Thickening of uterus wall after menopause?

Hi Kimberley. 

I haven't updated my post for many months so here goes...

I saw a well respected gynaecolgist at a major teaching hospital - he did a pelvic and internal exam and took some biopsies from the uterus.  It was uncomfortable but not painful, only took a minute, and there was minimal bleeding afterwards.  A hysteroscopy was scheduled, and that was done by a wonderful and very experienced lady gynaecologist.  She explained that the initial biopsies were inconclusive, mainly because they were slightly too small,

She did the hysteroscopy, which was immensely painful but only for a minute or two.  Two tips for anyone about to have it done...they tell you to take 400mg Ibuprofen an hour before, which I did.  If I were to have it again I would take a higher dose, plus co-codamol!  Also, try to watch what they are doing on screen as it happens - it seems to help with the pain for some reason.  The results of the biopsies (all 12 of them!!) were thankfully all clear and it was explained that the uterine wall thickening I was told about - at 6mm - was only in one place.  At the top of the uterus the thickening was 27mm, but it was due to fibroids in the uterine wall, which need no treatment at all.   am SO glad I wasn't told that measurement when the ultrasound was done as I would have been beyond worried.

The bleeding after the hysteroscopy was very slight and I was able to go a shopping trip right after leaving the hospital.

Vagifem was prescribed and the consultant told me it was not HRT, but would deal with any spotting I might have.  When I read the patient info leaflet it WAS described as HRT, so I decided against taking it.

Thankfully, there have been no more spotting episodes in the intervening 8 months and I am 100% fine.  I'm sure the spotting was just nature's way of winding down, after all, it makes sense to think that not everything will stop right after the last period as there must be residual hormones, despite what the medics say. My spotting was never like blood, more brownish/pinkish and very light.  I was told that was not normal but I'm not so sure about that, as it appears to have been normal for me.  I hope anyone else reading this will be able to take some reassurance and won't worry unneccessarily until there is actually something to worry about  

Hi Louise, I'm so glad alls turned out well for you. I fell upon this forum because I'm doing the worst thing and googling!

I'm 46 and have been in the menopause since I was 39. I've actually sailed through it with my periods just stopping and having no hot flushes. I've been back and forth to the dr as having pain in my lower back and sometimes over my hips for a year now which has steadily got worse. A year ago I was sent for an ultrasound to rule out any problems with my ovaries and all was fine. Having seen many different locum drs over this past year and having had X-rays and lots of bloods taken it was found that my esr levels were a little high and they were thinking along the lines of arthritis, this last dr decided that as it was a year since having the ultrasound he would send me for another one just to eliminate any problems with the ovaries before going down the arthritis route. Last week I had the ultrasound and was told my uterus lining is thickened and to return to my dr. Unfortunately the dr I saw although very nice was very straight and to the point and said he needs to refer me to gyne urgently to rule out cancer. I got the call from the hospital the same day and now have a week to wait until I have my appointment. I have no idea what will happen at this appointment but I'm assuming they will try to take a biopsy. I too like yourself and many others am extremely worried and can't think of anything else. I don't appear to have any symptoms other than back ache yet I'm still really sick with worry. Any response would be really appreciated. Thank you

Claire 

Good morning Claire.  I know exactly how you feel with all the worry - Google is indeed a wonderful thing at times, but it is very much a double edged sword!  I honestly think the not knowing is the worst thing because the worry is just horrible.

Just recently I had a small ulcer on my tongue which was slow to heal, probably because I'd had a couple of heavy colds and was a little run down.  After looking up all the information I was convinced I had cancer and I'd have to have radical surgery and go through all sorts of oncology treatment, and would have to learn to talk again, etc.  I saw my GP who was rather unconcerned, and it cleared up perfectly well on its own.  Panic over, and panic due solely to Google!

The thickening of your uterus could be due to lots of things, but apparently around 50% of women have fibroids at some time, and they are more common in the 40s and 50s, and then start to shrink.  If you have fibroids then I know they can occasionally cause low back pain.  Of course, the back pain could also well be arthritis or one of a million other causes.

