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What Are The Risks Of Uterine Fibroids And Excessively Thick Endometrium?
Question: My wife is having uterus size 9x7x5.5 cm . she has uterine fibroids ..3 in nos..two are small while one is of size 5.4 cmx5.1cm which is posterior intramural...she has endometrium thickness 18-19mm.. periods are every 26-28 days and are normal with more bleeding in first two days. is endometrium thickness too large.. what are the risks involved ? Does she need immediate D&C ? if she goes for D&C is it very complicated ? what are the side affects/after affects of D&C ?
Brief Answer:
urgent D&C needed. high risk of malignancy
Detailed Answer:
Hello Thanks for trusting health care magic.
At the age of 45 years (perimenopausal age) endometrial thickness of 18 mm is very thick and thus bothersome. She has fibroids and excessively thick endometrium both are highly risk factors for development of endometrial cancer.
In my opinion, she needs urgent hysteroscopic d&c and evaluation. It is a simple OPD procedure which needs admission in day care only and patient is fit to walk and eat after 12 hours of procedure. It is usually not complicated in experienced hands; but on rare occasions, the following symptoms might occur:
- excessive bleeding
- post operative pain for about 3-4 days.
- rarely perforation of uterus ( less than 0.1%)
Post operative period is usually uneventful except for mild pain for a day and bleeding for 2-3 days.
Please visit her gynecologist and discuss about my opinion at the earliest.
In case you have any other query I will be happy to help.
urgent D&C needed. high risk of malignancy
Detailed Answer:
Hello Thanks for trusting health care magic.
At the age of 45 years (perimenopausal age) endometrial thickness of 18 mm is very thick and thus bothersome. She has fibroids and excessively thick endometrium both are highly risk factors for development of endometrial cancer.
In my opinion, she needs urgent hysteroscopic d&c and evaluation. It is a simple OPD procedure which needs admission in day care only and patient is fit to walk and eat after 12 hours of procedure. It is usually not complicated in experienced hands; but on rare occasions, the following symptoms might occur:
- excessive bleeding
- post operative pain for about 3-4 days.
- rarely perforation of uterus ( less than 0.1%)
Post operative period is usually uneventful except for mild pain for a day and bleeding for 2-3 days.
Please visit her gynecologist and discuss about my opinion at the earliest.
In case you have any other query I will be happy to help.
Above answer was peer-reviewed by :
Dr. Prasad
Hi Doctor,
My wie is planned for D&C(Hyesteroscopic) after 3 days. However she might have menses by that time. Doctor says there is no problem due to menses and D&C can still be done. What is your opinion ? Regds
My wie is planned for D&C(Hyesteroscopic) after 3 days. However she might have menses by that time. Doctor says there is no problem due to menses and D&C can still be done. What is your opinion ? Regds
Brief Answer:
no problem in d&c even in periods
Detailed Answer:
Hello Mr XXXXXXX
Your doctor is right in saying that even if she is having menses d&c can be done and will give tissue for analysis.
So you can go for d&c as planned and surely that will not be affected by her period date.
Wish her the best of health.
Take care
no problem in d&c even in periods
Detailed Answer:
Hello Mr XXXXXXX
Your doctor is right in saying that even if she is having menses d&c can be done and will give tissue for analysis.
So you can go for d&c as planned and surely that will not be affected by her period date.
Wish her the best of health.
Take care
Above answer was peer-reviewed by :
Dr. Prasad
My wife was done D&C on 26th. IT was first day of her menses. After D&C she was discharged from Hosp on 27th Morn. The tissues have been sent to lab for biopsy..Although D&C procedure was normal she is still having some bleeding and some red threads coming out . Is it normal ?
Brief Answer:
Normal to have bleeding for 3-5 days
Detailed Answer:
Hello Mr XXXXXXX good to see you again.
It is common to have bleeding and passage of clots for 3-5 days after d&c.
See if
- she soaks more than 3 pads a day or
- passage of excessive clots while sitting on toilet --or if she has intolerable pain lower abdomen.
In case any such complaint appears visit your gynecologist immediately otherwise normal menstrual like bleeding is normal.
Wish her the best of health and wait for biopsy results with fingers crossed.
Normal to have bleeding for 3-5 days
Detailed Answer:
Hello Mr XXXXXXX good to see you again.
It is common to have bleeding and passage of clots for 3-5 days after d&c.
See if
- she soaks more than 3 pads a day or
- passage of excessive clots while sitting on toilet --or if she has intolerable pain lower abdomen.
