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Had Pelvic And Transvaginal Ultra Sound For Ovarian Cysts. Have Regular And Normal Period. Have Thick Endometrium. Suggest?

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Posted on Thu, 5 Sep 2013
Question: I had a pelvic and transvaginal ultra sound today. to follow up on some small ovarian cysts. those cysts have resolved. i just turned 50 in late july 2013. my periods have been regular, and on XXXXXXX 25 2013 had a normal period. I have not had a period since then. the ultra sound interpertaion was the endometrial stripe is 10mm, and non specific thickness of the endometrial stripe. and correlation is advised. could the endometrium have got that thick in just missing one period? what should be done?
doctor
Answered by Dr. Aarti Abraham (50 minutes later)
Brief Answer:
CONSULT GYNECOLOGIST - PROGESTERONE WITHDRAWAL

Detailed Answer:
Hello
Thanks for writing to us.
As you are nearing 50, you are now approaching menopause.
Around this time, the period DO get irregular.
You start off by missing a period, or having scanty bleeding, or sometimes heavy and erratic , basically unpredictable menstrual bleeding.
By missing a period, the endometrium that has grown in the previous cycle is not shed off, hence yes, by missing just one period, it can easily grow upto 10 mm.
If you are not symptomatic, do not worry.
You might need progesterone tablets, to induce a withdrawal bleed.
By taking progesterone for a few days, and then stopping, you mimic the natural process that happens each month ( that gets disordered as hormones go awry closer to menopause ), and hence bleeding would occur in response to progesterone withdrawal.
Do consult your gynecologist regarding this.
Take care, and do feel free to discuss further.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Aarti Abraham (3 hours later)
what if i do nothing? my doctor has still not responded with his suggestions from this report. since i feel fine and no heavy bleeding, if i do nothing could that be problematic in the future? i dont want to have heavy bleeding all of a sudden. would i have to have a D&C? being that i have only missed my period for july, and nothing yet in august. would a D&c be an impulsive thing,? i am not keen on taking any hormones like progesterine. family history of breast. but i can be reassured its not ominous 10mm since my period just stopped last month for the first time in 30 plus years. pap smear in january was normal. thanks i am a little anxiuos
doctor
Answered by Dr. Aarti Abraham (1 hour later)
Brief Answer:
DETAILED BELOW

Detailed Answer:
Just one skipped period, a lining of 10 mm is not ominous. However, sometimes there is a condition called endometrial hyperplasia, where again, due to hormonal imbalance, the lining of the uterus continues to thicken and grow, failing to shed off.
In this condition, a D and C and biopsy is required, as ONLY certain ( around 5 % ) of endometrial hyperplasia progresses on to malignancy.

As you have a family history of breast cancer (I assume its that, since you have failed to type in a key word after breast --- ), it is recommended to have a D and C as it will put your mind to rest.

If you have a spontaneous period within a few days, no medication is required.
If you do not have a period, then progesterone is required only for a few days ( 5 - 10 days ) to induce a period.
If this condition of missing periods and the thickening of the lining persists, then D and C should be done.
Take care.
Always feel free to discuss further.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Aarti Abraham (8 hours later)
Thank you! You have been very helpful(. Yes my mother had breast cancer at age 65,possibly due to her taking HRT in the 1980's . She is 80 years old today , she had a lumpectomy with radiation and has been fine.). No other family history of any cancer.do you not think doing a Pap smear to ensure no abnormalities and repeat transvaginal/ pelvic ultra sound in 1- 3 months would be best instead of a d&c right away as I may get a period at any time? I have very good insurance to cover these tests. Thanks in advance for your response
doctor
Answered by Dr. Aarti Abraham (7 hours later)
Brief Answer:
DETAILED BELOW

Detailed Answer:
Hi
Firstly, a Pap smear just reveals the status of the cervix, that is, it screens for cervical cancer.
Endometrial hyperplasia is a risk for endometrial ( uterine cancer ).
I would not advice a D and C right away, unless you have heavy and torrential bleeding.
You can wait for your periods for another couple of weeks, have a repeat ultrasound, and if the thickness persists or increases, go for a diagnostic D and C, as it is a quite minor procedure, and would keep you safely covered.
Take care.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Aarti Abraham

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Had Pelvic And Transvaginal Ultra Sound For Ovarian Cysts. Have Regular And Normal Period. Have Thick Endometrium. Suggest?

Brief Answer:
CONSULT GYNECOLOGIST - PROGESTERONE WITHDRAWAL

Detailed Answer:
Hello
Thanks for writing to us.
As you are nearing 50, you are now approaching menopause.
Around this time, the period DO get irregular.
You start off by missing a period, or having scanty bleeding, or sometimes heavy and erratic , basically unpredictable menstrual bleeding.
By missing a period, the endometrium that has grown in the previous cycle is not shed off, hence yes, by missing just one period, it can easily grow upto 10 mm.
If you are not symptomatic, do not worry.
You might need progesterone tablets, to induce a withdrawal bleed.
By taking progesterone for a few days, and then stopping, you mimic the natural process that happens each month ( that gets disordered as hormones go awry closer to menopause ), and hence bleeding would occur in response to progesterone withdrawal.
Do consult your gynecologist regarding this.
Take care, and do feel free to discuss further.