What should I do if my endometrium is thickened and my menstruation is absent?

Generally, the absence of menstruation accompanied by endometrial thickening may be caused by factors such as hormonal imbalance, pregnancy, endometrial polyps, simple endometrial hyperplasia, and polycystic ovary syndrome (PCOS). It is recommended to seek timely medical consultation to identify the underlying cause and receive appropriate treatment under a doctor's guidance. Detailed explanations are as follows:

1. Hormonal Imbalance: Excessive estrogen secretion combined with insufficient progesterone can lead to continuous endometrial thickening without shedding, causing the absence of menstruation. This is commonly seen in individuals experiencing significant emotional fluctuations or staying up late. Under a doctor's guidance, hormonal regulation can be achieved using medications such as dydrogesterone tablets, progesterone soft capsules, or medroxyprogesterone acetate tablets to promote endometrial shedding. Maintaining a regular sleep schedule and avoiding excessive fatigue is also important.

2. Pregnancy: After conception, the endometrium thickens to support embryo development, resulting in the cessation of menstruation, which is a normal physiological phenomenon. Symptoms such as nausea and breast tenderness may accompany this condition. Confirm pregnancy using a home pregnancy test or blood HCG test. Ensure adequate rest, take folic acid supplements, and attend regular prenatal checkups to maintain a healthy pregnancy.

3. Endometrial Polyps: Polyps occupying uterine cavity space can interfere with normal endometrial shedding, leading to endometrial thickening and absent menstruation, often accompanied by increased menstrual flow or prolonged periods. Small polyps may be monitored regularly, while larger or symptomatic polyps require hysteroscopic polypectomy to remove the polyps and restore normal uterine structure. Postoperative care includes maintaining external genital hygiene to prevent infection.

4. Simple Endometrial Hyperplasia: Excessive proliferation of endometrial cells causes abnormal thickening of the endometrium, resulting in absent menstruation, which may be accompanied by irregular bleeding. Patients may follow medical advice to use medications such as progesterone injection, dydrogesterone tablets, or megestrol acetate dispersible tablets to inhibit endometrial hyperplasia. Regular ultrasound follow-ups are necessary to monitor endometrial changes.

5. Polycystic Ovary Syndrome (PCOS): Ovulatory dysfunction caused by the ovaries leads to hormonal imbalances, resulting in continuous endometrial thickening without cyclical shedding, manifesting as oligomenorrhea or amenorrhea, often accompanied by hirsutism and acne. Patients may follow medical advice to use medications such as ethinylestradiol cyproterone tablets, spironolactone tablets, or metformin tablets to regulate hormones and metabolism. Weight management, reduced intake of high-sugar and high-fat foods, and appropriate physical activity are also essential.

Maintain healthy lifestyle habits daily, avoid excessive dieting or overeating, keep emotions stable to reduce hormonal fluctuations. Regular gynecological checkups help detect and manage endometrial abnormalities promptly, promoting reproductive health.