Is endometrial curettage necessary for a thickened endometrium?

Whether endometrial curettage is required for thickened endometrium depends on the specific cause, symptoms, and examination results; it cannot be generalized. Detailed analysis is as follows:

If the thickened endometrium is caused by physiological factors, such as natural endometrial thickening before menstruation, and there are no symptoms such as abnormal vaginal bleeding or abdominal pain, and ultrasound examination shows the endometrial thickness within the normal fluctuation range, curettage is generally unnecessary. Physiological thickening will naturally shed with the menstrual cycle. Follow-up ultrasound after the menstrual period can confirm whether the endometrial thickness has returned to normal, without requiring special intervention.

When thickened endometrium is accompanied by abnormal uterine bleeding, postmenopausal bleeding, or ultrasound reveals uneven endometrial echoes, polypoid changes, or suspicion of endometrial hyperplasia, polyps, or malignancy, curettage may be necessary. Dilation and curettage (D&C) not only helps stop the bleeding by removing the thickened endometrium but also allows collection of endometrial tissue for pathological examination to determine the nature of the lesion and provide a basis for further treatment. For example, if endometrial hyperplasia is diagnosed, medication may be used to regulate the condition accordingly; if malignancy is confirmed, further treatment will be required.

Decisions regarding whether to perform curettage for thickened endometrium should follow medical advice, integrating assessment of the menstrual cycle, symptoms, and related examinations. Self-diagnosis or decision-making should be avoided. Postoperative care should include rest and hygiene maintenance to prevent infection.