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  • Q&A with Australian Health Practitioners

    I'm a 49 year old menopausal woman with 24mm thickened endometrium

    Related Topics
    Endometriosis Menopause Women's Health
    I have had three blood tests that have all confirmed that I'm menopausal. Last month, I had a period that lasted 3 weeks and was medium to heavy. The doctor thought that given the blood tests that I should have a pelvic ultrasound, which I did and it came back that I had a 24-mm thickened endometrium with traces of fluid in the endocervical canal. I have made an appointment to see a specialist in 3 weeks time thinking nothing major but after reading about the cancer risk should I be trying to see a specialist urgently?
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  • 26

    Thanks

    Dr Joseph Jabbour

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    Dr Joseph Jabbour is a specialist Obstetrician & Gynaecologist and Fertility Specialist with Monash IVF situated in Sunnybank (Brisbane Southside). Dr Jabbour has had the … View Profile

    Hi there.

    Menopause is diagnosed in hindsight after having no periods for 12 months. The blood tests can sometimes be misleading. If this is your first period in 12 months, then you have postmenopausal bleeding. Postmenopausal bleeding should be looked at promptly. The most common cause is an atrophic endometrium (thin endometrium lacking oestrogen). But the most important diagnosis to rule out is a precancerous or a cancerous lesion of the lining of the uterus (the endometrium). In our profession, we say that postmenopausal bleeding is cancer until proven otherwise. 

    If you are still menstruating irregularly and are perimenopausal, a heavy period is abnormal and also requires urgent attention. The normal thickness of the endometrium in a postmenopausal woman is 4-5 mm. 24 mm is quite thickened and you would definitely need to rule out endometrial cancer. Most studies suggest that an endometrial thickness above 20 mm is a sinister sign. 

    That being said, you would be categorized as category 1 and would be deemed as an urgent appointment (usually within 4 weeks). You can certainly seek an earlier appointment or seek another specialist who may be able to see you sooner. The investigation that you would require is an endometrial biopsy. This can be obtained in the clinic at your first consultation with a Pipelle device. This is a thin long tube that is inserted into the uterus through the cervix and a biopsy is obtained. The gold standard procedure is a Hysteroscopy D and C to visualize the lining of the uterus and obtain a decent sample for histology.

    Good luck. 

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  • 19

    Thanks

    Leanne Vella

    HealthShare Member

    Thanks very much for your answer to my enquiry, i appreciate it greatly. I have managed to see a specialist and am booked in for a hysteroscopy and D&C on the 1st of November which is the earliest i could get. The specialist doesn't think he will find anything sinister as he does not believe the endometrium has been that thick for long, i can only hope he is correct. I think i will feel better when it is confirmed that there is nothing major wrong. Once again thank you very much for your imput, it is appreciated.

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  • 16

    Thanks

    Dr Joseph Jabbour

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    Dr Joseph Jabbour is a specialist Obstetrician & Gynaecologist and Fertility Specialist with Monash IVF situated in Sunnybank (Brisbane Southside). Dr Jabbour has had the … View Profile

    Good luck with your procedure Leanne, I hope it turns out well for you.

    All the best.

    Joseph

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