Thickened Endometrium: Questions and Concerns in Women's Health

Endometrial thickening but not detectable on imaging?

I would like to ask about my menstrual cycle.
My last period was on May 15, and for the past four months, my cycle has extended to nearly 40 days.
Therefore, I went for an examination at the end of May, and they diagnosed me with polycystic ovary syndrome (PCOS), but there were no cysts.
On June 16, I had a little bleeding, but it stopped.
On June 21, I did not have sexual intercourse, but there was some foreplay (I was concerned about accidental contact).
On June 23, the doctor noted that my endometrium was thickened, but there was no pregnancy detected.
On July 6, the doctor again observed a thickened endometrium, but no embryo was found.
I was prescribed Medroxyprogesterone (Provera) on July 7.
Another doctor also noted the thickened endometrium and confirmed no pregnancy, advising me to continue taking the Medroxyprogesterone from the first doctor.
I started taking it, and in the past few days, I have experienced some discharge, but it is not discolored (just normal discharge).
Additionally, I have some abdominal discomfort.

I would like to ask:
1.
If there was an issue on June 21, until what date would a test be able to detect it?
2.
Is it possible to have a thickened endometrium and not have a period, but not have PCOS?
3.
If I take Medroxyprogesterone and still do not get my period, how long should I wait before seeing a doctor? What tests should I ask the doctor to perform?
Thank you, doctor.

J, 20~29 year old female. Ask Date: 2016/07/09

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, a pregnancy test usually requires at least 12 days after conception to yield accurate results.
If you are taking medication to induce menstruation, it typically takes about a week for your period to arrive.
It is recommended to wait a few more days, and if your period does not come after more than a week, it is advisable to consult a gynecologist.
Wishing you good health.

Reply Date: 2016/07/09

More Info

Understanding thickened endometrium and its implications in women's health can be complex, especially when considering the interplay of hormonal balance, menstrual cycles, and underlying health conditions. Based on your situation, let's address your questions and concerns systematically.

1. Timing of Pregnancy Tests: If you had unprotected sexual activity on June 21, and you are concerned about a potential pregnancy, it is generally recommended to wait at least one week after the missed period to take a pregnancy test for the most accurate results. Since your last menstrual period started on May 15 and you mentioned a cycle length extending to nearly 40 days, if you have not had a period by the end of June, you should ideally wait until early July to take a test. However, if you experience any unusual symptoms, such as significant abdominal pain or unusual discharge, it is advisable to consult your healthcare provider sooner.

2. Thickened Endometrium Without Polycystic Ovary Syndrome (PCOS): Yes, it is possible to have a thickened endometrium and not have PCOS. A thickened endometrium can result from various factors, including hormonal imbalances, stress, weight changes, or other underlying conditions. In some cases, it may indicate the presence of endometrial hyperplasia, which is an overgrowth of the endometrial lining that can occur due to excess estrogen without adequate progesterone. If your menstrual cycles are irregular or prolonged, this can contribute to the thickening of the endometrium. Therefore, it is essential to monitor your symptoms and discuss them with your healthcare provider.

3. Waiting Period After Starting Medications: After starting a medication like Medroxyprogesterone (often referred to as "美得能"), which is a form of progesterone, it may take some time for your body to respond and for your menstrual cycle to normalize. Typically, if you do not have a period within 7 to 10 days after completing the course of medication, you should follow up with your healthcare provider. They may recommend further evaluation, which could include blood tests to check hormone levels, an ultrasound to assess the endometrial lining, or other diagnostic procedures to rule out any underlying issues.

In addition to these points, it is crucial to maintain open communication with your healthcare provider. They can offer personalized advice based on your medical history, current symptoms, and treatment response. If you experience any concerning symptoms, such as heavy bleeding, severe pain, or any other unusual changes, do not hesitate to seek medical attention promptly.

In summary, understanding the implications of a thickened endometrium involves considering various factors, including hormonal balance and menstrual health. Regular follow-ups with your healthcare provider and adherence to prescribed treatments are essential for managing your reproductive health effectively.

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