The lining inside the uterus is too thick.
The lining that you shed should be an appropriate thickness on a routine basis. When you start having heavy periods, that lining can get to be too thick.
How does the lining of a uterus become too thick?
You make estrogen from two sources, your ovaries and your adrenal glands make a hormone that is converted into a type of estrogen in your fatty tissues. If you have too much estrogen in your body then your body may be making a lining that is too thick. This generally happens with heavier women that have irregular cycles. This is due to the fact that they have more estrogen present in their fatty tissues and they are not producing progesterone, the hormone that causes you to shed your lining every month, allowing their body to build up the thickness of your uterine wall.
The lining inside the uterus is too thin.
This means that the lining is too thin and when you shed the lining during your cycle, you are down to the bare blood vessels and they are starting to bleed heavily.
How does the lining of a uterus become too thin?
Women that are thinner and are having irregular periods do not have a proper storage of estrogen in their fatty tissues and are not making estrogen during ovulation due to their irregular cycles, so their lining becomes very thin. It becomes so thin that the bare walls of the uterus just keep on bleeding.
You may have fibroids or polyps inside your uterus.
All fibroids start in the wall of the uterus and can grow outwards or inwards. Fibroids that grow outwards are more of an annoyance and do not cause too many problems. Fibroids that grow to the inside of the uterus cause more problems. When you body is trying to build the lining of your uterus, it can't when there is a fibroid in the way. polyps are benign pieces of tissue that can grow inside the uterus. They typically grow where a placenta had been attached during a previous pregnancy.
If your uterus is too thick:
We like to start with the addition of progesterone to help your body naturally shed the lining of your uterus. After several weeks, we will check with another ultrasound to ensure that your lining has improved. If this method does not work, then we can try a surgical procedure in which we dilate the uterus and scrape away the lining that has built up (D&C).
If your uterus is too thin:
We need to build the lining up with the addition of estrogen. We can use birth control pills on those patients that will tolerate it, otherwise we can use natural estrogen.
If you have fibroids/polyps:
We can perform a D&C or an ablation (an ablation is where we take an instrument and burn or shave off the fibroid inside the uterus) and either of these options can be helpful. If you have consecutive difficulties with fibroids and are done having children, you may consider having a hysterectomy.
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