Endometrial uterine wall thickening – causes and symptoms

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thickening of the uterine wall aka endometrial hyperplasia


Thickening of the uterine wall (endometrium) is one of the characteristics of a person experiencing endometrial hyperplasia. What is endometrial hyperplasia?

This condition is generally caused due to excess cell growth. Although not cancer, this condition can also trigger cancer of the uterus.

How Can Thickening of the Uterus Wall Occur Throughout the Menstrual Cycle?

FSH hormone

Hormonal activity in the body causes the thickening of the uterine wall. The first is a hormone called follicle-stimulating hormone (FSH). FSH is a hormone that triggers the development of follicles and thickening of the uterine wall.

FSH is a hormone produced by the pituitary gland. FSH is a hormone that has an important role in the reproductive system.

FSH regulates the process of egg development, affects follicle cells that provide food (nutrients) for the egg, and produces the hormone estrogen.

Low levels of the hormone FSH indicate that a woman is not ovulating, has a pituitary gland disorder, and is pregnant.

On the other hand, a high FSH hormone can be a sign that a woman is starting to go through menopause, indicating the presence of a pituitary tumor, as well as a symptom of Turner Syndrome.

Estrogen hormone

The endometrium changes throughout the menstrual cycle in response to hormones. During the first period of the menstrual cycle, the hormone estrogen is made by the ovaries which later produces estrogen.

This estrogen causes the membranes to grow and thicken to prepare the uterus for pregnancy. In the middle of the cycle, an egg is released from one of the ovaries (ovulation). After ovulation, levels of another hormone called progesterone begin to rise.

Progesterone prepares the endometrium to receive and maintain a fertilized egg. If pregnancy does not occur, estrogen and progesterone levels decrease. The drop in progesterone triggers menstruation, or the shedding of the thickened uterine lining. After the lining is completely shed, a new menstrual cycle begins.

Causes of thickening of the uterine wall

When ovulation does not occur, progesterone is not made, and the lining is not shed. The endometrium may continue to grow in response to estrogen.

The cells that make up the lining may clump together and may become abnormal. This condition, called hyperplasia, can cause cancer in some women.

Please note, there are several triggers that can make a spike in estrogen levels but less progesterone, namely:

  • Use of drugs that act like estrogen
  • Long-term use of high-dose estrogen after menopause (in women who have not had a hysterectomy)
  • Irregular menstrual periods, especially those associated with polycystic ovary syndrome or infertility
  • Obesity

Endometrial Hyperplasia Risk Factors

There is a risk for developing endometrial hyperplasia. If you have one or more of these, you may have risk factors for developing endometrial hyperplasia.

Some common risk factors include:

  • Over 35 years old
  • Fair skin
  • Early puberty
  • Hormonal changes before menopause (premenopause) or during menopause
  • Irregular menstrual cycle
  • Obesity
  • Smoking habit
  • Have a family history of uterine cancer, colon cancer, or ovarian cancer
  • Have a history of diabetes, polycystic ovary syndrome (PCOS), gallbladder disease, or thyroid disease

Related article: These 4 ways can reduce the risk of ovarian cancer

Symptoms of thickening of the uterine wall

The most common sign of hyperplasia is abnormal uterine bleeding. If you have any of the following, you should see a healthcare provider:

  • Bleeding during menstrual periods that are heavier or last longer than usual
  • Menstrual cycles shorter than 21 days (counted from the first day of your menstrual period to the first day of your next menstrual period)
  • Bleeding after menopause

It is possible that the symptoms are not mentioned above. However, if you have any suspicions or concerns about the symptoms you are experiencing, check with your doctor.

Diagnosing uterine wall thickening

There are many causes of abnormal uterine bleeding. If you have abnormal bleeding and you are 35 years of age or older, or if you are younger than 35 and your abnormal bleeding has not tried medication, your health care provider may perform diagnostic tests for endometrial hyperplasia and cancer.

Transvaginal ultrasound may be performed to measure the thickness of the endometrium. A small device is placed in the vagina which will later show pictures of the pelvic organs. If the endometrium is thick, it may mean that endometrial hyperplasia is present.

Treatments You Can Do

In most cases, endometrial hyperplasia can be treated with progestins. Progestins are given orally, in a single shot, as a contraceptive, or as a vaginal cream.

How much and how long you use it depends on your age and type of hyperplasia. Treatment with progestins can cause vaginal bleeding like menstrual periods.

If you have atypical hyperplasia, especially complex atypical hyperplasia, your risk of cancer increases. A hysterectomy is usually the best treatment option if you don’t want to have more children.

Read also:

5 reasons it’s difficult to get pregnant that couples often don’t realize during promil

Characteristics of women who are difficult to get pregnant, number 4 is the most rarely realized!

Here are 5 signs of endometriosis that women don’t know

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