Thick and Irregular Endometrium

[reebee86]

I'm 29 years old and had a D&C w/ ablation 4 months ago due to heavy bleeding.  I went to my OBGYN because of pelvic pain and pressure along with intense pain during intercourse and orgasm.  I have completely stopped having periods as of 3 months ago.  I now have a very milky discharge, constant pain in my lower back and changes in my bowel habits.  I had adrenal neuroblastoma as a baby and my mother has colorectal cancer.  My ancestry is asheknazi jew and my paternal grandmother and aunts all have or have had breast/ovarian cancer.  My doctor did a pelvic exam and ordered a transvaginal ultrasound which shows my endometrium is thick and irregular.  If I had fibroids or polyps or cysts, would my doctor have seen them during my ablation? Would they be visible on a sonogram? I'm waiting to hear the next step. The nurse thinks the doctor will order a pelvic MRI. Is a thick and irregular endometrium a good indicator of endometrial cancer?

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
If you have completed your family, and continue to have significant bleeding, pain, and other uterine symptoms, then it is rational to explore the possibility of a surgical removal of the uterus (especially because of your history and ancestry). Please discuss in detail with your doctor.
Good Luck!

[reebee86]

Thank you for your advice.  Can you tell me what may be causing the symptoms I'm having?  Is it drastic to request a complete hysterectomy at my age? I have four children now and have had my tubes tied plus the ablation.  It seems that my chances are really high for getting cancer again and I want to safeguard myself the best I can.  I already have yearly mammograms and I had my first yearly colonoscopy last year. I just don't want to take any chances.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Endometrial cancer usually occurs in older women, and presents with post menopausal or irregular bleeding. It is focal, and usually does not cause diffuse thickening of the endometrium.
Please continue to be under close surveillance and treatment of your gynocologist for your present symptoms. You may also like to consult a genetic counselor and an oncologist for screening you for cancer, given your family history, personal history, and racial/ethnic history.
All the best, and God Bless!