Causes of Endometrial Thickening
Aug 24, 2022
Source: Cainiu Health
Dr. Lv Aiming
Introduction
Endometrial thickening may be caused by factors such as obesity, endocrine-functional tumors, or simple endometrial hyperplasia. In that era’s society, obese individuals had greater adipose tissue mass. Increased fat mass enhances the capacity for peripheral aromatization of androgens to estrogens, thereby promoting endometrial thickening in women. When women present with this symptom, it may not only lead to abnormal pituitary gonadotropin function but also disrupt the hypothalamic–pituitary–ovarian axis.
The uterus is a vital organ for women, and its health directly determines the ability to achieve a successful pregnancy. Currently, national policy permits second-child births, making the desire to have a second child increasingly common among women; thus, maintaining a healthy uterus is critically important. In daily life, uterine disorders frequently occur. What, then, are the causes of endometrial thickening?
Causes of Endometrial Thickening
Endometrial thickening may result from factors such as obesity, endocrine-functional tumors, or simple endometrial hyperplasia. In contemporary society, obese individuals possess greater adipose tissue mass. Increased fat mass enhances aromatase activity—leading to elevated peripheral conversion of androgens into estrogens—which in turn stimulates endometrial proliferation. When women present with this condition, not only may pituitary gonadotropin function become abnormal, but it may also trigger granulosa cell tumors of the ovary—a type of tumor that persistently secretes estrogen. Pathologically, the uterus appears slightly enlarged, with markedly thickened endometrium. During dilation and curettage (D&C), large, smooth, red, polypoid tissues may be observed. Microscopically, the lesion exhibits diffuse involvement, with impaired function of both the functional and basal endometrial layers.
Regarding treatment for endometrial thickening: management requires careful timing, as not all cases of endometrial thickening necessitate intervention. During the luteal phase of the menstrual cycle—just before menstruation—the endometrium is naturally thicker. Therefore, transvaginal ultrasound is generally recommended 3–7 days after menstrual bleeding has ceased. An endometrial thickness exceeding 10 mm warrants consideration of pathological endometrial thickening. Diagnosis relies on both imaging findings (e.g., apparent endometrial thickening) and clinical symptoms (e.g., abnormal uterine bleeding). In such cases, hysteroscopy combined with diagnostic curettage is advised to obtain tissue samples for histopathological evaluation. Only after identifying the underlying cause can targeted, etiology-specific treatment be initiated.
In daily life, adequate rest and balanced nutrition are essential; patients should closely monitor vaginal bleeding and abstain from sexual intercourse for one month post-procedure. Strenuous physical labor should also be avoided during this period. We hope this information proves helpful to you.
