which compared the small, in office, type to both D&C and full suction machine procedures. Overall, the smaller, in office types in common use were statistically as accurate for diagnosis as the more invasive procedures.
It is certainly possible to have a thickened uterine lining ("endometrial hyperplasia") without abnormal ("atypia") cells. Hopefully your D&C will put you into this category of just a too thick lining ("simple hyperplasia without atypia").
Yours,
Jane
It is certainly possible to have a thickened uterine lining ("endometrial hyperplasia") without abnormal ("atypia") cells. Hopefully your D&C will put you into this category of just a too thick lining ("simple hyperplasia without atypia").
Yours,
Jane
Report This| Share this:Thick uterus liningDear Dawn: Yes, a full D&C can usually get more tissue for examination by the pathology lab. If it's any reassurance, when the current endometrial biopsy procedures were being developed there were MANY randomized clinical studies which compared the small, in office, type to both D&C and full suction machine procedures. Overall, the smaller, in office types in common use were statistically as accurate for diagnosis as the more invasive procedures.<br /><br />It is certainly possible to have a thickened uterine lining ("endometrial hyperplasia") without abnormal ("atypia") cells. Hopefully your D&C will put you into this category of just a too thick lining ("simple hyperplasia without atypia").<br /><br />Yours,<br />Jane
dmm2cats replied to Jane Harrison Hohner, RN, RNP's response:
Jane,
Well good news! The D&C found a long thin polyp that was "hiding" between the lining of the uterus (causing the thickness). Dr. removed polyp and biopsied other tissue from the D&C. All was benign. Said the rest of the lining looked great and that more polyps might grow back and if I have bleeding again to call him. So I am relieved and the D&C was not as bad as I thought. Did have cramping for a few days and bleeding for about a week but all is good now.
The bad news is that I am still getting the medical bills -- my share of which (since I have a high deductible) will probably be in excess of $6000! Oh joy! This has been a very expensive way to have peace of mind.
Dawn
Well good news! The D&C found a long thin polyp that was "hiding" between the lining of the uterus (causing the thickness). Dr. removed polyp and biopsied other tissue from the D&C. All was benign. Said the rest of the lining looked great and that more polyps might grow back and if I have bleeding again to call him. So I am relieved and the D&C was not as bad as I thought. Did have cramping for a few days and bleeding for about a week but all is good now.
The bad news is that I am still getting the medical bills -- my share of which (since I have a high deductible) will probably be in excess of $6000! Oh joy! This has been a very expensive way to have peace of mind.
Dawn
Report This| Share this:Thick uterus liningJane,<br /><br />Well good news! The D&C found a long thin polyp that was "hiding" between the lining of the uterus (causing the thickness). Dr. removed polyp and biopsied other tissue from the D&C. All was benign. Said the rest of the lining looked great and that more polyps might grow back and if I have bleeding again to call him. So I am relieved and the D&C was not as bad as I thought. Did have cramping for a few days and bleeding for about a week but all is good now. <br /><br />The bad news is that I am still getting the medical bills -- my share of which (since I have a high deductible) will probably be in excess of $6000! Oh joy! This has been a very expensive way to have peace of mind.<br /><br />Dawn
Dear Dawn: Thanks for the happy-ending news on your thickened uterine lining. Yes, a large polyp, or a cluster of smaller ones, can "lie down" on top of the lining creating an uneven thickened appearance. An endometrial biopsy or D&C will often get all or part of the polyp(s) so that confirms the diagnosis. Other ways of detecting polyps (for your future information) include a hysterosonogram (saline infused ultrasound) or a hysteroscopy (fiber optic light scope which looks inside the uterus). With the saline infused ultrasound the fluid causes the polyps to float up (like sea grass) so they can be visualized more clearly with ultrasound. The fiber optic light scope has attached cutting tools so any apparent polyps can be removed.
Dang, the health insurance news is not so great. A MD friend, who has remained involved with the Occupy Wall Street movement, related the following. Through donations, a group is buying up medical collections accounts. Usually these are less than10 cents on the dollar (ie your bill would be a few hundred dollars to them). They then pay off the bill and write the patient a letter stating that their credit is clear. I'd never heard about this, but I think it's great. Here's what I could find on Google:
http://www.care2.com/causes/occupy-wall-street-is-buying-and-paying-the-99s-debt.html
Yours,
Jane
Dang, the health insurance news is not so great. A MD friend, who has remained involved with the Occupy Wall Street movement, related the following. Through donations, a group is buying up medical collections accounts. Usually these are less than10 cents on the dollar (ie your bill would be a few hundred dollars to them). They then pay off the bill and write the patient a letter stating that their credit is clear. I'd never heard about this, but I think it's great. Here's what I could find on Google:
http://www.care2.com/causes/occupy-wall-street-is-buying-and-paying-the-99s-debt.html
Yours,
Jane
Report This| Share this:Thick uterus liningDear Dawn: Thanks for the happy-ending news on your thickened uterine lining. Yes, a large polyp, or a cluster of smaller ones, can "lie down" on top of the lining creating an uneven thickened appearance. An endometrial biopsy or D&C will often get all or part of the polyp(s) so that confirms the diagnosis. Other ways of detecting polyps (for your future information) include a hysterosonogram (saline infused ultrasound) or a hysteroscopy (fiber optic light scope which looks inside the uterus). With the saline infused ultrasound the fluid causes the polyps to float up (like sea grass) so they can be visualized more clearly with ultrasound. The fiber optic light scope has attached cutting tools so any apparent polyps can be removed.<br /><br />Dang, the health insurance news is not so great. A MD friend, who has remained involved with the Occupy Wall Street movement, related the following. Through donations, a group is buying up medical collections accounts. Usually these are less than10 cents on the dollar (ie your bill would be a few hundred dollars to them). They then pay off the bill and write the patient a letter stating that their credit is clear. I'd never heard about this, but I think it's great. Here's what I could find on Google:<br /><a rel="nofollow" href="http://www.care2.com/causes/occupy-wall-street-is-buying-and-paying-the-99s-debt.html"><br /><a href="http://www.care2.com/causes/occupy-wall-street-is-buying-and-paying-the-99s-debt.html">http://www.care2.com/causes/occupy-wall-street-is-buying-and-paying-the-99s-debt.html</a></a> <br /><br />Yours,<br />Jane
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