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Having stomach ache, bloating, enlarged uterus and breast. In menopause, thick endometrial lining. Is it ovarian cysts?

DOCTOR OF THE MONTH - Mar 2013
Mar 2013
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I have right sided pain (probably an ovarian cyst that couldn't be seen during my ultrasound; they couldn't see my right ovary at all), bloating, and in menopause five months (except I did have to cycles in February). My endometrial lining is 15mm (has been 11mm for past couple of years). I do not have spotting or bleeding, just enlarged uterus and breasts. Doctor wants to do a D & C on me (I also have multiple lymenomas?, fibroids, one is 2.5cm diameter) due to lining thickness alone. Is that really necessary? I'm for a quick biopsy, but don't really want a D & C with all my fibroids and uterine enlargement (shaped like a softball and 11cm long and wide) in there. I'm worried about a perforated uterus or cutting a large fibroid to deeply. Plus...would like to see what is up with my right ovary before that too. What is your opinion?
leiomyomas, not lymenomas.
Posted Sun, 12 May 2013 in Vaginal and Uterus Health
 
 
Answered by Dr. Aarti Abraham 28 minutes later
Hello XXXXXX
Thanks for your query.
You are having post menopausal bleeding, which requires investigations, as there are chances of atypical endometrial hyperplasia and uterine malignancy.
Also, after menopause, ovaries are ideally not visualised, however to resolve the issue of pain, you can have a repeat transvaginal ultrasound , or a CT scan or MRI .
Biopsy of the uterine lining is definitely recommended, and in your case with fibroids and a distorted uterine cavity, a quick biopsy might not be enough to sample all areas .
A D and C is more thorough and reliable.
To minimise risks of perforation and injury, you can insist on a hysteroscopy guided biopsy, where the interior of the uterus is always under vision, and chances of injury are minimised.

Take care, and feel free to discuss further.
Above answer was peer-reviewed by
 
Follow-up: Having stomach ache, bloating, enlarged uterus and breast. In menopause, thick endometrial lining. Is it ovarian cysts? 7 minutes later
I just started menopause though and no periods since February, no bleeding. My blood tests done in March showed that I was "in" menopause. I had a period in November. None in December or January, then two in February, second one heavy, then none (or bleeding) in March or April. My ultrasound was done in January before my two periods in February (of which let out a lot, so lining is probably thinner now). I am worried about perforation and excessive bleeding from cutting in to one of the large fibroids.

How can the ovaries not be visualized if they are still there? Yes, I would like a new ultrasound at least to see if the lining is still thick and if they can see the right ovary.

Thank you for your answers. Do you also know why I have right-sided pain then from my ovary? Why my lower back aches and I am bloated?
 
 
Answered by Dr. Aarti Abraham 5 minutes later
The size of ovaries normally shrinks after menopause, hence they become atrophic and are often not seen during ultrasound.
I think the bloating and back ache is due to menopausal hormonal changes and resultant calcium and vitamin D deficiencies.
The pain could be due to fibroids and uterine enlargement, and not due to ovaries at all.
Above answer was peer-reviewed by
 
Follow-up: Having stomach ache, bloating, enlarged uterus and breast. In menopause, thick endometrial lining. Is it ovarian cysts? 2 minutes later
Thank you so much!
 
 
Answered by Dr. Aarti Abraham 2 minutes later
You are most welcome.
And wish you luck.
Above answer was peer-reviewed by
 
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