What causes thickening of the uterine wall?

The uterus is a very important and special organ for women. The outermost layer of the uterus has a protective uterine wall, but one special thing about the uterine wall is that its thickness changes with the cycle. The most common reason is the female menstrual period. It can also be said that the uterine wall will thicken during the female ovulation period. But in addition to this normal phenomenon, if a woman has symptoms of hormonal disorders, the uterine wall may also thicken.

The endometrium has a period of proliferation every month: it starts around the 5th day of the menstrual cycle and lasts for 7-10 days. At this time, the estrogen level in the blood gradually increases, the basal layer of the endometrium begins to repair, the endometrium gradually thickens, and blood vessels and uterine glands also grow accordingly, but the endometrium is still very thin at this time; starting around the 15th day after menstruation, the progesterone secreted by the ovaries after ovulation causes the already thickened endometrium to continue to thicken, the glands further increase and bend, and secrete mucus. At this time, the endometrium becomes thick and soft, storing necessary secretions, ready to allow the fertilized egg to implant at any time.

The above is the physiological thickening of the endometrium under normal circumstances. However, if the secretion of ovarian hormones is disordered, it can easily lead to abnormal thickening of the endometrium, namely endometrial hyperplasia.

If a woman's hypothalamus-pituitary-ovarian axis is out of balance, or she is affected by diseases such as polycystic ovary syndrome, the endometrium may be continuously affected by estrogen for a long time, leading to anovulation. In this case, the endometrium is continuously affected by estrogen for a long time, without progesterone to counteract it, and lacks the transformation of the cyclical secretory phase. It will be in a state of hyperplasia for a long time, causing abnormal endometrial hyperplasia.

Most patients with endometrial hyperplasia are in menopause or adolescence, and obese women are also more likely to develop endometrial thickening. The clinical manifestations are irregular and heavy abnormal uterine bleeding. Patients may experience continuous bleeding after a long period of amenorrhea, which may be suspected of miscarriage clinically. It may also manifest as shortened cycles and prolonged menstruation, with bleeding time lasting up to 1 month.