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Dr.M.D.Mazumdar
Dr.M.D.Mazumdar, Doctor
Category: OB GYN
Satisfied Customers: 8584
Experience:  MD (Obst&Gynecology)
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I am 37 yr old healthy female...130lbs..67 inches...nulliparous.

Resolved Question:

I am 37 yr old healthy female...130lbs..67 inches...nulliparous. I have always had normal regular periods until last January...I missed my period for 3 months. I did see my GYN and had my annual exam and PAP....all was negative. Only thing he noted was guarding pain when tilting my uterus to the right. After that visit on June 4, I got a regular period. Then I got another July 1-7, and again July 17-21, and bleeding again July 23 and 24. I do not take birth control pills. I had a transabdominal ultrasound today and it measured my endometrium as 12mm. I know the endometrial lining varies in thickness depending cycle timing. Based on the information does 12mm seem normal? Do you think he will recommend further evaluation of the endometrium or look for a hormonal cause such as hypothyroid for the sudden irregularities?
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr.M.D.Mazumdar replied 1 year ago.
Hello,

Welcome and thank you for your question. I am Dr.Mazumdar and I hope I'm able to help you with your medical problem today.

How much did you bleed on the July 23 and 24? Was it like a normal period or was it only spotting? When did you have a normal period-like bleeding - July 1?
Customer: replied 1 year ago.

July 1 was a normal period lasting until the 7.... and July 17-21 was like a normal period....both were heavier to start and tapered off. They were pretty heavy periods. I used 6-8 super tampons for 3-4 days of each period. The 23, 24 one was lighter...maybe 15-20cc

. Clarification....6-8 tampons each day of the period!
Expert:  Dr.M.D.Mazumdar replied 1 year ago.
Thank you for the additional information.

The thickness of teh endometrium does vary at different times in the menstrual cycle. Just after the period ends, it is about 3-5mm, at around the time of ovulation (approx 14 days from 1st day of last period) it is about 8-10 mm. Just before the period, it can range from 12-15 mm.

In your case, since you had a heavy bleed from July 17-21, the endometrial thickness should not have been 12 mm today, especially since you spotted again on 23rd and 24th. You need further evaluation of the endometrium - your doctor will probably order a D&C (endometrial biopsy) for a microscopic examination.

It is possible that you have developed endometrial hyperplasia - overgrowth of the endometrium. A simple endometrial hyperplasia can be treated with medicines like progesterone. But atypical hyperplasia may need other treatments like ablation or a hysterectomy.

I hope this helps.

Customer: replied 1 year ago.

Thank you so much for the information...so its unlikely it is a hormonal issue? And in your opinion it would be best not to wait on doing a d&c if I am given the option?

 

Expert:  Dr.M.D.Mazumdar replied 1 year ago.
Endometrial hyperplasia is related to a hormonal issue in as much as the overgrowth of the endoemtrium is due to either high levels of estrogen or progesterone in the blood or due to oversensitization of the endometrium to normal levels of estrogen and progesterone.

Thyroid hormones or other hormones do not have much of a role to play.

Yes, you should go in for a D&C given the option.

I hope this helps.
Dr.M.D.Mazumdar, Doctor
Category: OB GYN
Satisfied Customers: 8584
Experience: MD (Obst&Gynecology)
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