Content

Many diseases in the field of gynecology are associated with pathology of the uterine body. The inside of the uterine mucosa is lined with cells of a special layer called the endometrium.

The endometrium is the mucous membrane of the uterus, which lines its cavity from the inside and is quite abundantly supplied with blood vessels. The main function of the endometrium is to create suitable conditions for the implantation of a fertilized egg into it.

The endometrium consists of two layers: functional and basal. The functional layer grows every month during menstrual cycle and is rejected by the uterus at its end under the influence of the complex interaction of the hormones estrogen and progesterone. The rejected layer comes out through the cervix, which is slightly open during menstruation, in the form of bloody discharge. With the beginning of the next cycle, the subsequent growth of a new functional layer of the endometrium begins. The basal layer is not rejected during critical days, but it is precisely thanks to its regenerating properties that the monthly growth of the functional layer of the endometrium occurs.

For the onset of conception and the determination of various pathological conditions, the thickness of the functional endometrium is very indicative. It seems possible to measure its thickness using an ultrasound scan using a vaginal sensor of the pelvic organs.

Thickness of the mucous membrane of the inner layer of the uterus is a non-constant quantity. It changes in women reproductive age depending on the day of the cycle. During the period before and after menopause, the thickness of the functional layer of the endometrium has different sizes.

The thickness of the functional layer of the endometrium varies depending on the day of the menstrual cycle as follows:

• from the fifth to the seventh day of the cycle, the thickness is about five millimeters;
• from the eighth to the tenth day of the cycle, the inner layer of the uterus thickens up to 10 millimeters;
• from the eleventh to the fourteenth day of the cycle, the mucous membrane can grow up to 14 millimeters;
• from the fifteenth to the eighteenth day of the cycle, the thickness varies up to 16 millimeters;
• the maximum thickness of up to 18 millimeters is recorded from the nineteenth to the twenty-third day;
• from the twenty-fourth day of the menstrual cycle, the thickness of the mucous layer of the uterus decreases.

The thickness of the functional endometrium has its own characteristics in premenopause:

• on the days of menstruation, the thickness of the mucous layer is up to four millimeters;
• in the initial proliferative stage up to seven millimeters;
• in the stage of late proliferation up to eleven millimeters;
• in the secretory stage the thickness is up to sixteen millimeters.

In postmenopause, the thickness of the functional endometrium should not exceed eleven millimeters.

Under the influence various factors and the reasons why the endometrium undergoes changes that cause its pathological conditions. Among the most common pathologies of the inner layer of the uterine mucosa is endometrial hyperplasia. Endometrial hyperplasia is a pathological thickening of the inner layer of the uterus beyond the established norm. This proliferation is the result of changes that occur in the glands and stroma of the endometrium. Over time, the mucous membrane becomes much thicker than required for its normal functioning.

As a rule, hyperplasia is characteristic of hormonal imbalance and certain concomitant diseases in the body. For example, diseases such as diabetes and hypertension blood pressure often accompany hyperplasia of the uterine mucosa. Hormonal disorders in combination with other pathologies lead to an increase in the amount of estrogen while a simultaneous decrease in progesterone levels. The result of this improper interaction of hormones is hyperplasia of endometrial tissue.

The thickness of the functional endometrium of the uterine cavity ranges from six to eighteen millimeters in healthy women. With hyperplasia of the mucous layer, its thickness increases to 20 millimeters.

Thickness of the functional endometrium in different types of hyperplasia

It should be noted that the endometrium with hyperplasia can grow unevenly while maintaining healthy areas. In this case they talk about focal form of hyperplasia. It is characterized by the formation of cysts and polyps, which can be visualized using ultrasound. At diffuse hyperplasia The thickened mucosal surface is smooth.

The thickness of the functional endometrium also depends on the type of hyperplasia.