In case any such complaint appears visit your gynecologist immediately otherwise normal menstrual like bleeding is normal.
Wish her the best of health and wait for biopsy results with fingers crossed.
Above answer was peer-reviewed by :
Dr. Yogesh D
OK Thanks Doctor .
She doest have that much of bleeding so we will wait for a couple fo days more.
Also please advice on when to start normal walking /other movements/using stairs etc when can she can take up . What kind of food she should take for recovering from this and also otherwise also as she has fibroids and thickened endometrium. I heard food which can restrict estrogen are good . What are these food actually ?
regards
She doest have that much of bleeding so we will wait for a couple fo days more.
Also please advice on when to start normal walking /other movements/using stairs etc when can she can take up . What kind of food she should take for recovering from this and also otherwise also as she has fibroids and thickened endometrium. I heard food which can restrict estrogen are good . What are these food actually ?
regards
Brief Answer:
resume normal lifestyle
Detailed Answer:
Hello,
She can move around normally and use stairs or do kitchen work or routine office work.
She should take lots of water and fruits.
Intake of nuts and green vegetables will give her a nice vitality in body and bulk to stools so that there is no constipation.
Till a month let her take whatever she likes to eat.
After that you can give certain food stuffs which are at times labelled as 'anti-fibroid foods'
- broccoli, cabbage
- carrots
- vitamin A and carotene rich foods like radish, pumpkin, apple, guava.
- garlic.
These foods have only empirical role to play and the histology report will be the deciding factor for further management.
Take care.
resume normal lifestyle
Detailed Answer:
Hello,
She can move around normally and use stairs or do kitchen work or routine office work.
She should take lots of water and fruits.
Intake of nuts and green vegetables will give her a nice vitality in body and bulk to stools so that there is no constipation.
Till a month let her take whatever she likes to eat.
After that you can give certain food stuffs which are at times labelled as 'anti-fibroid foods'
- broccoli, cabbage
- carrots
- vitamin A and carotene rich foods like radish, pumpkin, apple, guava.
- garlic.
These foods have only empirical role to play and the histology report will be the deciding factor for further management.
Take care.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Doctor , my wife's(Manisha Sharma) post D&C biopsy report has come. There is no evidence of Hyperplasia or MAlignancy. However tortuous/focally fragmented Endometrial gland are there line by columnar epithelium.showing insipissated luminal secretions in some of the glands. focally star shaped glands lined by epithelium are noted set in a compact cellula stroma which is pseudodecidualised and shows focal fragmentation and haemorrhage . Pl note D&C was done on the first day of menses.
I have queries:
- what do you make out from this report
- what should be next round of action suggested
- she is still having some blood stains (though it has come down)
- will teh next menses be on same date or there is chance of shifting of the same
- Finally considering tiny polyp in Gall Bladder , a benign gland in left breast and thickened but not malignant endometrium clubbed with fibroids . What is this all suggesting . How frequent check ups and precautions to be taken ?
Thanks for your patient reading and valuable pieces of advises.
I have queries:
- what do you make out from this report
- what should be next round of action suggested
- she is still having some blood stains (though it has come down)
- will teh next menses be on same date or there is chance of shifting of the same
- Finally considering tiny polyp in Gall Bladder , a benign gland in left breast and thickened but not malignant endometrium clubbed with fibroids . What is this all suggesting . How frequent check ups and precautions to be taken ?
Thanks for your patient reading and valuable pieces of advises.
Brief Answer:
HYSTRECTOMY NEEDED FOR CURE
Detailed Answer:
Hello Mr XXXXXXX good to hear your wife's name for obvious reasons.
Her report is suggestive of age related changes in endometrium which are common but not normal.
These changes right now are normal but can eventually cause malignancy to occur in case left unattended.
The purpose of D&C was to see if endometrium (thickened highly 18 mm) is already harboring any malignant focus which is common at this thickness and age and with god's grace that is not the case.
In my practice i will advice you to get her hystrectomised because
- high chances of malignant change
- presence of fibroids in uterus
- benign gland in breast
All the three problems are estrogen dependent and levels of estrogen increase with advancing age and is accompanied by decrease in progesterone (which otherwise heals the damage done by estrogen)
Her next periods will most probably coincite with her D&c date which is also the date of her last periods by chance but slight deviation from periodic pattern can occur.
