The endometrium is the glandular innermost layer of the uterus, commonly known as the female womb. This lining plays a pivotal role in supporting fetal life during pregnancy. It prepares itself every month for fetal implantation in order to support the new life form, but disintegrates when no pregnancy occurs, resulting in the monthly menstruation which every woman experiences right from puberty to menopause.
How to Maintain a Healthy Endometrium
The fundamental factor responsible for endometrial health is the balance between the two hormones estrogen and progesterone. Any disturbance in this balance will result in a number of diseases, some of which may be as serious as endometrial cancer. There are many factors in the life of a woman which make her susceptible to hormonal imbalance in the endometrium.
Hormonal imbalance is seen in those who are elderly, in menopause, who were never pregnant, diabetic, obese, menopausal and those who take hormone therapy drugs. People under these conditions have the potential risk of endometrial cancer and they should take adequate care to prevent it.
Normal Functioning of the Endometrium
Under normal conditions the 6.7 inches thick endometrium prevents the walls of the myometrium (uterine middle layer consisting of contractible smooth muscles from sticking to each other. The function of the myometrium is to facilitate uterine contractions).
The endometrium thickens with blood vessels throughout the month during the non-menstrual period of a woman in preparation of pregnancy. If pregnancy occurs, the endometrial vascular cells get interconnected with each other to form a shield called the placenta which protects and nourishes the fetus. The endometrium disintegrates causing menstruation when there is no pregnancy.
The endometrium can be affected by a number of diseases which are discussed further in the article. Under such circumstances this echogenic (its functionality can be identified by medical examinations using ultrasound scanning techniques) uterine lining functions abnormally.
How to Detect Endometrial Disorders
One of the causes of infertility may be an endometrial disorder. Here are certain characteristic behaviors exhibited by people with endometrial disorders:
Inability to conceive despite normal sexual intercourse
Painful sexual intercourse (dyspareunia)
Painful periods and cramping (dysmenorrhea)
Difficulty in passing free bowels (dyschezia)
Chronic pain in the pelvis
Spotting in the phase before menses
Miscarriage- resulting in delivering a fetus before the 20th week of pregnancy when it is not yet fully developed and prepared for the outside world. This results in death of the fetus.
A number of endometrial diseases are discussed below:
This is a condition in which uncontrolled proliferation of malignant endometrial cells takes place. High levels of estrogen are seen to be the major causal factor of this disease. Mostly, women in the age group of 60-70 years are most susceptible to this disease, but at times, it is reported in women within 40 years of age. The causal factors of this disease are many. Infertility, no pregnancy history, ovarian cysts or polyps, hormone replacement therapy, breast cancer drugs (tamoxifen), early puberty, late menopause, diabetes, obesity and irregular menstruation are some of the factors that make a woman conducive to endometrial cancer, though it is not necessary that the disease will definitely occur in persons with one or more of the causal factors stated above.
Endometrial Cancer is symptomized by a number of symptoms, chief among which are abnormal discharge. Spotting outside one’s menstrual schedule and long and heavy bleeding during menstruation are some common symptoms. Pelvic pain and/or abdominal cramps and a clear or white discharge after menopause are indicative of a probability of endometrial cancer.
Diagnosis of endometrial cancer involves a number of medical examinations which depend on the stage and complexity of the issue on hand. A pelvic examination is one of the preliminary tests that your doctor may suggest for you. This involves examining the size, shape and feel of the uterus for diagnosing the presence of malignancy. Other tests that are done are endometrial aspiration (biopsy), Dilation and Currettage (removal of endometrial tissue by surgical dilation of the cervix), and pap smear. Confirmation of cancer leads to the performance of other tests called staging to understand the stage of cancer.
Treatment of endometrial cancer is done by hysterectomy (surgical removal of uterus). It is coupled with radiation or chemotherapy depending upon the stage of the cancer.
This condition is characterized by abnormal growth of the endometrium caused due to excessive activity of estrogen due to insufficient progesterone. It is poses a potential risk of endometrial cancer or represents its co-existence. Therefore, it is one of the endometrial diseases that demand prompt and perfect care.
Endometrial Hyperplasia is also detected by standard tests such as endometrial curettage, endometrial biopsy or hysterectomy. Endometrial hyperplasia is symptomized by abnormal bleeding and tests are done to confirm that the bleeding is from the uterus and not from parts or regions outside the uterus.
Endometrial Hyperplasia treatment is individualistic and the standard methods of treatment call for hysterectomy or progestin therapy.
This is characterized by painful periods and can lead to difficulty in conceiving or infertility if not treated. It is caused due to abnormal growth of endometrial tissue outside the uterus- in the fallopian tubes, vagina and on other places where it should naturally not grow. Autoimmune Endometriosis is a condition in which the endometrial cells that are found in parts of the body where they should not be present are not cleaned up by the immune system due to an inefficient immune system resulting in endometriosis.
Differential diagnosis of endometriosis is done based on the symptoms exhibited. Palpation of the pelvic region is done by the doctor to detect any abnormality in the region. Though the basic condition of the pelvic region can be assessed by palpation of the region, a laparoscopy of the region is required to confirm the findings.
Endometriosis is treated by administering drugs or by surgical methods. The former is practiced for patients reporting pain or dyspareunia. Surgical treatment is done on cases of advanced endometriosis and infertility.
Maintaining Endometrial Health Naturally
Though we cannot totally control endometrial health in the natural way, good food and exercise go a long way towards maintaining endometrial health. Foods or food supplements rich in vitamin B complex, vitamin C, antioxidants, omega fatty acids, sylimarin and bromelin are known to improve estrogen health.