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[NikkiD]

Hi all

I posted a while back following excruciating pain I experienced on the day my last period started (before the bleeding started) which had me admitted to hospital and had to be given morphine to control the pain.  That was 28th April, and my GP referred me for an ultrasound scan.  I had the scan last week, and the results have come back.  They said 'essentially' it's normal, but my uterus is 'fibrous' and I have an endometrial thickness of 13mm.  I haven't had a period since 28th April, but then my periods have been all over the place for the past 18 months and I've had a 3 month gap before so I'm not worried about the lack of periods.  However, of course I have googled what a thickened endometrium could be, and it's pretty darned scary!! I'm wondering though that because I haven't had a period for 2 months, and because I'm probably not yet fully in the menopause so am probably due a period fairly soonish, that this could be why my endometrium has thickened?  I've got an appointment with my GP soon, but I wonder if anyone else has had similar? Thanks.

[positivethoughts]

Hi NikkiD

It does sound to me as though the lining has thickened up prior to a period. I had a similar situation recently when I came off the POP contraceptive and didn't bleed for 11 weeks with alot of terrible pains during that time. I too was referred for a scan and they thought perhaps there was a polyp, and they also said I had a thickened womb lining. I was referred for a hysteroscopy and they took a biopsy which is all fine and no polyp. I had bled by then so the womb lining was fine. I would imagine that when you do bleed next the lining will be shown to be normal. I'm also in the perimenopausal stage where I'm not yet menopausal, still having periods but not regularly. Nobody seems to experience it in quite the same way and it can be scary! Let us know how you get on. Try not to google symptoms. I am guilty of it too but it really does cause more stress often and I am training myself to stop it!!
 

[Dancinggirl]

I would degree with everything positivethoughts has said.
This site is great but many other sites just scare you unnecessarily.  The peri stage can be awful and if you continue to have problems then perhaps consider a Mirena coil as it will protect the lining of the womb and reduce any heavy bleeding, act as a contraceptive while you are still peri meno and then you if you get other meno symptoms e.g.  flushes etc.  you can simply add some oestrogen in gel or patch form.
Try not to worry - the tests came back as normal.  DG x

[NikkiD]

Thank you for your replies.  I've been sterilised, so am not on the Pill, never have been in fact because I discovered very early in life that it didn't suit me, so there are no 'artificial' hormones in my body at all, and haven't been since I was 18.  I'm wondering if that means I've just got too much estrogen without any added by the Pill or similar.  My periods, before all this perimenopause nonsense, were regular, every 25 days like clockwork for 3 days with a pretty light flow, so to suddenly experience heavy painful periods was a bit of a shock to the system!!! I've had hot flushes too, but they seem to have died down a bit recently.  Over the last 18 months of these weird symptoms, only my last blood tests (March this year) came back as 'possibly perimenopausal', but my doctor assures me I've been perimenopausal for 18 months.  I think hormones are hard to quantify.  I have had the Mirena suggested to me by my GP, but as I've not had artificial hormones in my body for so long, I am a little reluctant.  That said, there's no way I can experience pain like I did when I was admitted to hospital again - it was just like childbirth! 

From what I understand, the lining of the womb thickens when there's a build up of estrogen.  Is that possible when it's just my own body that could be producing it?                     

[Dancinggirl]

Through the peri stage I should think it would be very possible to get some thickening but as your oestrogen level drops this will lessen.  I doubt you are producing too much oestrogen it's more likely your body is struggling to create the hormones levels to produce a proper period regularly.  You will have had a FSH level test to see if you are menopausal. The follicle stimulating hormone (FSH) blood test measures the level of FSH in blood. FSH is a hormone released by the pituitary gland, located on the underside of the brain and it stimulates ovulation.  If the FSH level is high then the body is struggling to ovulate and therefore less progesterone and oestrogen is produced. The FSH level can rise and fall throughout peri meno that is why blood tests are notoriously unreliable. I'm afraid it can be a rollercoaster of a ride, hormone wise, through peri and into post meno with symptoms coming and going.  As you haven't had problems with your periods in the past it must be quite a shock. 
Please don't compare the contraceptive pill with HRT, they are different and with HRT you are replacing the natural level of hormone and the oestrogen used in most HRTs now is bio-identical so is the same as our own hormones - in other words it is not artificial.  The Mirena often suits people who struggle with hormones as it releases progesterone locally and little is absorbed systemically - having said this some do get a few side effects. The plus of a Mirena is that it will gradually reduce your periods down to nothing, protect your uterus from thickening and you can use oestrogen gel(natural oestrogen) - starting with a very low dose and increase as necessary to control the flushes, night sweats etc.  If you continue to get heavy and painful periods then it could be worth giving the Mirena a go.
Using any form of HRT is a very personal decision and many women start out firmly believing they will do the 'Natural Route'. EVeryone experiences the meno differently and whether you use HRT will depend on how much the meno symptoms are impeding your life. 
I personally don't think there is anything natural about it - it's a negative part of the ageing process - let's face it, 100 years ago your were lucky to get to 50. We keep saying on these threads "life is short".  I tried to go without HRT for 3 years and now consider those lost years as I really struggled with meno symptoms. I'm now 58 and on another break from HRT - I'm doing ok but making quite a lot of compromises; I wouldn't rule out going back on HRT if my joints get any worse and the sleep depravation gets me down.
Do read up all the info under the headings to the left of this screen - it's really worth getting clued up.  DG xxx

[Hurdity]

Yes I agree with Dancinggirl.

During peri-menopause it is often the case that you go through "anovulatory cycles" - ie you don't ovulate. When you ovulate normally, the corpus luteum left in the ovary after the egg is released, produces progesterone. If the egg is not fertilised then progesterone levels fall and this triggers a bleed - the lining that has built up to prepare for pregnancy.

If you don't ovulate, the lining continues to build up as no progesterone is produced. This is when many women start HRT because it regulates the cycle as well as providing symptom relief.

There is a great article on peri-menopause on this site here which explains it all very well:
http://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php

During peri-menopause I would have said it is difficult to attach great significance to a particular thickness of lining for the very reasons we have described. Provided it does eventually shed as a period then all will usually be well.

I am post-menopausal but taking HRT on a cycle through choice and I was referred last year partly due to a thickened lining - even though I told the gynaecologist that I was quite far on in my (long) cycle - so it would be expected to be thick!

In your case - with fibroids, I would agree with Dancinggirl and perhaps consider a Mirena, and then a low dose of added oestrogen if you start to get symptoms of flushes and sweats (which indicate declining oestrogen) while you are still peri-menopausal.

Hurdity x