The uterus is the womb that carries the embryo up until the time of birth. Under normal conditions, the uterus is known to naturally thicken every month to prepare a woman for pregnancy. When an egg attaches itself to the lining of the uterus, the uterus thickens.
If pregnancy does not occur, the lining of the uterus is shed and the uterus returns to normal. If pregnancy does occur, the uterus remains thickened to prepare itself to hold the baby for the next 9 months.
Thickening Of The Uterus Under Normal Conditions
Types of Thickening
There are three types of thickening of the uterus or endometrial hyperplasia. Simple Hyperplasia, complex hyperplasia without atypia and complex hyperplasia with atypia. In simple hyperplasia, there is thickening of the endometrium that is not associated with any malignancy. This is treated with a progesterone supplement. In the case of complex hyperplasia without atypia, the thickening is more severe than in the case of simple hyperplasia. Again, treatment is progesterone supplementation.
Hysterectomy may be suggested to women who have passed the childbearing years. If this condition is not treated at this stage, a small percentage of women are at the risk of developing endometrial cancer. In complex hyperplasia with atypia, the cells look very much like the cells that are associated with endometrial cancer and it is very difficult to distinguish the two (especially when the cells are obtained via a D&C or an endometrial biopsy). To rule out endometrial cancer, more tests need to be conducted.
Causes For Endometrial Hyperplasia Or Thickening Of The Uterus
There are other times when thickening of the uterus is noticed. The reasons behind this thickening is not pregnancy but some abnormal condition. Listed below are some of the abnormal conditions that give rise to the thickening of the uterus.
Fibroids And Polyps
When there is a growth within the uterus – such as a fibroid or polyp, the uterine lining thickens abnormally. There are also other complications such as heavy periods, bleeding between periods and painful periods.
A detailed examination and scan can determine the root cause of the thickening of the uterus. Once the root cause of the endometrial hyperplasia is determined, treatment is started accordingly.
The thickening of the uterus is generally caused by a hormonal imbalance. The period of fertility and even pregnancy are times when there is hormonal imbalance – hence the uterus naturally thickens during these times.
An increased level of estrogen in comparison to the level of progesterone in the body causes the thickening of the Uterus. Pregnancy is not the only cause for hormonal imbalance. Menopause, diabetes and irregular menstrual cycles are some of the other conditions that cause this imbalance of hormones.
Endometrial cancer is cancer arising from the endometrium. The endometrium is the inner lining of the uterus. When cancer affects this endometrial lining, thickening of the uterus is noted. However, it must be noted that cancer is not the only cause for the uterus lining to thicken.
There are several reasons for the uterus lining to thicken. When Endometrial hyperplasia is detected, it is necessary that further tests are conducted to find out the root cause of the condition; and treatment must be started immediately.