Patient's question:
Go for an ultrasound examination, the endometrial thickness is 0.7 cm. Two days ago, I had another check-up, and the endometrial thickness was 1.0 cm. What's going on? Is this normal? What are the reasons for endometrial thickening? I heard that pregnancy can cause endometrial thickening. Is that true?Doctor's answer:
The endometrium is the mucous membrane that covers the uterine cavity; it is one of the most highly differentiated tissues in the human body. During childhood, the endometrium develops and grows slowly until the premenarcheal period, when estrogen begins to have a significant effect on the glandular stroma of the endometrium. Menstruation marks the beginning of sexual maturation in women, and during the menstrual cycle, the endometrium undergoes cyclical changes. Under normal conditions, one ovum is released per menstrual cycle. If fertilization does not occur, menstruation occurs, and a new cycle begins. If the ovum is fertilized and pregnancy occurs, the endometrium undergoes decidualization. The menstrual cycle is primarily regulated by ovarian hormones. If ovarian hormone levels are disrupted, it will inevitably lead to menstrual irregularities, along with corresponding morphological changes in the endometrium. Clinically, this may manifest as amenorrhea or "functional uterine bleeding" (menorrhagia). Among these, "functional uterine bleeding" is more common. There are many causes of "functional uterine bleeding," and the primary causes vary depending on the age group. Endometrial hyperplasia is one of the most common conditions. Endometrial hyperplasia is caused by excessive estrogen stimulation of the endometrium. Clinically, it presents as irregular, excessive, and abnormal uterine bleeding. Patients may experience persistent bleeding after a prolonged period of amenorrhea, which may be mistaken for miscarriage in clinical practice. It can also manifest as a shortened cycle length, prolonged menstrual periods, with bleeding lasting up to one month. Pathological examination shows that the degree of endometrial hyperplasia does not always correlate with the severity of bleeding. It is characterized by endometrial thickening, with thickness ranging from 3 to 12 millimeters, and in some cases, it can even reach 20 millimeters. The endometrium appears grayish-white or pale yellow, with a smooth surface or polypoid elevations, which may be accompanied by edema. The cut surface may sometimes reveal dilated glands forming cystic spaces.