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    Thick uterine wall and polyps
    jwhittington posted:
    I am 32 years old and just had uterine polyps removed along with a D & C for thick uterine wall. Is this normal for my age? I have been reading and usually you get a thick wall at the beginning and near end of reproduction.
    Jane Harrison Hohner, RN, RNP responded:
    Dear jwhittington: You are correct, a thickened uterine lining is more common as a teen or a perimenopausal women. The common feature is fewer ovulations. As you may have read, endometrial hypertrophy means an overgrowth of the lining of the uterus. Another term for this is endometrial hyperplasia.

    Simply stated, if the uterine lining is like grass or lawn, estrogen is like the fertilizer (causes a thickening of the lining or hypertrophy), and progesterone is like the lawnmower (keeps the lining thin by three different mechanisms). This is why DepoProvera (high dose synthetic progesterone) brings about a thin lining, and why birth control pills (relatively progesterone dominant) bring about shorter, lighter periods. It is also why women who miss ovulations (no progesterone produced) are at a greater risk for endometrial hypertrophy/hyperplasia and endometrial cancer. The most common reasons for a woman to not be ovulating (no lawn mower activity so thicker lawn) are being heavy set or being early perimenopausal.

    Endometrial hypertrophy is a common cause of heavy and prolonged bleeding. The diagnosis can be made by ultrasound or endometrial biopsy. The ultrasound image measures the thickness of the lining ("endometrial stripe"); with hypertrophy it is usually more than 12-15 mm. I had a patient once with a stripe of 30mm! The endometrial biopsy takes a sample of lining tissue and the pathologist can then make a very accurate diagnosis base upon the cells seen under the microscope. The treatment for simple hyperplasia/hypertrophy which does not contain abnormal cells is synthetic progesterone pills or shots. This shrinks down the too thick lining.

    jwhittington, there can be many other reasons for missing enough ovulations to develop a too-thick lining. You might want to ask your GYN if they think you have a predisposing condition (eg low thyroid, overweight, pituitary problem, etc) which is the culprit. As an aside, lots of polyps growing out of the uterine lining can also create the appearance of a too-thick lining.

    cknapp319 replied to Jane Harrison Hohner, RN, RNP's response:

    I had a bleeding polyp, D&C, and and endo ablation done July 19th. I was told that the uterine wall had some thickening and it was 22 cm. He also that after this procedure I would no longer get my periods and no longer need birth control. I had some spotting the first few weeks following. Then about 3 weeks after when I should have my period I got it. I called the doctor he told me it was normal cause I was still healing. However I wasnt comfortable and thought something was wrong so I called my primary she saw me right away and checked and confirmed that I did in fact have my menses. She said it was sometimes normal to still get a period but if I had another in 3-4 weeks that may need a second D&C and ablation. I have tried to contact the gynie but he isnt calling me back so I dont know what to do.

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