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The endometrium is a mucous membrane which lines the inner surface of the uterus. During reproductive period endometrium normally changes its thickness due to the hormones and depending of the phase of the menstrual cycle it may be thin or become thicker. However, in some cases thickened endometrium is not considered normal especially if the cause of thickening is endometrial hyperplasia.

Pathological Thickened Endometrium

Endometrial hyperplasia or thickened endometrium is a medical condition which features with excessive proliferation of the endometrial cells. In majority of cases endometrial hyperplasia is caused by elevated levels of estrogens and low levels of progesterone. This typically occurs in certain gynecological illnesses such as polycystic ovary syndrome, estrogen producing tumors and in case of estrogen replacement therapy. Endometrial hyperplasia must be taken seriously and treated properly and timely since it represents a risk factor for endometrial cancer.

Classification of Thickened Endometrium

Thickened endometrium or endometrial hyperplasia is actually a physiological response of the endometrium to estrogen. There are several subtypes of endometrial hyperplasia which are classified according to their pathohystological characteristics.

Simplex or complex endometrial hyperplasia represents irregularity and cystic expansion or budding of endometrial glands. There are no bothersome changes in the appearance of the glands.

Simplex or complex atypical endometrial hyperplasia features with bothersome architectural changes in gland cells. These changes include cell stratification, tufting, loss of nuclear polarity, enlarged nuclei and increased mitotic activity. All of the previously mentioned makes atypical endometrial hyperplasia precancerous condition which eventually turns into actual invasive endometrial cancer. In atypical endometrial hyperplasia there is no invasion of the connective tissue.

Symptoms of Thickened Endometrium

Endometrial hyperplasia may be asymptomatic or lead to several symptoms such as vaginal discharge, bleeding between menstrual cycles, heavy and/ or prolonged menstrual bleeding, and pelvic and / or abdominal pain.

Diagnosis and Treatment for Thickened Endometrium

Diagnosis of thickened endometrium can be easily confirmed with the assistance of ultrasound of the uterus. What follows is biopsy of the endometrium and pathohistological examination of the biopted tissue so that the underlying cause can be properly identified.

Treatment for thickened endometrium basically depends on the underlying cause and may be conservative or surgical. Most of the time simplex or complex hypertrophic endometrium without cellular atypical is treated with birth control pills or progesterone. Women who are in menopause, particularly those suffering from atypical endometrial hyperplasia are perfect candidates for hysterectomy, a surgical removal of the uterus. This is both, the treatment for endometrial hyperplasia and method of prevention against potential endometrial cancer.

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