Is surgery required for endometrial thickening?

Generally, whether endometrial thickening requires surgery depends on the underlying cause and associated symptoms. Physiological thickening or benign lesions without significant symptoms may not require surgical intervention, whereas pathological thickening accompanied by abnormal symptoms or suspected malignancy typically necessitates surgery. If there are concerns, it is recommended to seek medical consultation promptly. Detailed explanation is as follows:

If endometrial thickening is due to normal menstrual cycle changes, such as secretory phase endometrial thickening, and there are no symptoms such as abnormal bleeding or menstrual irregularities, or if histopathological examination confirms simple or complex hyperplasia without atypia, surgery may not be necessary initially. In such cases, hormonal medications may be used to regulate hormone levels and promote cyclical endometrial shedding. Regular follow-up with ultrasound and histopathological evaluations are recommended to monitor endometrial changes. For example, mild thickening caused by hormonal fluctuations in reproductive-age women can often be managed conservatively with medication.

When endometrial thickening is accompanied by irregular vaginal bleeding, postmenopausal bleeding, or histopathological findings of atypical hyperplasia, suspected malignancy, or failure of medical treatment, surgical intervention should be considered. Surgical options typically include hysteroscopic endometrial polypectomy, diagnostic dilation and curettage (D&C), or hysterectomy. These procedures help remove the lesion and determine its exact pathological nature. Atypical hyperplasia is considered a precancerous condition, and surgery can significantly reduce the risk of malignancy. Postmenopausal women with endometrial thickening should be closely evaluated for possible malignancy, and timely surgical intervention is crucial.

Women experiencing endometrial thickening should seek medical attention promptly to undergo comprehensive ultrasound and histopathological examinations. A physician will evaluate whether surgery is necessary. Postoperative care includes adequate rest, maintaining perineal hygiene, and following medical advice for follow-up assessments of hormone levels and endometrial status.