• With glandular hyperplasia, the mucous membrane thickens due to the proliferation of cells that are found in the connective and glandular tissue. There are two forms of the disease: acute and chronic.
• Glandular cystic hyperplasia is manifested by blockage of tissue glands, which causes the formation of cysts.
• Atypical hyperplasia or adenomatosis is manifested by pathological proliferation of cells with changes in the structure of the nucleus. This phenomenon may indicate the presence of cancer.

Symptoms of thickening of the uterine mucosa

This pathological condition of the uterine mucosa is characterized by asymptomatic progression. A woman may suffer from hormonal disorders and not know about the presence of endometrial hyperplasia.

Symptoms of hyperplasia usually includes:

• abundant spotting during menstruation;
• infertility;
• lack of ovulation;
• hormonal imbalance.

The thickness of the functional endometrium is not always indicative. If a woman ovulates regularly and there are no problems with conception, then during the study the thickness of the inner layer of the uterine cavity does not play a big role.

Normally, the thickness is allowed to vary up to eighteen millimeters depending on the day of the menstrual cycle. If necessary, it is recommended to measure the thickness of the mucous membrane before ovulation.

Often in gynecological practice, there is an absence or disturbance of ovulation and cycle while maintaining the normal thickness of the functional endometrium. Such an inner layer of the uterine cavity may not always be good quality for fertilization.

Women after menopause may experience spotting and even bleeding. In such cases, an examination with mandatory measurement of the thickness of the mucous layer is indicated. In healthy women in this category, the thickness does not exceed five millimeters. If the excess according to the ultrasound results is insignificant, then in the absence of complaints the patient is under the supervision of a doctor and is regularly examined. Subject to availability accompanying pathologies, for example, cysts and a significant excess of the normal thickness of the functional endometrium requires a diagnostic curettage procedure.

Diagnostic curettage with hysteroscopy is one of the most valuable methods used in gynecology.

During the procedure, the doctor, using special instruments, performs curettage of the uterine cavity and collects material for further examination. The procedure can be used both for diagnosis and as treatment. If curettage of the uterine cavity is required and cervical canal, they are talking about carrying out the so-called separate diagnostic curettage.

The diagnosis of “endometrial hyperplasia” should be made as a result, first of all, of laboratory diagnostics. Thickening and proliferation of the mucosa occurs at the level of cells and tissues, which can be detected during examination under magnification. Based on the results of an ultrasound examination of the pelvic organs using a vaginal sensor alone, it is not enough to identify pathology. There are often cases when the thickness of the mucosa is measured incorrectly. Endometrial hyperplasia is also sometimes accompanied by cysts and polyps, which cannot be carefully examined using equipment. Their benignity can be judged only after special histological studies.

Endometrial hyperplasia is quite insidious disease. If left untreated, this pathology can cause.

• Heavy character of menstruation. Regular blood loss has a negative impact on overall health: it worsens over time general health, anemia develops.
• Infertility. The altered endometrium is not able to provide normal nutrition to the embryo during implantation. Often, the introduction of the fertilized egg into the walls of the uterus is not at all possible due to the pathological growth of the mucous membrane.
• Pathologies of the fetus during developing pregnancy. Cases are not uncommon cancer in a fetus developing with endometrial hyperplasia.
• Development cystic formations in the uterine cavity. The endometrium thickens unevenly in the uterine cavity, some areas transform into cysts and polyps of different sizes.
• Malignant tumors. Some forms of thickening of the functional endometrium can develop into cancer over time.

Endometrial hyperplasia is often complicated other pathologies of the female genital area. The growth and thickening of tissue leads to various disorders: fibroids, endometriosis, chronic inflammation in the reproductive system.

In order to determine thickening of the mucous membrane, it is necessary, first of all, to undergo regular examination and examination by a gynecologist. Women who are concerned about excessive bleeding, infertility, high blood pressure, or diabetes should be extremely attentive to their health and well-being, and also be examined for the presence of hyperplasia or thickening of the functional layer of the uterus. This pathology can be quite successfully eliminated with adequately selected treatment, including mandatory hormonal therapy. It must be remembered that untreated growth of the mucous membrane over time can degenerate into a malignant tumor.

