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Have had months of heavy bleeding between periods. Ultrasound done. Should I go for biopsy?

May 2013
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Practicing since : 2006
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Hello, I'm 39, have had months of bleeding between periods, very heavy periods (I'm not obese, normal height weight ratio). I just had an ultrasound done. My endo thickness was 16mm (on day 15 of my cycle). I do have two fibroids, one is intramural about 1.5 (it's been there for years) and a subserosal of 2.7. My doctor referred me to an ob/gyn for an endometriol biopsy. I had pre-cancerous cervical cells removed many years ago, and my pap has been normal since. Is the thickness enough of a concern to have a biopsy? I've read that it is painful. I do have insurance but don't want to have unnecessary procedures done, unless there is a enough cause.
Posted Sun, 12 Aug 2012 in Women's Health
Answered by Dr. Sree Gouri SR 2 hours later
Thanks for the query.

normal thickness of endometrium ranges from 1mm to 8mm,
possibly on 15th day of periods it should be around 4mm, so definitely your endometrial thickness is more,

the possible causes for your heavy intermenstraul periods are,
-hormonal imbalance leading to irregular ripening or irregular shedding of endometrium,
-dysfunctional uterine bleeding probably because of metropatia hemorrhagica which will show swiss cheese pattern in histopathology,
-fibroids may sometimes lead to intermenstrual bleeding as in case of ulceration etc but that is rare with intramural and subserous types, may be by increasing endometrial surface area intramural fibroid may contributing to some extent.

so to diagnose what is the cause of your bleeding and to exclude rare causes like malignancies better to undergo biopsy, as in ultrasound we can only measure the thickness but to know the exact character of the endometrium better to undergo biopsy with histopathological examination.

it will be like per vaginal and speculum examinations only, you need not worry about the pain which will be minimal usually.

Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.

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