What Does A Thickened And Irregular Endometrium Post Menopause Suggest?

Posted on Mon, 24 Oct 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 24 Oct 2016 Answered on

Thu, 10 Nov 2016 Last reviewed on

Question : Hi! My mother is 48 years old, pre-menopausal and is suffering from pancreatitis (has had two attacks, one last year in March and another mild one this year in July but is doing fine now). Additionally, she's also been suffering from gynaecological issues. In November last year, her endometrium thickness was found to be quite high and subsequently she had a hysteroscopy and a biopsy. The results were good and no abnormalities were found, however underlying polyps were suspected. She was taking medication and was absolutely fine. Had follow-ups almost every month and a trans-vaginal ultrasound showed things were normal in XXXXXXX Post that, about half a month back her endometrium thickened again (missed periods hence we suspected and got an ultrasound done). She started bleeding in clots and her gyn asked her to get a ca-125 test done which was 37.6 (slightly off limits). Gyn suggested total hysterectomy immediately and suspected polyps. We got a second and even a third opinion and they said immediate surgery was unnecessary and ca-125 was only marginally high and was not a cause of worry at all. She had a D&C on Thursday, no polyps were found but endometrium was thick and new gyn said medicines should cure the problem and hysterectomy is not required. Biopsy reports will arrive on Friday. Doctors have said that because she had a biopsy only a year ago and because everything was fine then, there is no need to worry about any abnormalities. However, this being about my mother, I'm probably more worried than even she herself is. Please advice on what such a condition is indicative of and what should we be expecting! Thanks so much, in advance!

Answered by Dr. Manisha Jain (23 minutes later)

Brief Answer:
No need of surgery

Detailed Answer:
Hello dear, thanks for trusting health care magic.
Yes there is no need for hysterectomy unless biopsy suggests some problem.
This increased thickness can be easily managed via drugs and the thickness problem will vanish once she achieves menopause.
CA 125 levels are almost normal as alarming levels are more than 200 usually.
Just relax and wait for biopsy report which if normal then high dose regular progesterone intake will suffice.
Regards
Dr Manisha

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

Follow up: Dr. Manisha Jain (3 minutes later)

Dear Dr. XXXXXXX

Thank you so much for your valuable advice. Do you think there maybe any chances of abnormalities showing up in the biopsy report? That's the main worry. Also, if we don't get a surgery done now and treat this condition with medicines, is there any chance of things getting worse later in life and should surgery be done to reduce the risk factors?

Answered by Dr. Manisha Jain (12 hours later)

Brief Answer:
Less chances of abnormality

Detailed Answer:
Yes it needs a regular follow up eventually even if biopsy comes normal till she attains menopause.
There are less chances of abnormality on biopsy but nothing conclusive can be said at her age.
It is a common problem at her age and chances of abnormalities are 1-3%.
Medical management will arrest the problem if at all present and thus nothing to worry except a regular follow up via yearly ultrasound and pap smear.
All the best dear

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

Follow up: Dr. Manisha Jain (10 hours later)

Dear Dr. XXXXXXX

Thank you very much for your valuable advice.

Best,
XXXX

Answered by Dr. Manisha Jain (2 hours later)

Brief Answer:
Welcome

Detailed Answer:
Hello again, its a pleasure ......Regards Dr Manisha Jain. You can directly contact me on the site if needed in future.

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