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What Causes Endometrial Thickness Of 22 Mm In An Elderly Person?

Posted on Fri, 11 Dec 2015

Question: Hi. My mother has been diagnosed with a thickened endometrium. She is 47. Her periods have been regular for a few months with heavy flow and she was also diagnosed with pancreatitis in March this year. Her periods got delayed last month and when she got them this month, she bled for 2 weeks and by the end of it there were heavy clots. She took a medicine called "Pause" which helped in stopping the bleeding, only for them to resume 2-3 days later when she had watery bleeding. When she consulted a doctor with the ultrasound reports she had for pancreatitis, it showed a 15 mm endometrium. She has been on a medicine called "Registrone" since then and the bleeding stopped. Day before yesterday, we went for a second opinion and her pap reports were negative, thankfully. Today, she got a transvaginal ultrasound done revealing a 22 mm endometrium. I believe the next step is a biopsy. We are extremely worried and we don't know how treatable it is if at all the reports turn out not good. Any advice would be helpful! Thanks!

Answered by Dr. Manisha Jain (13 minutes later)

Brief Answer:
Biopsy is a must

Detailed Answer:
Hello mam, thanks for trusting health care magic.
She has endometrial hyperplasia causing all these symptoms, this thickness of 22 mm is very high for her age and especially with these symptoms of excessive bleeding.
So a biopsy is a must at this stage.
If biopsy comes out normal then only regestrone and pause will suffice in case she gets excessive bleeding eventually.
But in case thus erratic pattern of bleeding continues further then she might need hysterectomy.
Regards
Dr Manisha

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

Follow up: Dr. Manisha Jain (33 minutes later)

Thank you very much for your advice, doctor. Though, there is one thing that I forgot to mention that two fibroids have also been found in her uterus during the transvaginal usg today. Although, her pap smear reports are good and no epithilial cells were found. Additionally, no adnexal mass was found. She also has high levels of thyroid and parathyroid hormones for which she has been on medication for some years now. We are all naturally very worked up about the biopsy, but how serious is the issue and how much risk does she face at this point? Also, how treatable is the problem in case the biopsy reports aren't good?

Answered by Dr. Manisha Jain (12 hours later)

Brief Answer:
Low risk and easily manageable

Detailed Answer:
Presence of fibroid doesn't change her management but decreases the risk of poor outcome as it us common to have excessive and irregular bleeding in patients with fibroid and thyroid problems.
So in case the biopsy is normal then simple drugs will control her symptoms.
In case biopsy results come out unfavorable then also only hysterectomy I.e. removal of uterus will suffice for her.
Even if a high grade problem is detected in biopsy then also prognosis is good after full treatment.
So just relax and get the biopsy done.
The risk in her case is very low but still owing to her age cannot be left without proper work up.

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