The endometrium during menopause undergoes many changes associated with hormonal changes. female body. Under the influence of a deficient level of estrogens and progesterones in the uterine cavity, atrophic changes its mucous surfaces leading to a complete stop menstrual function. There are certain boundaries for the thickness of the endometrial layer during menopause, and if these are violated, certain pathological diseases begin to develop.

Many women who have entered the threshold of menopausal changes stop paying attention to their health. They attach special importance to all ailments that appear during this period of time, attributing everything to changes hormonal levels. But, of course, you can’t treat yourself like that. After all, it is with the onset of menopause in the female body that the level of the immune defense system weakens. And she is at greatest risk of developing serious pathologies: from benign neoplasms to cancer. Therefore, regular examination in a gynecological office is so necessary: ​​at least 2 times a year, during which they can be detected initial stages development of disorders.

The development of endometrial hyperplasia during menopause is the most common pathological change in the functional layer of the uterine mucosa.

Hyperplasia of the endometrial layer is characterized as pathological growth functional layer of the mucous surfaces of the uterine cavity, promoting the formation of uterine bleeding.

This pathology of the endometrium in menopause develops under the influence of hormonal changes in the body. The following factors also contribute to the development of pathology:

• being overweight;
• pathological change in liver functionality;
• development of diabetes mellitus;
• progressive stage of hypertension;
• hereditary factor.

This pathology of the endometrium in postmenopause is quite dangerous, as it can progress to the stage of malignancy and degeneration into cancerous tumor. Development atypical hyperplasia may result in cancer in 25% of cases. To prevent such complications, it is necessary to know the norms of the condition reproductive system organism during the fertile and menopausal periods.

You also need to promptly pay attention to emerging symptoms, undergo examinations and not avoid modern developments therapeutic treatment of menopause and its pathologies.

Endometrial norms during menopause

All processes of changes in the endometrium during menopause and the postmenopausal period must be carefully monitored to prevent serious complications and development of oncology.

Methods ultrasound diagnostics are the most effective and reliable ways to determine the condition of the uterine organ and the norm in the endometrium during menopause.

Normally, M-ECHO of the uterus should not be more than 5 millimeters. When the value of this indicator is within 6 mm, maximum 7 mm, it becomes necessary to dynamically control the thickness of the endometrium in menopause with repeated ultrasound examinations after 3 and 6 months. Although such indicators are still allowed, 7 mm is in some cases a normal thickness.

If the thickness of the endometrium at menopause exceeds 8 mm, then this indicates the development pathological process. In this situation, in order to put accurate diagnosis, a specialist performs diagnostic curettage of the uterine cavity.

In the case when the endometrium in menopause, that is, its thickness itself, greatly exceeds 12-13 mm, separate curettage mucous membrane and goes to histological examination obtained biological material from the uterine cavity.

It is important to remember that curettage methods are necessary in case of violations of the norms of endometrial thickness in order to study the structure of the resulting material, make an accurate diagnosis and begin appropriate treatment.

Types of pathology

Hyperplastic processes in the endometrium can have 4 various shapes currents, namely:

1. Ferrous.
2. Glandular-cystic.
3. Focal.
4. Atypical.

One of the most common forms of the hyperplastic process is glandular pathology. It is accompanied by the proliferation of glandular tissues, but has a less dangerous form of flow, since it develops over a very long period time. But we should not forget that the development of glandular hyperplasia in the absence of appropriate treatment can develop into oncology.

A less common variant of hyperplastic processes are glandular-cystic pathology. It's pretty dangerous form hyperplasia, characterized by the formation of cystic lesions of the mucous membranes of the uterine cavity. In 5-6% of cases they can also develop into a cancerous tumor of the endometrial layer.

