Thickened endometrium urgent referral

[diasy]

Hi Eve,

I just wanted some advice please as I have been unable to get any info from my doctors. I'm 39 and have been having episodes of flooding (losing about a pint of blood each time) it can happen on my period but also happens mid cycle.... so i went to the doctor who advised mirena coil, she also said my uterus felt hard??

I then had pelvic scan first which showed a small fibroid, but also said 'my endometrium was prominent - the cause of which is uncertain' they never told me this they just said i had a fibroid, i found out after i read the screen at the gynaecologist appointment.

I was fast tracked to gynaecologist in one week ,who again just said i was there to get the mirena in. However he did a transvaginal ultrasound and said he could see the 1cm fibroid, but also suspected a polyp and that my endometrium was thick as i was due my period (but my period didn't come for two weeks) He also tried to do a biopsy and insert the mirena but he couldn't get it through my cervix. He then referred me urgently for hysteroscopy, but i don't know why?

I still have my periods, so how can they tell there is something wrong by having a thick endometrium? Does the endometrium not get thick and thin during the monthly cycle - as he said it was thick because i was due my period, but then referred me urgently for hysteroscopy?? Does a polyp make it thick?

I just don't think they are being very forward with me - id rather they just told me why its urgent -as its making me think they suspect something and are not telling me!! I have tried to contact my doctor but the results of the transvaginal scan are not back.

What does a thick/prominent endometrium mean ? Can a polyp be mistaken for cancer on an ultrasound? Or does a polyp cause the endometrium to be thick? Can a thick endometrium cause heavy bleeding ?

Thank you!!!

[thelordsanger]

how can they tell there is something wrong by having a thick endometrium?. because it is some times accompanied by a cancer diagnosis thick/prominent endometrium. can mean not always mean cancer. Can a polyp be mistaken for cancer. No but it can cause heavy bleeding as can a fibroid He then referred me urgently for hysteroscopy, but i don't know why? because it is standard procedure id rather they just told me why its urgent -as its making me think they suspect something and are not telling me!! they honestly do not know but if it is cancer it,s best to know as soon as possible INPORTANT i strongly recommend that you do not go for a outpatient hysteroscopy since they were not able to do a biopsy because your your cervix is closed it can be excruciatingly painful you are legally entitled to a GA if you wish they may try to persuade you to try it with local it MUST be allowed to time to work 10 mins and take some one in with you if they do not allow some some in PLEASE demand a GA and please have a look at this site facebook.com/HysteroscopyA

[diasy in reply to thelordsanger]

oh my god thank you - i didn't even know that they would give me local anaesthetic but i will get GA now because he tried for 45 min for a biopsy and it was awful. i couldn't wait to get out of there quick enough . thank you for being so honest i really appreciate your advice! Ive never had kids so never been to gynaecologist etc its all very new to me!

[thelordsanger in reply to diasy]

hope fully it will be nothing to worry about and sorry if i made you worry im not tack full some times hopefully when they remove the fibroid and polyp every thing will settle down macmillan.org.uk/ 0808 808 00 00 are good for advice even if you don,t have cancer i have called them many a time sorry i should of thought to give you there number

[diasy in reply to thelordsanger]

I read the comments on the facebook group you mentioned and I am so glad for the heads up, I will make sure to get GA, its awful what some poor women have had to go through . thanks again

[thelordsanger]

i have tried to put in paragraphs but it wont let me sorry

[Eismysunshine]

Hi Diasy,

I can see you are worried and I’m sorry that you’re not being given much information.

I had the same bleeding issue as you that turned out to be Endometrial Hyperplasia, which is where your womb lining thickens more than is usual during a cycle.

Initial treatment for EH is normally a Trans-vaginal scan to confirm the thickness and any other underlying issues (I had fibroids), then they do a hysterscopy to check the cells of the lining for signs of cancer.

EH doesn’t always mean cancer. Sometimes it’s just your womb having a freak out. They treated mine with the coil, I had to have 2,further hysterscopy’s at 6 months and a year to check the cell structure of my lining.

I know it’s hard, but please badger your med tram to sit down and explain what is happening and why to you, it will help you to feel less worried and they do have a duty of care to keep you informed.

I hope you get some more information and support soon x

[diasy in reply to Eismysunshine]

Thanks so much for your advice, it does sound possibly like EH - my uterus does feel so hard and the pain is dreadful, i honestly add a clot the size of my palm one day and I nearly passed out with the pain of it. I take a lot of naproxen to get me through the day, but it is more the fear of having a sudden gush in public that frightens me as i use a menstrual cup and pad, but nothing stops it! Did the mirena help you? I have read some awful stories, but i can't continue with this bleeding so i have no other option i suppose. I feel much better after reading the advice here. thank you

[AskEveTeam]

Hi there.

Thank you for getting in touch.

We are sorry to hear you are having a worrying time.

You are quite right the endometrium (womb lining) does change in thickness through the menstrual cycle , being at it’s thickest just before a period.

Scans are very useful to give an indication of what is happening in the uterus ( womb ) , the term “ uncertain “ is commonly used in medical “speak” to tell us the scan can 100% describe what something is and then a biopsy ( taking a piece of tissue / collection of cells ) to identify it under the microscope is the normal procedure.

This is why you have now been referred for a hysteroscopy as trying to obtain a sample and put the mirena in was difficult ( not unusual / uncommon ).

Do you want to talk this through with our Specialist Nurse, then send us an email via [e-mail]

Best Wishes,

The Ask Eve Team

[diasy in reply to AskEveTeam]

Thank you for replying . I feel much better after reading the advice on here. I am going to ask for a general anaesthetic to get there mirena coil put in and fingers crossed there is nothing serious - do you think they could remove the polyp when i get the hysteroscopy done? Is this something I would have to ask them to do? thanks again, this website is wonderful!

[diasy in reply to AskEveTeam]

Hi Eve!

I have another question for you - i got my transvaginal ultrasound scan back and the consultant says by endometrium is thickened in the fundas(the top i think) he says it 'seems' like a polyp. He also says a have a pinhole cervix so I need to have the hysteroscopy done with truclear resection of the polyp , a biopsy and insertion of the mirena coil.

I am absolutely terrified at the thought of a hyteroscopy as i have a pinhole cervix I have read truly horrible things happening when a women has a pinhole cervix.

I also worry that if the mirena coil does not suit me i will have to go through this procedure again to remove it!!

I am happy to live with the polyp and just take the pill for my heavy bleeding. I am just worried that they want to do a biopsy too - I am willing to pay for an MRI or CT scan instead, do you think an MRI or CT could confirm the thickening is just a polyp rather than cancer and then maybe i wouldn't have to go through this procedure??

thanks again for your advice!