எண்டோமெட்ரியல் தடிமன்: நீங்கள் தெரிந்து கொள்ள வேண்டியது

Key examples

• Endometrial thickness varies throughout the menstrual cycle, with normal measurements being 2-4 mm during menstruation, 5-7 mm during the proliferative phase, and 11-16 mm during ovulation. A minimum thickness of 7-8 mm is optimal for pregnancy.

• Thickness is usually assessed by transvaginal ultrasound, which provides accurate visualization.

• A thin endometrium can be caused by estrogen deficiency, age, or uterine fibroids, while a thick endometrium can arise from pregnancy, endometrial hyperplasia, or hormone therapy.

• Symptoms include irregular cycles and abnormal bleeding, with treatments ranging from hormone therapy to surgical options.

• Proper endometrial thickness is essential for fertility and successful embryo implantation.

As you embark on your fertility journey, you may come across various medical terms that may seem unfamiliar to you. One such term is ‘endometrial thickness’, which refers to the thickness of the inner lining of the uterus. Understanding what endometrial thickness is and how it affects your fertility can help you feel more informed and empowered throughout your journey.

The endometrium plays a vital role in your reproductive health. Its thickness varies throughout your menstrual cycle and life stages, and understanding these changes can help you spot potential problems. Whether you’re trying to conceive or experiencing unusual symptoms, knowing what’s normal when it comes to endometrial thickness is essential.

Normal endometrial thickness

The thickness of the endometrium changes throughout the menstrual cycle and at different stages of life. Here’s what you need to know:

Endometrial thickness during the menstrual cycle

• Menstrual phase (days 1-5): The endometrium is very thin, measuring 2 to 4 mm.
• Proliferative stage (days 6-14): As your body prepares for a possible pregnancy, the endometrium thickens to 5-7 mm.
• Ovulation and secretory phase (days 15-28): The endometrial thickness peaks at around 16 mm during the secretory phase, having previously reached 11 mm after ovulation .

Endometrial thickness and pregnancy

When it comes to normal endometrial thickness for pregnancy , thicker endometrium is generally better. A thickness of at least 7-8 mm is considered optimal for implantation. However, since other factors also play a role in fertility, successful pregnancies can occur with either thin or thick linings.

Endometrial thickness after menopause

After menopause , your endometrium is usually 5 mm or less thick as estrogen levels drop. A thick endometrium in postmenopausal women may be a cause for concern and warrant further investigation.

Here’s a quick reference chart of normal endometrial thickness at different stages:

Stage	Normal endometrial thickness
Menstruation (days 1–5)	2–4 mm.
Proliferative stage (days 6–14)	5–7 mm.
Ovulation and secretory phase	Between 11 and 16 mm
Pregnancy	About 6 mm
Postmenstrual	5 mm or less

How is endometrial thickness measured?

Endometrial thickness is usually measured using transvaginal ultrasound . This quick, painless procedure involves inserting a small ultrasound probe into the vagina to visualize the uterus and measure the endometrium at its thickest point.

Causes of abnormal endometrial thickness

The endometrium can be thinner or thicker than normal due to various factors. Let’s explore some of the common reasons:

Causes of thin endometrium

• Estrogen deficiency: Low estrogen levels during the follicular phase can cause insufficient thickening.
• Age: The endometrial lining may be thinner in older women approaching menopause.
• Uterine fibroids or polyps : Non-cancerous growths that can interfere with endometrial growth.
• Anovulation: Irregular or absent ovulation affects estrogen and progesterone levels necessary for proper endometrial growth.
• Poor blood circulation: Inadequate blood circulation restricts endometrial growth and development.

Causes of thick endometrium

• Pregnancy: Especially in early pregnancy or ectopic pregnancy .
• Endometrial hyperplasia: Too much estrogen and not enough progesterone can cause thickening.
• Endometrial cancer or uterine cancer: These conditions can significantly increase endometrial thickness.
• Obesity: Associated with increased endometrial thickness.
• Hormone replacement therapy (HRT): Unopposed estrogen can cause thickening.

Symptoms of endometrial thickness variations

Symptoms of thin endometrium

• Implantation failure and miscarriages: A thin endometrium can lead to difficulties with embryo implantation and early pregnancy loss.
• Irregular menstrual cycles: Women may experience irregular periods, which can manifest as missed cycles or variations in cycle length.
• Light menstrual flow: Menstrual bleeding may be unusually light, sometimes lasting only a short period of time (e.g. half a day) with little or no clotting.
• Painful periods: Some individuals may experience discomfort or pain during menstruation, which may be exacerbated by underlying conditions such as chronic endometritis.
• Asymptomatic cases: In some cases, women may not exhibit significant symptoms until they are diagnosed through ultrasound or other medical evaluations.

Symptoms of a thick endometrium

• Abnormal vaginal bleeding: heavy or prolonged bleeding during menstruation, spotting between periods, and bleeding after menopause.
• Irregular menstrual cycles: Cycles that last less than three weeks or more than five weeks.
• Pelvic pain: Unexplained pelvic pain may be a symptom of underlying problems, such as endometrial cancer.

Treatments for abnormal endometrial thickness

Treatment for abnormal endometrial thickness depends on the underlying cause and severity of the condition. Options include:

Treatments for thin endometrium

• Estrogen therapy: This treatment aims to stimulate endometrial growth. Estrogen can be administered in various forms, including pills, patches, or injections, and helps the endometrial lining to thicken.
• Human Chorionic Gonadotropin (hCG): Administration of hCG after embryo transfer to support implantation . This hormone mimics the natural hormonal changes that occur during early pregnancy, promoting an appropriate environment for the embryo.
• Medications and supplements: Some medications and supplements can improve blood flow to the uterus, which is essential for nourishing the endometrial lining. Improved circulation can help thicken the endometrium.

Treatments for thick endometrium

• Progestin: This hormone therapy is usually used to counteract the effects of excess estrogen, which can lead to endometrial hyperplasia (thickened endometrium). Progestin helps regulate the menstrual cycle and prevents the uterine lining from thickening further.
• Hysterectomy: In severe cases where other treatments have failed or if there is a risk of cancer, a hysterectomy may be necessary. This surgery removes the entire uterus, eliminating the possibility of future problems related to a thick endometrium.
• Pills and vaginal creams: These treatments contain hormones that help regulate the endometrial lining. They are effective in managing symptoms associated with a thick endometrium and restoring hormonal balance.
• Intrauterine devices (IUDs): Hormonal IUDs can deliver progestin directly to the uterus, which helps thin the excessively thick endometrial lining and effectively manage bleeding symptoms.

The importance of endometrial thickness in fertility and pregnancy

Endometrial thickness plays an important role in fertility and pregnancy:

• Optimal thickness for IVF: An endometrial thickness of 7-10 mm is considered optimal for achieving favorable outcomes. IVF treatment . This thickness ensures that the lining of the uterus is adequately prepared to support embryo implantation and subsequent growth.
• Successful implantation: A properly developed endometrium—one that is neither too thin nor too thick—is essential for successful embryo implantation . An ideal thickness allows for adequate nutrient delivery to the embryo, while also providing an appropriate environment for its growth.