Why does the endometrium become thickened?

Under normal circumstances, endometrial thickening may be caused by continuous stimulation from high estrogen levels, hormonal fluctuations during puberty or perimenopause, simple endometrial hyperplasia, polycystic ovary syndrome (PCOS), endometrial polyps, and other factors. It is recommended to seek timely medical consultation to identify the underlying cause and receive appropriate treatment under a physician's guidance. Detailed explanations are as follows:

1. Continuous stimulation from high estrogen levels: Excessive secretion of estrogen in the body or long-term use of estrogen-containing medications can continuously stimulate the endometrium, leading to excessive proliferation and thickening, accompanied by increased menstrual flow and prolonged menstruation. The endometrium may become thinner once hormone levels return to normal. Avoid taking estrogen-containing supplements (e.g., royal jelly) without medical advice. If estrogen medications are necessary, strictly follow medical instructions, maintain regular作息, reduce factors causing hormonal imbalances, and undergo regular gynecological ultrasound examinations to monitor endometrial thickness.

2. Hormonal fluctuations during puberty or perimenopause: In puberty, the hypothalamic-pituitary-ovarian axis is not fully developed, while in perimenopause, ovarian function declines, both leading to hormonal fluctuations with relatively high estrogen levels, which may cause endometrial thickening. Endometrial changes during puberty often normalize with development, while those in perimenopause may recur. No significant intervention is usually needed. Maintain a healthy diet and regular exercise. Monitor menstrual cycle regularity during puberty and perform regular endometrial checks during perimenopause. Seek medical attention promptly for abnormal bleeding.

3. Simple endometrial hyperplasia: Anovulation or infrequent ovulation leads to progesterone deficiency, causing the endometrium to be continuously stimulated by estrogen, resulting in simple hyperplasia characterized by endometrial thickening, menstrual irregularities, and prolonged spotting. This is a benign condition. Patients should control weight to avoid hormone imbalance caused by obesity, follow medical advice to use progesterone supplements such as dydrogesterone tablets, medroxyprogesterone acetate tablets, or progesterone capsules to antagonize estrogen and promote endometrial shedding, and undergo regular follow-up to monitor endometrial thickness.

4. Polycystic ovary syndrome (PCOS): Patients with PCOS have elevated androgen levels that convert into increased estrogen, leading to prolonged endometrial stimulation and thickening, accompanied by oligomenorrhea, hirsutism, acne, and more significant endometrial thickening with severe hormonal imbalance. Patients should reduce weight through low-calorie diets and exercise to improve hormonal levels. Follow medical advice to use medications such as ethinyl estradiol/cyproterone acetate tablets, spironolactone tablets, or metformin hydrochloride tablets to regulate hormones and improve insulin resistance, thereby indirectly reducing estrogenic stimulation to the endometrium.

5. Endometrial polyps: Localized excessive endometrial proliferation forms polyps, leading to overall endometrial thickening, presenting as single or multiple polyps, accompanied by intermenstrual bleeding and prolonged menstruation. Larger polyps result in more significant endometrial thickening. Small asymptomatic polyps can be monitored regularly, while larger or symptomatic polyps should be removed via hysteroscopic polypectomy as advised by a physician.

In daily life, maintain emotional stability and avoid long-term anxiety that may affect the endocrine system and indirectly regulate hormone levels. Maintain hygiene during menstruation to prevent infections that may cause endometritis and affect endometrial thickness. Choose breathable cotton underwear, keep the external genital area clean and dry, and reduce the risk of reproductive system infections to provide a healthy environment for the endometrium.