Endometrium is the tissue that lines the inside of the uterus and its thickness varies during the menstrual cycle depending on the variation in the concentration of hormones in the blood.
It is in the endometrium where the implantation of the embryo occurs, initiating pregnancy, but for this to happen, the endometrium must be the ideal thickness and show no signs of disease. When there is no fertilization, the tissues flake and menstruation is characterized.
- The thickness of the endometrium varies each month in all women of childbearing age.
- Characterizing the phases of the menstrual cycle:.
The endometrium can be evaluated by gynecological imaging tests, such as pelvic ultrasound, colposcopy, and MRI, for example, where the gynecologist checks for any signs of disease or modification of this tissue. See the other tests requested by your gynecologist.
The ideal endometrium to get pregnant is one that measures about 8 mm and is in the phase of secretion, because the thin or atrophic endometrium, which measures less than 6 mm, is unable to allow the baby to develop. The main cause of endometrial delicacy is a lack of progesterone, but this can also occur due to contraceptive use, the baby’s uterus and injuries after an abortion or degree.
The minimum thickness to get pregnant is 8 mm and the ideal is about 18 mm. In women where this does not occur naturally, the doctor may prescribe the use of hormonal drugs such as Utrogestan, Evocanil or Duphaston to increase the thickness of the endometrium, thus facilitating the implantation of the embryo in the uterus.
The reference thickness of the endometrium after menopause is 5 mm, which can be seen on a transvaginal ultrasound. At this stage, when the thickness is greater than 5 mm, your doctor will order a series of other tests to better evaluate the woman and see other signs that may reveal possible diseases such as endometrial cancer, polyp, hyperplasia or adenomy, for example.
Endometrial changes may be due to diseases that can be treated and controlled by the use of hormones and, in some cases, by surgery. Medical follow-up is critical to avoid complications of each disease, maintain uterine health, and increase your chances of getting pregnant. The most common diseases related to endometrium are:
The most common disease affecting the endometrium is endometrial cancer. This can be easily discovered as its main symptom is bleeding outside of menstruation. For women who are already in menopause and who have been menstruating for 1 year, the symptom is immediately noticeable.
For those who have not yet reached menopause, the main symptom is an increase in the amount of blood lost during menstruation. You should be aware of these signs and immediately look for a gynecologist, because the sooner the problem is discovered, the greater the chances of recovery. Learn how to identify endometrial cancer.
Polyps located in the endometrial region are benign and are easily perceived because they cause symptoms such as blood loss before or after menstruation or difficulty getting pregnant. This change is most common after menopause and usually occurs in women who take medications such as tamoxifen.
Most of the time, this disease is discovered on an ultrasound that shows an increase in its thickness. Treatment is at the gynecologist’s choice but can be done with removal through the polyps by surgery, especially if the woman is young and wants to become pregnant, but in many cases there is no need to perform surgery, nor take hormonal medications, following the case every 6 months to check the changes.
Increased endometrial thickness is called endometrial hyperplasia, being more common after age 40. Its main symptom is bleeding outside the menstrual period, in addition to pain, abdominal cramping and enlarged uterus, which can be seen on a transvaginal ultrasound.
There are several types of endometrial hyperplasia and not all are cancer-related. Treatment may include hormone medications, grading or surgery, in the most severe cases. Learn more about endometrial hyperplasia.
Adenomyosis occurs when tissue inside the uterine walls increases in size, causing symptoms such as heavy bleeding during menstruation and cramps that make life difficult for a woman, as well as pain during intimate contact, constipation and abdominal swelling. Its causes are not properly known, but this can occur due to gynecological surgery or C-section, for example, in addition, adenomyosis may occur after pregnancy.
Treatment can be done with the use of contraceptives, the insertion of an IUD or surgery to remove the uterus, in the most severe cases, when symptoms are very bothersome and when there is a contraindication for the use of hormonal medications. Learn more about adenomyosis.