Focal forms of hyperplastic processes are quite rare, but are one of the most dangerous pathological disorders of the endometrium. When developing this form, no therapeutic treatment. In this case, strict control is maintained over the development of polyps that have a high predisposition to malignancy.

Appearance atypical forms of hyperplasia is the most dangerous pathology, when identified, a biopsy examination is performed, which in more than 60% of cases confirms the presence of carcinomas.

This form of the disease requires immediate surgical treatment.

Symptoms of endometrial pathology

The development of the hyperplastic process over a long period of time is accompanied by rather mild symptoms. With an increase in the thickness of the endometrial layer, a woman may experience bleeding, which cannot be ignored.

Subject to availability of this characteristic You must urgently contact a qualified specialist.

Other symptoms of the development of hyperplasia in the endometrial layer make themselves felt in quite rare cases. Sometimes, as this pathology progresses, white or gray discharge of a smearing nature. Pain during hyperplastic processes does not appear.

The development of this pathology, in most cases, is detected during a routine examination in the gynecological office.

Diagnostic measures

In cases where a woman, taking care of her health, undergoes regular routine examinations, no problems with timely identification There will be no pathological changes in the uterine cavity. Since during the examination, special gynecological mirrors are used, which make it possible to clearly see the fibrous and glandular-cystic types of hyperplasia.

As mentioned above, the endometrium has a certain thickness norm, the excess of which indicates pathology. Endometrial thickness is determined by ultrasonic method diagnostics

But in addition to ultrasound, in case of serious disorders, methods for diagnosing the uterine cavity using radioactive phosphorus may be prescribed.

Based on the results obtained and after all diagnostic procedures, the specialist develops the most effective scheme further treatment.

Treatment methods

IN modern medicine exists large number varieties therapeutic methods treatment: both conservative and surgical.

In the case when the reason for the development of pathology is a change in the hormonal levels in the female body, and the thickness of the endometrial layer undergoes minor changes in indicators, replacement therapy will be effective hormone therapy. In most cases, medications containing the hormone progesterone are prescribed. Duration hormonal treatment can take from 3 months to a year.

Important! Correct selection of hormone-containing drugs and dosage can help full restoration endometrial layer.

Another type of treatment for hyperplastic processes in the endometrium are methods surgical intervention. Initially, a diagnostic curettage procedure is performed, on the basis of which a specific diagnosis is established. Moreover, the developing pathological process is also slowing down and the developing uterine hemorrhage is stopping.

If localized processes of hyperplastic growths are detected, then ablation, or cauterization of the thickened layers of the endometrium, is performed. At atypical form development of hyperplasia, surgical hysterectomy is prescribed, that is, complete removal of the uterine organ. But such a radical treatment method is used when there is no effect from hormone replacement therapy, as well as while maintaining the likelihood of transition to malignancy and the development of a cancerous tumor.

In modern medicine they are increasingly used combined techniques treatment of hyperplastic processes in the menopausal period. Consisting in the initial use of hormone replacement drugs that help reduce lesions. Then the remaining small defects are excised surgically.

In addition to hormones during the menopausal period, vitamin complexes, helping to strengthen the immune system of the female body and contribute to a noticeable relief of overall well-being.

Traditional methods of treatment for the development of such a disease will not be able to have the necessary effect.

But they can still be used as an addition to the main treatment. It is recommended to use decoctions or infusions of medicinal plants only after general agreement with a qualified specialist.

To prevent the development of such pathological changes in the reproductive system of the organs of the female body it is necessary to abandon bad habits, promptly eliminate the inflammatory process using appropriate treatment, and maintain healthy image life. And getting rid of excess weight will not only transform your external appearance, but will also be a good preventive measure against many pathologies.

Useful video on this topic:

Throughout monthly cycle changes occur in the uterus that affect the endometrium. Its thickness varies different days cycle. Depending on the size of the endometrium, doctors learn about the health of the uterus.

