The endometrium is the inner lining of the uterus. Its thickness varies with a woman’s age, reproductive stage and specific point of her menstrual cycle. A thickened endometrium may or may not be a typical finding, depending on various elements of a woman’s menstrual stage. To evaluate endometrial thickening, ultrasound or magnetic resonance imaging (MRI) might be used.
Normal Endometrial Thickness in Menstrual Cycle
The endometrium generally changes in thickness and appearance throughout your menstrual cycle. These changes are associated with the hormone changes that happen during the cycle.
Early in the menstrual cycle, estrogen, which is produced by the ovaries, causes the uterine lining to grow, to prepare the uterus for possible pregnancy.
At mid-cycle, the ovary launches an egg during ovulation. Following ovulation, another hormone (progesterone) starts to increase to prepare the endometrium for implantation of fertilized egg. You might have a thickened endometrium at this moment. Nevertheless, if fertilization does not occur, hormone levels reduce, triggering menstruation, which is due to the dropping of the uterine lining. Once finished, a new cycle starts.
What Causes Thickened Endometrium?
In most cases, thickened endometriumor endometrial hyperplasia is non-cancerous (benign). Aside from the regular changes associated with the menstrual cycle, hormonal changes during perimenopausal stage may likewise cause endometrial thickening. Chronic disorders like weight problems, diabetes, or PCOS (polycystic ovarian syndrome) might also be associated with thick endometrium.Aside from these, endometrial hyperplasia might also be related to uterine cancer.
Symptoms of endometrial thickening include unusual changes in the length of menstrual periods, much heavier menstrual blood circulation, irregular bleeding/spotting in between periods, or postmenopausal bleeding. Anemia (low blood count) may likewise take place.
Risk factors connected with endometrial thickening include:
- Age > 35 years
- Racial aspects: White women are most likely to be affected
- Women who have never been pregnant are more likely to have thick endometrium
- Reaching menopause at an older age increases your risk.
- Early menarche (when menstruation started).
- Weight problems is typically connected with thick endometrium.
- Medical conditions such as diabetes, gallbladder disease, thyroid disease, or polycystic ovary syndrome.
- Cigarette smoking increases your risk.
- Family history of uterine cancer, ovarian cancer, or colon cancer.
Can It Be Cancer?
If you are postmenopausal and you have an unusually thickened endometrium, you will require further examination to find out if you are at risk for endometrial cancer. The endometrial thickening often shows estrogen stimulation, which may be due to hormone replacement therapy or from consumption of breast cancer drug, tamoxifen, or constant estrogen production resulting from weight problems. An unusual cause is ovarian tumor, which might be producing excess estrogen.
A thickened endometrium might cause bleeding after menopause, but even without bleeding, the possibility of endometrial cancer can not be dismissed. Verification might be done using endometrial biopsy. Endometrial thickness should be assessed together with endometrial morphology as well as risk factors for malignancy when thinking about endometrial tasting.
Thickened Endometrium Diagnosis
An ultrasound examination of the uterine lining may be used as a screening tool. During pelvic examination, biopsy of the endometrium may be taken after performing dilatation and curettage. Hysteroscopy may also be carried out to discover irregular areas in the endometrium. It includes making use of a thin device into your uterus to analyze and remove tissues.
Abnormally thick endometrium may take place for different reasons, which may or may not be pregnancy-related. Causes may also categorized based upon whether you are pre- or postmenopausal.
Pregnancy-Related Causes
- Early pregnancy (< 5 weeks).
- Ectopic pregnancy.
- Intra-uterine blood clot.
- Molar pregnancy.
- Current delivery.
- Endometritis.
- Maintained placenta.
Non-pregnancy Related Causes
- Endometrial cancer.
- Endometrial hyperplasia.
- Endometrial polyp.
- Tamoxifen-related changes.
- Hormone replacement therapy.
- Endometritis.
- Ovarian tumours.
How to Treat and Prevent Thickened Endometrium
- In many cases, treat of endometrial hyperplasia involves elimination of uterine tissue through dilatation and curettage (D and C).
- Postmenopausal women who are taking replacement hormones triggering frequent endometrial thickening must discuss with their gynecologists options which include either supplementing their therapy with progesterone or stopping therapy, states iytmed.com.
- Premenopausal women who have thickened endometrial may take contraceptive pills or progesterone as recommended to thin out their endometrial lining.
- Surgical elimination of the uterus (hysterectomy) and other reproductive organs might be encouraged for some women, particularly those who are postmenopausal or women who are not planning to have children. This will reduce their risk of cancer when their condition does not respond to progesterone therapy.
- Endometrial thickening can likewise be treated with oral or injectable progestin. It might likewise be used as a vaginal creamorin an intrauterine device. Nevertheless, progestin treatment might cause vaginal bleeding similar to menstrual bleeding.
What Can I Do to Prevent Endometrial Thickening?
To reduce your risk of thickened endometrium:
- Take progestin/progesterone if you are taking estrogen after menopause.
- Lose weight if you are overweight or obese. This might likewise reduce your risk of endometrial cancer.