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[Bird]

Hello!  I am new to this message board and seeking help.

I recently had a endometrium biopsy.  Prior to that, I had a pelvic ultrasound which showed that the lining of my uterus was thicker than normal.  But the diagnosis from the biopsy shows I have atrophic endometrium -which means my lining is thinner than normal. As you can imagine, this is very confusing.  Additionally, the pathologist also reported that although he was able to make a diagnosis, the sample was suboptimal.

Anyone have an experience with this?  I have an email out my doctor about this, but I would like to hear from women who have atrophic endometrium.

Many thanks,

Bird

[Annemaria]

Hi Bird,
Yes, this is just exactly what I went through last fall. Ultrasound said 8mm. Went in for D&C/biopsy. Result was atrophied endometrium less than 1mm. and barely enough sample for biopsy. GYN said ultrasound was read incorrectly. I'm still scratching my head over this one as well.

[Bird]

Hi Annemaria,

Even with a D&C, there wasn't enough of a sample? 

I had three attempts for the biopsy:  1) at my check-up, without any painkillers.  We didn't get far.  2) Another one scheduled a week later, with the use of 1m adavin; had to stop because of the pain and the pathologist couldn't determine anything because the sample size was too small, and then finally 3) a week ago, with 2m adavin and hydrocodone and although the pathologist made a diagnosis, still noted that the sample was suboptimal.

My ob/gyn recommends a wait-and-see approach - do another ultrasound in three months. 

But I've also read that antrophic endometrium can lead to Type II uterine cancer, which spreads more rapidly.  I am reluctant to wait three months, but concerned that a D&C might still net inconclusive results. 

What did you end up doing?

Bird

[Annemaria]

Hi Bird,
There was no way she could get in there without me passing out so we opted for D&C, this way she could have a good look around. The spotting that sent me to ultrasound in the first place ended up she said, was my thin lining bleed. She put me on vaginal estrogen cream for this and for my bladder atrophy at the same time. Getting the latter in check is an ongoing experiment. Also, I'm 7 years menopausal and 58 yrs. old. Not sure what your age/meno situation is.

[Hurdity]

Hi Bird

 

I wasn't aware of that type of endometrial cancer until you mentioned it, so that being the case and due to the ambiguity in the measurements of your scan, I would suggest you push for the biopsy?

By the way do you also have post-menopausal bleeding and in the absence of taking HRT?  You didn't say the reason for the scan? Also how old are you and how long since menopause? In the absence of any bleeding there is far less cause for concern since most women will eventually have an atrophic endometrium post menopause.

Hurdity x

[CLKD]

The most common causes are: inflammation and thinning of the vaginal lining (atrophic vaginitis) or womb lining (endometrial atrophy) – caused by lower oestrogen levels. cervical or womb polyps – growths, which are usually non-cancerous, that can form in the cervix (neck of the womb) or the womb itself.

19 Jan 2015

from NHS Choices: inflammation and thinning of the vaginal lining (atrophic vaginitis) or womb lining (endometrial atrophy) – caused by lower oestrogen levels

no mention of cancer anywhere in the article!

[Annemaria]

CLKD: The original post is the question of why ultrasound shows thickened endometrium and biopsy and D&C shows very thin lining concluding the sample was suboptimal.

[CLKD]

I would suspect that the biopsy is more likely to be correct?  Maybe give the Dept. a ring next week and ask ........ then let us know?

[CBA]

Exactly the same happened to me! They said it's because my womb is tilted backwards (very common) which meant the scans were incorrect (had two) but the procedure with the inserted camera (forget the name) shows the real picture.

Basically it means your estrogen levels are low. I was put back on HRT immediately.

Hope this helps.

Jx

[Jenna]

This also happened to me and, like you CBA, I do have a retroverted uterus, so thank you very much for the explanation. It has always puzzled me how I could have a thickened lining on the scan and yet barely anything to test from the biopsy.

It will be interesting to see whether Bird and Annemaria also have a retroverted uterus!

[Annemaria]

Hi Ladies,
No tilted uterus in my case. Still a mystery really and I don't like mysteries much.

[Jenna]

Hi Annemaria,

Just when we thought we might have solved the mystery! I was never given a reason for mine, though, so I am just assuming my retroverted uterus could be to blame, as it was with CBA.

Maybe Bird's doctor will have some other possible explanations - I hope so, as I don't like mysteries either.

[Bird]

Hello All:

Thank you all so much for your responses. 

Tilted uterus is interesting:  I have a vague recollection of a doctor telling me my uterus was tilted.  But that was so long ago ... my recollection is hazy.

My ob-gyn first suggested we just wait for three months and do another ultrasound, but I don't want to wait.  I am scheduled for a D&C and hope that will provide a definitive answer (at least in terms of whether this is cancer).

I am 60, at least ten years since my last period and I have never taken any kind of hormones for menopause.  And I don't really want to.

My discharge and spotting has been light - no heavy bleeding - and it is off and on. 

Oddly, my regular doctor, (whom I saw last week for my physical) had an explanation of why there is a discrepancy between the ultrasound and the recent biopsy:  Each technique only sees part of the picture.  He also recommended a D&C to get a fuller picture. I just wonder why my ob-gyn didn't recommend that in the first place. Sigh.

Bird