What is the size of the endometrium on different days of the menstrual cycle? What could be the reasons for deviations from the norm?

Endometrium and its structure

The endometrium is the inner lining of the uterus. Its purpose is to create optimal conditions for the attachment of the embryo to the uterine cavity and provide normal development fetus

During the monthly cycle, the size of the endometrium changes under the influence of female sex hormones - progesterone and estradiol.

Estradiol promotes the maturation and thickening of the uterine layer, progesterone maintains the required thickness until the end of the cycle and in the event of fertilization.

The endometrium consists of 2 layers:

• Functional. It is this part of the surface of the uterus that is rejected during menstruation and undergoes changes during the menstrual cycle.
• Basal. This layer is adjacent to the middle uterine covering - the myometrium. It consists of various connective tissues and glands, permeated blood capillaries. U healthy woman its size is constant and amounts to 10-15 mm.

Why and how is endometrial thickness measured?

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The thickness of the uterine layer is measured if a woman has problems with reproductive function and disruption of menstrual cycles. Indications for clarifying the indicators of the endometrial layer:

• periodic delays in menstruation;
• absence of menstruation without pregnancy;
• intense or scanty menstrual discharge;
• problems with conception and pregnancy.

Endometrial thickness cannot be determined during a routine gynecological examination. An ultrasound is required for measurements.

Most optimal method measurement is a transvaginal examination. The examination is carried out by inserting the apparatus tube directly into the vagina. This method allows you to obtain the most reliable data. Ultrasound is recommended to be performed in the period close to ovulation. If it is necessary to measure the size of the mucous layer during a complicated pregnancy, a routine ultrasound is performed.

Table of endometrial norms

The parameters of the endometrial layer change daily throughout the menstrual cycle. When deciphering the results, doctors are guided by the standards that the inner uterine layer must meet on a certain day. The table describes how many cm the layer should be normally.

Endometrial norms by phase

The endometrial layer goes through several phases of development: initial (bleeding), middle (proliferation), final (secretory). The minimum thickness of the endometrial layer is observed in the bleeding phase, the greatest - in the secretion phase.

Bleeding phase

The bleeding phase begins on the first day of the monthly cycle and lasts 5 days. During this period, the old layer is rejected and gradually restored due to the basal layer. Initial phase has two stages:

• Rejection. Lasts the first 2 days of the menstrual cycle. During this stage, the thickness of the endometrium reaches 4-9 mm. On ultrasound it is noticeable that the epithelial layer becomes loose, the vessels have increased fragility, bleeding begins.
• Regeneration. Tissue restoration occurs on days 3-5 of the cycle. During this period, the old layer completely peels off, and the new one has not yet grown, so the mucous layer acquires the smallest thickness - 2-5 mm.

Proliferation phase

The proliferation stage occurs on days 6-7 of the menstrual cycle. Throughout the entire phase, the process of preparing the uterus for possible conception. Under the influence of hormones, the uterine layer grows intensively. The proliferative phase goes through several stages:

• Early. From days 6 to 7, the uterine layer has low density. On the first day of this stage it reaches 6 mm. Every day the endometrium increases by about 1 mm. By the end of the stage it reaches 7-8 mm.
• Average. From 8 to 10 days, the uterine layer grows from 8 to 11 mm. At this time, the endometrium begins to become overgrown with capillaries and acquires a pink tint.

• Late. At the final stage, from days 11 to 14 of the cycle, the layer reaches a thickness of 14 mm. The density becomes optimal for fertilization. Simultaneously with the preparation of the uterine layer, the egg matures in the ovaries. Ovulation occurs, which means pregnancy is possible.

Secretory phase

The final phase of endometrial development occurs from days 15 to 30 of the menstrual cycle. During this period, tissue growth active influence provides progesterone. Under its influence, the uterine layer grows and thickens. It becomes overgrown with vessels and acquires functionality that provides nutrition to the embryo if it is attached to the uterus.

