What Causes Endometrial Hyperplasia?

Posted on Mon, 3 Mar 2014

Question: Last MP was October 16, 2013, 43 yo female I have had an U/S showing an endometrial thickness of 15mm with numerous cystic areas. Right ovary was enlarged to 6.4 x 3.5 x 4.6 cm with two “simple” cysts measuring 4.5 x 2.9 x 3.2 cm and 2.9 x 2.5 x 2.5 cm. I had urine screen done showing: an elevated MCH and Blood and and eGFR of 90 Blood testing showed: Bilirubin of 38 with all other liver functions within normal parameters and TSH of 4.28, everything else within or near normal. What do you think?

Answered by Dr. Aarti Abraham (1 hour later)

Brief Answer: EXPLAINED BELOW Detailed Answer: Hello Thanks for writing to us with your health concern. Regarding your ultrasound scan - it is indicative of endometrial hyperplasia. This means a thickening of the lining of the uterus - that is common in the perimenopausal age group due to hormonal imbalances inherent at this time. You would need to undergo an endometrial biopsy. This is because some types of endometrial hyperplasias are precursors for endometrial ( uterine ) cancer, however, do not worry, as most are not. The types which are, can be picked up only after biopsy, hence biopsy is a must. Treating endometrial hyperplasia is simple - it can be done with cyclical hormonal therapy ( cyclical progesterone or oral contraceptives for 3 months ). Regarding the ' simple ' cysts, these can be observed again for 2 - 3 months. For ' simple ' cysts, generally a wait and watch policy is advocated, unless there are intervening symptoms such as pain, discomfort, pressure on bowel or bladder, which would necessitate a surgery. For your blood reports, please upload them if possible, as I would need to see the units and the lab parameters. If possible, also upload the scan results. Also, the urine screen results would need to be uploaded for a specific comment ( this is because various labs have varying reference ranges ). All the best. Please do revert. Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (13 minutes later)

I have uploaded the reports as one document. Please give your feedback again.

Answered by Dr. Aarti Abraham (8 hours later)

Brief Answer: EXPLAINED BELOW Detailed Answer: Hello Have gone through your reports. My opinion regarding the ultrasound remains the same. There is endometrial hyperplasia, which should be biopsied. The cysts can be observed for a couple of months, unless there is intolerable pain. The other lab parameters are fine, only am concerned about the raised total bilirubin. It is definitely high, and indicates jaundice. Do you have any symptoms of the same. Would suggest contacting your physician for the bilirubin levels. Take care.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar