Specialist Answers on Menopausal Cramps and Thickened Uterine Lining Everyday Health MenuNewslettersSearch Menopause Specialist Answers on Menopausal Cramps and Thickened Uterine Lining By Dr. Marcie RichardsonReviewed: July 28, 2008Fact-CheckedQ1. I am 55 and have been menopausal for four years now. A few months ago, I started having pain that feels exactly like menstrual cramps. It's getting more frequent. Is this still related to menopause, or something else? Is it normal to feel cramps? I haven't had any diarrhea. If by saying menopausal you mean that you haven’t had a period for four years, then it is not normal to be having pains like menstrual cramps unless, of course, you are on hormone therapy. Without estrogen, your female pelvic organs sort of go into hibernation. Once they are in this quiescent state, they should not cause any symptoms. You mention diarrhea, and you are correct that a likely source of cramps in a postmenopausal woman is her gastrointestinal tract. You should see a doctor and have this evaluated. In the meantime, keep a diary of what activities and foods might provoke your cramps. Q2. I have been told that it is very common for postmenopausal women to have a thickened uterine lining. Can you tell me the measurements of this thickening and what they mean? How high does the scale go? — Pam, Rhode Island In postmenopausal women, the lining of the uterus (known as the endometrium, or uterine lining) should really be no thicker than 4 to 5 millimeters. If you are truly postmenopausal and not on hormone therapy — which can thicken the uterine lining — and your measurement is above 4 to 5 mm, your doctor may want to investigate further. A uterine lining thicker than 4 to 5 mm could be a sign of hyperplasia, or abnormal cell growth, and in some cases it could even indicate endometrial cancer. If a woman who has already gone through menopause suddenly has bleeding, and an ultrasound test shows that her uterine lining is thicker than 4 to 5 mm, she may need an endometrial biopsy to make sure there is no evidence of hyperplasia or cancer. A postmenopausal woman who isn’t experiencing bleeding could have a slightly thicker measurement — say, 7 mm — before her doctor might want her to have a biopsy. Bleeding is really the worrisome symptom; it’s rarely necessary to check the thickness of the uterine lining unless you’re experiencing bleeding after menopause. Bottom line: If you’re postmenopausal, experiencing bleeding, and your uterine lining measure is greater than 4 to 5 millimeters — you need to follow up with your doctor to rule out any serious problems Learn more in the Everyday Health Menopause Center. NEWSLETTERS Sign up for our Women' s Health Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. 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