Almost impossible I know, but try to put it to the back of your mind until your appointment.  On the day take a pad with you as - if you are going to an NHS hospital - they tend to give you a horrible maternity-style pad, which is just gross!  On my first gynae appointment the consultant took biopsies which was uncomfortable but only for a minute.  I only had spotting afterwards, nothing much at all.  They may then schedule you for a hysteroscopy - see my comments above about that.

You are in a good place right now because you are going to have the correct investigations and, no matter what the result, you can deal with it.  Knowledge is power, and all that  !

I will be thinking of you and please let me know how it goes.  Big hugs <3 <3  

Hi Louise, thank you for your speedy reply. It really helps to read that others have gone through the same thing and all been ok. Thanks also for your tips. I'll be stealing a pad from my daughter 😉. Got my appointment on Friday so not too long to wait now. I'll definitely let you know the outcome. Just out of curiosity if the initial biopsy isn't good enough how long did you wait for the hysteroscopy appointment? X

Hi again Claire.  After seeing my GP and being referred to the hospital for an ultrasound, I was then referred to see a gynaecologist - the first hospital appointment with him was when the initial biopsies were taken  after having a chat about what was happening and doing a pelvic and internal exam.  They do it by inserting an instrument through the neck of the uterus, which is uncomfortable, but only for a minute or so.  You don't feel the biopsies being taken, only the instrument being there...if that makes sense.  I was totally fine afterwards and had a small amount of spotting but it was really nothing.  I was told at the time that I would be scheduled for a hysteroscopy (so they were arranging that regardless of the biopsy result) and would receive an appointment letter in a couple of weeks.  I think it was a bit over 2 weeks before the letter came.  To give you an idea of timescale I saw my GP on 14th Dec, had the ultrasound on 5th Jan, the firsy gynae appointment/biopsies on 2nd Feb, an appointment with my GP on 14th Feb to get the blood test and biopsy results (there wasn't any results for the biopsies because they had been too small) and the hysteroscopy on 17th March.  

I don't know if the procedure is the same in all hospitals but, if so, you will probably get an appointment letter for a hysteroscopy within 2 or 3 weeks of your first appointment, and my actual appointment was 6 weeks after the first biopsy appointment.  I suppose every hospital is different and they will all have different waiting times and different preferences by consultants, so don't read anything into it if yours is done differently or sooner.

If there's anything else you want to know, just ask, although you run the risk of me going on and on!

Thinking of you, and please let me know how it goes xxxx

Lol thank you. I don't mind you going on .... it reassures me tremendously!

I will be in touch soon. Take care x

Hi Claire, just wondering how you got on?  I hope your gynaecology appointment wasn't too uncomfortable, and that it won't be too long to wait for any further appointments.  Thinking of you, Louise XXX

Hi Louise, 

Sorry I've been really busy and kept meaning to let you know. 

They did a biopsy and my smear at the same time as it was due. For the biopsy they used something that sucked the cells out and it did hurt more than I expected but only lasted a few minutes. She did say that all looked ok although she found a polyp that she cut away and sent for analysis and she says there might be more and that may be what the thickening was. At the moment I'm still waiting for my results but I'm hoping to hear sometime this week I'll let you know when i hear. How are you? Xx

Hi Claire, I'm good, thank you.  

It sounds as if you are in good hands.  I'm sorry you found that the procedure hurt more than expected, but polyps could explain the pain you are having. 

Fingers crossed for your results, I'll be thinking of you. xxx

Hi Elisa.  I'm sorry you are having pelvic pain, that must be very, very uncomfortable.

Although the lining of my uterus (the endometrium) was thickened and I'd been having a small amount of spotting, I didn't have any pain.  I guess everyone is different though.

Did you have a hysteroscopy, and were biopsies taken?  If not, I think I would be asking for that to be done just for peace of mind.  If it has, what is actually causing the thickening of the endometrium?

If you are happy with the diagnosis, and given that you are having pain, perhaps you should try the Provera as has been suggested.  If it's only for 3 months it may be worth a go - I know there is a lot of possible side effects listed but I suspect it's like most drugs and treatments - the list of POSSIBLE side effects is frightening, but most of them are really quite rare.

Speak with your gynaecologist again, and I hope all goes well.  Do keep us updated!

Hugs xx