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Diabetic. Have Regular Cycle. Ultrasound Showed Thick Endometrium. What Could E The Cause For That?

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Posted on Tue, 25 Jun 2013
Question: I recently had my yearly exam at my OB/GYN. Still waiting on the results. I asked if they could do an US so today I went to a place that does them. The lady couldn't tell me much as she is only a technician but she did tell me that I had a very thick endometrium. What could be the reason for that? I am sexually active and my cycle is exactly 28 days. I am also a type 1 diabetic. My last menstrual period's first day was May 11th and I have had 1 child 14 years ago. Never been pregnant again that I know of and I've never had an abnormal Pap smear. No complaints or problems to report.
doctor
Answered by Dr. Aarti Abraham (28 minutes later)
Hello XXXXXXX
Thanks for your query.

I would like to have a few details which would enable me to guide you better -
1. Your menstrual cycle - any irregularities.
2. Details of your " laparoscopy " which you have mentioned.
3. Any other gynecological complaint you might be having.

There are many known causes of a thick uterine lining, or a thick endometrium. During the normal menstrual cycle, just a week before your periods are due, the endometrium is at its thickest. This is normally under the effect of hormones every month, where the endometrium sheds off with each period, and then grows gradually, and is thickest just before your next period.

Another reason is pregnancy. During pregnancy, the uterine walls begin to thicken in order to prepare for the baby.

Another reason that the uterine wall may thicken is due to a painful disease called endometriosis. During the course of this disease, the uterine wall thickens and causes severe pain to the individual. It is speculated that the disease is caused by prior uterine surgery in which scar tissue has been left behind. The scar tissue is covered by more growing tissues which compound the problem. Eventually, the uterine becomes very thick. The scar tissue prevents the layers from being properly shed and the individual experiences painful cramps.

Endometrial hyperplasia is a condition where the uterine lining becomes abnormally thick each month. This is due to hormonal imbalance, and sometimes due to polycystic ovarian disease. The periods are generally delayed and irregular, and then when the thick lining eventually sheds off, the bleeding experienced is heavy and with clots and fleshy tissue . Diabetes is a risk factor that enhances your chances of having this condition.

Cancer, polyps and fibroids are also reasons why the uterine wall will thicken. If this is the case, only a biopsy can positively determine the results.

If this was just an incidental finding on the ultrasound, in the absence of any problems that you are having, there is generally no cause for worry.
Take care, and feel free to discuss further.
Be well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (14 minutes later)
Thank you. My periods are regular and 28 days exactly. I was trying to get back when I was 20. A long time ago and I was having difficulty in conceiving. I sought out a reproductive endocrinologist and we did a laparoscopy where she found a blocked Fallopian tube. No other problem as far as that at the time. However my post op visit I did gave a urine sample which o was spilling 1,000 grams of sugar in my urine. So a long story short I have up trying and addressed my diagnosis of diabetes. 6 months later I was pregnant with no help from fertility doctors. Had a great pregnancy and a very healthy son. I do not have any other gynecological problems whatsoever. No pain, irritations, no excessive bleeding, or anything else. I am not sure if I have ever been pregnant since my one and only. Of course I'm concerned about my fertility as I'm 36 now and would like one more child.

Thank you so much
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Follow up: Dr. Aarti Abraham (0 minute later)
Trying to get pregnant. Sorry about that
When I was pregnant my progesterone levels were very low so I had to take progesterone lozenges for the first 16 weeks. Sorry just remembered that part.
doctor
Answered by Dr. Aarti Abraham (11 minutes later)
Hi
Thanks for the information.
As your cycle is 28 days, your next period should be around 8th or 9th of XXXXXXX
If the ultrasound was done in the past couple of days, a thick lining is to be expected as I explained.
Please provide the exact ultrasound report ( measurement of the endometrial stripe to be precise ).
In the absence of any symptoms, do not worry.
For the fertility issue, have a complete assessment by an Infertility specialist.
That would include testing your ovarian reserve ( capacity of ovaries to produce eggs, which declines with age ) , semen analysis and testing patency of fallopian tubes.
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. Chakravarthy Mazumdar
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Answered by
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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Diabetic. Have Regular Cycle. Ultrasound Showed Thick Endometrium. What Could E The Cause For That?

Hello XXXXXXX
Thanks for your query.

I would like to have a few details which would enable me to guide you better -
1. Your menstrual cycle - any irregularities.
2. Details of your " laparoscopy " which you have mentioned.
3. Any other gynecological complaint you might be having.

There are many known causes of a thick uterine lining, or a thick endometrium. During the normal menstrual cycle, just a week before your periods are due, the endometrium is at its thickest. This is normally under the effect of hormones every month, where the endometrium sheds off with each period, and then grows gradually, and is thickest just before your next period.

Another reason is pregnancy. During pregnancy, the uterine walls begin to thicken in order to prepare for the baby.

Another reason that the uterine wall may thicken is due to a painful disease called endometriosis. During the course of this disease, the uterine wall thickens and causes severe pain to the individual. It is speculated that the disease is caused by prior uterine surgery in which scar tissue has been left behind. The scar tissue is covered by more growing tissues which compound the problem. Eventually, the uterine becomes very thick. The scar tissue prevents the layers from being properly shed and the individual experiences painful cramps.

Endometrial hyperplasia is a condition where the uterine lining becomes abnormally thick each month. This is due to hormonal imbalance, and sometimes due to polycystic ovarian disease. The periods are generally delayed and irregular, and then when the thick lining eventually sheds off, the bleeding experienced is heavy and with clots and fleshy tissue . Diabetes is a risk factor that enhances your chances of having this condition.

Cancer, polyps and fibroids are also reasons why the uterine wall will thicken. If this is the case, only a biopsy can positively determine the results.

If this was just an incidental finding on the ultrasound, in the absence of any problems that you are having, there is generally no cause for worry.
Take care, and feel free to discuss further.
Be well.