The endometrium is the lining of your uterus. It has a very important job: it prepares the environment for implantation of an embryo. Infertility and abnormal menstrual periods are often caused by problems with this lining. It’s also involved in the development of endometriosis, a condition that can lead to cysts on your ovaries and pelvic adhesions (adhesions between structures in your pelvis).
When an egg is fertilized in the fallopian tube, it implants inside the uterus. The endometrium then starts a new cycle of building and shedding. This cycle can take 28 days. During the proliferative phase of the cycle, the lining of the uterus is thinnest. During this time, the endometrium is receptive to the fertilized egg, and the glands in the lining secrete proteins, lipids, glycogen, and other substances that nourish an embryo. The lining is also vascularized during this period via straight and spiral arteries.
During the luteal phase of the cycle, hormones like estrogen cause the lining to thicken. The endometrium may measure up to 11 mm in thickness. If there’s a miscarriage during this time, the lining can become even thicker. This change in lining thickness is called endometrial hyperplasia.
in the DNA of the cells in the lining. This results in cells that look normal under a microscope but have a higher risk of becoming cancerous than normal cells. There are two types of endometrial hyperplasia: simple and complex. Simple and complex hyperplasia without atypia are less likely to become cancerous than untreated atypical hyperplasia. But untreated atypical hyperplasia has a very high chance of developing into cancer, and can eventually spread to your ovaries or the peritoneum.
A symptom of endometrial hyperplasia is abnormal or heavy bleeding during your menstrual periods. This can make you anemic, which means your body doesn’t have enough iron-rich red blood cells. In some cases, your healthcare provider may recommend hormonal therapy to treat the condition.
During this treatment, you’ll receive medication to increase your production of estrogen and suppress your production of other hormones. Depending on the type of hyperplasia, this may help to treat your symptoms or lower your risk for cancer. If your doctor doesn’t think the condition is serious, they may not suggest treatment. In other cases, they may recommend surgery to remove the lining of your uterus. This procedure is known as a hysteroscopy. This procedure is usually done by a specialist, such as a gynecologist. It’s a minimally invasive procedure, and you shouldn’t experience much pain or discomfort. Occasionally, your doctor may perform the procedure using other techniques, such as laparoscopy. These are more invasive procedures, but they have a similar effect. They can be performed in your doctor’s office or in an outpatient surgical facility. The doctor will use a scope to view the lining of your uterus and take a sample for testing.
