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[KarineT]

Hello,

Can the lining of the womb get too thiick in postmenopause even if you're on HRT ?

Thanks

Karine

[Taz2]

Yes it can.

Taz x

[KarineT]

Hi Taz,

Thanks for your reply.

There's a mistake in my post as I meant to ask if the endometrium can get too thick even if one is not on HRT.  I would have thought that this can only be caused by too much oestrogen but if HRT is not taken then the oestrogen will be low.  At this point, can the endometrium still get too thick?

Karine

[Ana21]

Hi Karine!

Yes, even if a woman is not on HRT, she can develop a thickened endometrium.  An increasing concern is obesity-driven endometrial hyperplasia in postmenopausal women.  Obesity is associated with an increased risk of endometrial cancer.  The connection exists because fatty tissue makes estrogen via the enzyme aromatase.  The greater the BMI, the greater the estrogen produced. 

This is one of the reasons why, for example, two women taking the same estrogen product at the same dose may be prescribed the same progestogen at different doses.  The woman with a high BMI may need a higher dose to counter the proliferative effects of her higher estrogen level.

One of the major emerging causes of the estrogen/progesterone imbalance is obesity.

[Lesley66]

Yes, I had some spotting 6 years post meno. Never been on HRT. Scan revealed my lining was 7mm.

Had a hysteroscopy on Friday. Thickening was a small polyp, which I had removed.

It was 3 weeks from bleed to polyp removal. No complaints whatsoever about the service I have received from the NHS. During that time I've also been fortunate enough to meet our new practice nurse who I saw for my smear (negative). She diagnosed me with VA and prescribed moisturizer. The consultant at the hospital has also referred me to the menopause clinic as she says I need HRT.

I read a lot about obesity fueling estrogen too. Although I'd gained weight like most of us during lockdown, I don't think that caused my issues - although I'm happy to say I'm getting back towards my pre pandemic weight by dropping the white stuff (carbs). Except for wine of course 😉😂

[KarineT]

Thanks for your replies everyone.

I am postmeno as I haven't a period for 19  months now.  I don't have VA or problems with my endometrium but I believe I have a uterine fibroid.  I was told that fibroids tend to shrink during the menopause so, hopefully, I will never be affected by postmenopausal bleeding. Back to the endometrium in postmenopause I always thought that it stayed permanently thin, unless a woman takes too much oestrogen as HRT.  I diidn't know that fat produced oestrogen as well but I was aware the adrenal glands produce a form of it caused estrone.  So do the ovaries stop producing it altogether?

[Ana21]

Yes, the ovaries eventually stop making the hormones estrogen and progesterone.  If you have a transvaginal ultrasound or a sonohysterogram to confirm you have fibroids, then they will look at your ovaries to ensure they are shrinking normally. 

The ovaries produce a number of hormones.  On this forum, we're primarily interested in estrogen, progesterone and testosterone, but they also produce some lesser hormones such as relaxin and inhibin.  Androgen production from the ovaries (testosterone and androstenedione) continues beyond the menopausal transition.

Postmenopausal women continue to have low levels of circulating estrogens primarily from peripheral aromatization of ovarian and adrenal androgens, as I understand it.  As mentioned previously, adipose tissue is also a major site of aromatization, so obesity is also a factor.  As you've read, estrone is the dominant form of estrogen in postmeno women.