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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 years of experience and an award-winning educator.
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I am 42 years of age i had a daughter 20 years ago. I have

Customer Question

hello I am 42 years of age i had a daughter 20 years ago. I have heavy periods all my lfe and bad menstrual pain. please let me know what this means? my transvaginal ultrasound was performed on me the uterus is anteverted and measure 10.7 x5 x5.5cm. the myometrium is heterogenous and bulky, particularly posteriorly. appearance raise the possibility of uterine adenomyosis.
there are also 4 small fibroids detected.
The endometrium measures 9mm.there is more prominent thickening of the fundal portion of the endometrium which appears heterogenous with irregular margins. there is also an impression of a rounded lesion within the endometrium measuring ~10 x 17mm. there is some vascular flow within the endometrium. There is no ovarian enlargement. there is a 16mm complex cystic lesion in right ovary -? hemorrhagic follicle. There is a 14mm corpus luteum in the left ovary.
No adnexal mass lesion.
No pelvic free fluid.
The fundal portion of the endometrium is heterogenous and thickened. There also appears to be an endometrium polyp in this region.
bulky heterogenous myometrium, which may be due to uterine adenomyosis. there are several small uterine fibroids present. Please help me as I'm very worried thinking it may be cancer please let me know I'm very worried
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. C. replied 1 year ago.

Hi, It's Dr. C. Board certified Ob-gyne. I can help you today. I have extensive experience in managing abnormal bleeding and interpreting such ultrasounds.

First off, let me say that there is nothing in your ultrasound that makes one think of cancer as the most likely cause of your heavy bleeding. You do seem to have at least 2 other possible non-cancerous causes. First there appears to be a polyp which is a small growth along the uterine lining. They are very common and are the second most common cause of heavy bleeding in your age group. They are rarely cancerous. Risk of cancer increases with age but at age 42 is highly unlikely unless you have specific risk factors. Risk factors for cancer include obesity, family history of uterine or colon cancer, diabetes and a few others. The second reason for bleeding showing in your ultrasound is suspicion for a condition called adenomyosis. This is a condition where the uterine lining starts growing into the muscle layer of the uterus. This causes the "heterogeneous" appearance. Adenomyosis causes heavy bleeding and cramping. It is not a cancerous condition. The fibroids can contribute to bleeding if large and/or located along the uterine lining. There is no such comment so it's not likely they are anything to be concerned about separately. They are also very rarely cancerous. At least 50% of women have fibroids. The description of your ovaries isn't particularly concerning. Perhpas a follow-up ultrasound in 2-3 months to make sure the complex cyst in the right ovary goes away over time. It most likely will. The next step is for the doctor to do a hysteroscopic removal of the polyp along with curettage of the endometrial lining. This will remove the polyp as a possible cause of the bleeding and all the tissue from the polyp and lining would be submitted to pathology to rule out cancer or precancer. The chance that all tissue will be benign (not cancer) is very very high. After that is back, 2 choices, wait to see if removal of the polyp helps the symptoms or proceed right away to discussion of further options for management. Adenomyoisis can sometimes be controlled with medications (especially the Mirena IUD) but sometimes hysterectomy is a good option too.

I hope this was reassuring and helpful. I can provide as much additional detail as you need so let me know if anymore is needed.

Expert:  Dr. C. replied 1 year ago.

Any questions?

Expert:  Dr. C. replied 1 year ago.

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