In case you are not willing for hystrectomy and want a conservative management she should get a periodic ultrasonography at 6 months intervals till menopause sets in and visit your gynecologist in case
- ultrasound report is abnormal or
- she develops symptoms like excessive bleeding in periods
But hystrectomy will be the best option in her case.
Tiny polyp in gall bladder is of no concern if symptomless.
You are most welcome in case you need any assistence in future you can contact me directly also on health care magic forum.
HYSTRECTOMY NEEDED FOR CURE
Detailed Answer:
Hello Mr XXXXXXX good to hear your wife's name for obvious reasons.
Her report is suggestive of age related changes in endometrium which are common but not normal.
These changes right now are normal but can eventually cause malignancy to occur in case left unattended.
The purpose of D&C was to see if endometrium (thickened highly 18 mm) is already harboring any malignant focus which is common at this thickness and age and with god's grace that is not the case.
In my practice i will advice you to get her hystrectomised because
- high chances of malignant change
- presence of fibroids in uterus
- benign gland in breast
All the three problems are estrogen dependent and levels of estrogen increase with advancing age and is accompanied by decrease in progesterone (which otherwise heals the damage done by estrogen)
Her next periods will most probably coincite with her D&c date which is also the date of her last periods by chance but slight deviation from periodic pattern can occur.
In case you are not willing for hystrectomy and want a conservative management she should get a periodic ultrasonography at 6 months intervals till menopause sets in and visit your gynecologist in case
- ultrasound report is abnormal or
- she develops symptoms like excessive bleeding in periods
But hystrectomy will be the best option in her case.
Tiny polyp in gall bladder is of no concern if symptomless.
You are most welcome in case you need any assistence in future you can contact me directly also on health care magic forum.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanks Doctor for such an elaborative explaination .
Is there any means/methods to fast increase the progesterone level. By any diet /therapy ?
Also how to measure the progesterone level in blood . Is t linked to Vitamin-D . She was having it very low some time back. Around 4. Then she started taking Vitamin D XXXXXXX and got it back to 20+.
She is 45 and menopause is around 5 more years away. These many years estrogen will continue to increase and problems will not alleviate for around 5 years and will only increase. It might be the case that less progesterone level in her is not putting check of bad impacts of high estrogen.
We propose doing Ultrasound/mammography in another 6 months time and if anything abnormal found we shall go for hysterectomy . Will that be OK ?
regds
XXXXXX
Is there any means/methods to fast increase the progesterone level. By any diet /therapy ?
Also how to measure the progesterone level in blood . Is t linked to Vitamin-D . She was having it very low some time back. Around 4. Then she started taking Vitamin D XXXXXXX and got it back to 20+.
She is 45 and menopause is around 5 more years away. These many years estrogen will continue to increase and problems will not alleviate for around 5 years and will only increase. It might be the case that less progesterone level in her is not putting check of bad impacts of high estrogen.
We propose doing Ultrasound/mammography in another 6 months time and if anything abnormal found we shall go for hysterectomy . Will that be OK ?
regds
XXXXXX
Brief Answer:
take progesterone for 6 months wait period
Detailed Answer:
Hello sir, see there are no foods which are listed as they increase the levels of progesterone per se.
Certain foods like cabbage, radish, broccli and condiments like pepper etc decrease the levels of estrogen.
Definitely vitamin D is related to progesterone increase but eventually body escapes from this effect of vitamin D but the estrogen levels in females with abnormal bleeding are way too high for minimal progesterone to combat the same.
MENOPAUSE can start any time from 45-53 years of age so she has a long journey to menopause but high enough estrogen levels which are giving symptoms too.
To wait for 6 months and repeating the ultrasound then is a fair plan of action but then you should ideally take progesterone 16th day of periods till 25th day every month and that will take care of excess estrogen present in her body.
Take care and all the best.
take progesterone for 6 months wait period
Detailed Answer:
Hello sir, see there are no foods which are listed as they increase the levels of progesterone per se.
Certain foods like cabbage, radish, broccli and condiments like pepper etc decrease the levels of estrogen.
Definitely vitamin D is related to progesterone increase but eventually body escapes from this effect of vitamin D but the estrogen levels in females with abnormal bleeding are way too high for minimal progesterone to combat the same.
MENOPAUSE can start any time from 45-53 years of age so she has a long journey to menopause but high enough estrogen levels which are giving symptoms too.
To wait for 6 months and repeating the ultrasound then is a fair plan of action but then you should ideally take progesterone 16th day of periods till 25th day every month and that will take care of excess estrogen present in her body.
Take care and all the best.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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