A thickened endometrium is characterized by the uterine lining becoming too thick. The condition of a thickened endometrium causes bleeding that can lead to an irregular menstrual period.
Endometrial hyperplasia1 is also known as a non-cancerous pathology, but it can increase the risk of endometrial cancer. It is diagnosed through a biopsy. Check the table below for the types of endometrial hyperplasia:
| Simple endometrial hyperplasia | This refers to homogeneous thickening of the endometrial tissue |
| Focal endometrial hyperplasia | It is characterized by the exposure of polyps outside the uterine cavity and a slight reduction in uterine size. |
| Cystic endometrial hyperplasia | It is characterized by an irregular appearance of the uterus (irregular cavities that resemble “Swiss cheese”). In more severe cases, this condition may be associated with endometrial cancer. |
| Atypical endometrial hyperplasia | This is a more serious condition of endometrial lesion. It is usually associated with endometrial cancer and as treatment requires removal of the uterus. |
Characteristics of endometrial thickening
The hormone estrogen is closely linked to the construction of the uterine lining. However, balanced growth of this lining depends on progesterone. If progesterone production is below normal, endometrial thickening occurs, and there are some issues that can lead to a hormonal imbalance between estrogen and progesterone levels.
Causes
The main causes are:
- Diabetes problems
- Some therapy involving estrogen without progesterone replacement
- Being overweight, near or in obesity
- Polycystic Ovary Syndrome (PCOS)
Symptoms
The thickening presents itself through signs such as:
- Bleeding in between menstrual cycles (spotting)
- Abdominal pain and cramps
- Pain in the pelvic region
- Increase in uterine size
Thickened and heterogeneous endometrium
Endometrial cancer or carcinoma2 is the most common type of gynecological neoplasia in developed countries. However, today, thanks to technology, it’s possible to detect the problem early and begin treatment promptly. Therefore, this issue is not among the main causes of cancer deaths.
Thickened endometrium in menopause
According to the research Transvaginal ultrasonography in the diagnosis of endometrial pathology in the reproductive years and menopause, endometrial thickening is characterized by an endometrium of 5 mm or more on ultrasound of women in menopause who have not undergone hormone therapy.
After menopause, when assessing the endometrium, a range of factors are taken into account, such as the patient’s medical history and whether hormonal therapy3 was used. This endometrial thickening can occur soon after menopause or many years later.
In women who undergo hormone therapy combined with cyclic therapy involving estrogen and progestin, endometrial thickness may vary by up to 3 mm.
Treatment
To treat endometrial hyperplasia, a diagnostic hysteroscopy is necessary to evaluate the uterine cavity and determine the cause of the thickening. This allows for determining whether it’s an endometrial polyp, hyperplasia (identified via biopsy), or cancer. Depending on the result, it may be necessary to remove the thickened area, use progesterone-based hormones, or even perform a hysterectomy (a procedure involving partial or complete removal of the uterus). If not detected and treated early, hyperplasia can lead to cancer, which may require removal of the organ.
Is it possible to get pregnant with a thickened endometrium?
Yes, it is possible to get pregnant. However, the woman and her partner will need to wait until the treatment is fully completed according to all required steps. The use of contraceptives becomes essential during treatment. Therefore, it’s important for the woman to manage her anxiety about motherhood, follow the appropriate treatment, and most importantly, not see treatment as an obstacle to her dream of becoming a mother.
Treatment is what will restore your health and the conditions needed for a safe and happy pregnancy. If you experience any abnormal symptoms, see your doctor for appropriate tests. Early detection of the problem prevents more serious issues.
