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Dr. Andrew Rynne

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Diagnosed with PCOS. Scan showed thickened endometrium. Looking for suggestion

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Dr. S Patra

OBGYN

Practicing since :2011

Answered : 4048 Questions

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Posted on Thu, 31 Jan 2013 in Women's Health
Question: i am a 26 yr old unmarried women.Recently i am diagnosed with PCOS and sac like structure is even found in the endometrial complex with ET=15.4mm. Doctor is suggesting it as either Beta HCG or a cyst. But i am not in any kind of physical relation with my boyfriend. I need your suggestion regarding this,i am realy very scared.
doctor
Answered by Dr. S Patra 1 hour later
Hello,

Thanks for your query.

I have gone through your history and ultrasound findings in detail.

The size of endometrial thickness (ET) varies with the phase of menstrual cycle and age of individual. At 15.5mm, the ET is above normal range in any phase of menstrual cycle.

There are certain possibilities associated with PCOS like endometrial cyst (an ovarian cyst with distended endometrium gland) or endometriosis of ovary which grows faster than usual cyst.

As you are not in relationship with your partner, another close possibility to explain the ultrasound finding is conception or gestational trophoblastic disease. Evaluation of Beta-hCG titre can rule out this.

With the current data available, it would be difficult to understand the true nature of the cyst. You will need to undergo further testing such as diagnostic Laparoscopy (for detailed review of the cyst morphology), Beta hcG titre along with thyroid profile, LH/FSH, Blood estrogen & progesterone level, blood sugar (PPBS), etc. In addition endometrial biopsy may be needed to rule out other pathology.

You will need complete medical treatment for initial management and the treatment will depends on size & type of the cyst (based on the investigation findings). Surgical removal of cyst is the treatment of choice and may be needed if size is large and the cyst is resistant to medical therapy. Consult your gynecologist and discuss about further testing to take this issue forward.

In addition, the following life style modification can be helpful:
1) Physical exercise / running / jogging regularly to control body weight
2) Take healthy diet and avoid spicy/fatty/salty food stuff.
3) Drink plenty of fluids/water and eat XXXXXXX vegetables.
4) Avoid stress/tension by regular XXXXXXX breathing exercise (20-30 times)
5) Maintain personal hygiene and rest adequately.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish your good health.

Regards,

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. S Patra 4 hours later
Thank you so much for your reply sir. Actualy its given in USG report that the sac like structure/cyst in my endometrial complex is of 5mm. Is anything very serious of risky with me?
doctor
Answered by Dr. S Patra 2 hours later
Thanks for your follow up query.

As per USG report,previously you told me that Endometrial Thickness (ET) was 15.4 mm and now you are telling 5 mm. It may be mistake.
Small endometrial cyst with ET 5 mm may resolve either spontaneously or by medical therapy.
But according to previous review,ET at 15.4 mm is above normal and Simple Endometrial Cyst may develop Endometrioma (blood or chocolate cyst) in future if you remain untreated. Most aggravated complications are rupture of the cyst with internal bleeding and spread of infection inside the pelvic cavity/ peritoneum.
So it has to be taken seriously and needs close monitoring or follow up by your consulting doctor.In case of failure of medical therapy,surgery is needed.
If you do not have any clarifications, you can close the discussion and rate the answer.
Be well and stay healthy.
Regards,

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. S Patra 16 hours later
sory for my wrong statement sir. But i mean 2 say is dat da fact given in my USG Report is dat my ET is 15.4mm and the cyst/sac found in my endometrial complex is of 5mmi i.e the cyst/sac measures 5mm. I hope now i can make you understand sir.And i dnt have even diabetes too,which i heard is very common for PCOS patients. Now i want to know that whether its risky or i'll be perfect in future.
doctor
Answered by Dr. S Patra 3 hours later
Hello,

Thanks for giving correct statement. Now everything is clear to me.

I want to comment two things here.

1) At 5 mm, endometrial cyst is very much small and nothing is XXXXXXX at present. It may resolve either spontaneously or by medical therapy. But you may need further follow up to your doctor to check out progression or regression of the cyst.
2) Second thing, you may undergo an endometrial biopsy to rule out other pathology as endometrial thickness (ET) is 15.4 mm, above normal range in any phase of menstrual cycle.

If you do not have any further clarifications, you can close the discussion and rate the answer. Please don't forget to give a feedback.

Wish you a good health

Regards
Above answer was peer-reviewed by : Dr. Mohammed Kappan
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