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Gynecology

Thick Uterine Wall

05/19/2010

Question:

I recently had a sonagram in my Doctors office and she called me right away and informed me that I have a very thick uterine wall and that she would recommend I get biopsy. I am very concerned and not sure what she is looking for, I guess I need someone to ease my mind from worrying. I am 53 years old and do not have normal periods, in fact I can go for about 3 to sometimes 4 months before I get a period. I have experienced a hot flashes a few times and of course, forgetting minor things, but other than that, I have been pretty healthy. I guess I need to know what she is looking for and should I be worried. Any information and help you could give me would be greately appreciated.

Answer:

The part of the uterus that is often of concern in women who have abnormal bleeding is not the wall, but the endometrium, or lining of the uterus.  This is the area of glands that grow in response to hormones in the early part of a woman's cycle. The lining becomes thin again as the glands slough off during a menstrual period. 

After menopause, there is no hormonal stimulation, and the lining remains thin.  In younger women without regular periods, or in menopausal women with continued exposure to estrogen, the glands continue to grow and the endometrium can become abnormally thickened.  This can lead to excessive bleeding, hyperplasia (an abnormal amount of glandular growth), or cancer.

An ultrasound of the uterus can measure the thickness of the endometrium.  After menopause, this thickness is usually less than 5 millimeters.  However, only a biopsy of this tissue can yield a diagnosis of what is causing an abnormal endometrial thickness.

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Response by:

Jonathan  A Schaffir, MD Jonathan A Schaffir, MD
Clnical Assistant Professor of Obstetrics & Gynecology
College of Medicine
The Ohio State University