Stages of the secretory phase:

• Early secretion. The uterine layer does not grow as quickly as in the previous period. From 15 to 18 days it thickens to only 16 mm. However, at this time its structure changes; the tissues reflect ultrasound most intensely at the edges. The shade of the layer is yellow.
• Average secretion. The stage occurs from 19 to 23 days of the cycle. During this period, the uterine layer reaches its maximum value– 18 mm. From this point on, the endometrium should not continue to thicken.
• Late secretion. From 24 to 28 days of the menstrual cycle, gradual preparation for future rejection of the uterine layer occurs. The endometrium becomes denser, but at the same time thins slightly (up to 12 mm). Atrophy of the overgrown endometrium occurs due to the fact that the level of progesterone begins to gradually decrease. Ultrasound shows changes in the capillaries, and the gradual formation of blood clots is noticeable.

Normal for delayed menstruation

Delayed menstruation occurs for various reasons: pregnancy, nervous tension, increased physical activity, hormonal disorders, genitourinary diseases. A few days before menstruation, the production of hormones that stimulate endometrial growth stops. The uterine layer is about 12 mm. If there is no menstruation due to pregnancy, the normal thickness of the endometrium is 11-13 mm.

If the delay occurs due to pregnancy, progesterone continues to be produced, which stimulates the growth of the inner uterine layer. Approximately 3 weeks after fertilization, the thickness of the endometrium reaches 2 cm. Many ultrasound machines determine the onset of pregnancy in the early stages precisely by the increased thickness of the uterine layer.

Normal before menstruation

Before menstruation, the endometrium is in the secretion stage. A week before menstruation, the thickness of the endometrium reaches its maximum value - 18-20 mm. However, in last days During the menstrual cycle, the uterine layer becomes thinner. The uterus is preparing for the release of an unnecessary layer of epithelium, its growth stops. Gradually thickening, the uterine layer becomes thinner. 2-3 days before menstruation it reaches 12 mm.

Pathological conditions

Deviations in the development of the endometrium arise due to various reasons: operations in the uterine cavity, abortions, miscarriages followed by curettage, caesarean sections, inflammatory diseases of the genital organs, hormonal disorders.

The following pathologies affecting the inner uterine layer are distinguished:

• Thinning of the endometrium (hypoplasia). It is diagnosed when there is a deviation from the norm by 0.5-0.8 cm. Most often it occurs due to a lack of endrogens and progesterone. At thin endometrium the uterus becomes vulnerable to infections, making it difficult to conceive and bear a child.
• Excessive thickness of the uterine layer (hyperplasia). Thickening of the endometrium occurs due to hormonal imbalance. The proliferation of the internal membranes of the uterus leads to the formation of benign and malignant tumors, infertility.
• Endometritis. Inflammation of the endometrium is often observed after surgical operations in the uterine cavity. Infection also penetrates into the uterus during prolonged inflammation of the genital organs and the installation of a spiral. The thickness of the uterine layer during inflammation has abnormal indicators.
• Endometriosis. The growth of uterine tissue in uncharacteristic places is observed as a consequence of complications of operations on the uterus.
• Uneven growth of the uterine layer. In this case, in one part of the uterus the endometrium becomes thicker than normal, and in the other - thinner.
• Degeneration of the uterine layer into a malignant tumor.
• Endometrial compaction, formation of cysts and polyps.

Elimination of pathologies depends on the causes that led to the disease. If the change is caused hormonal imbalance, the woman is prescribed hormone therapy. The lack of estradiol is compensated with the help of Divigel. The ripening of the layer is promoted by Utrozhestan and Duphaston. Excess uterine tissue is also corrected with hormone-containing drugs.

In the treatment of pathologies, physiotherapy is used: ozokerite therapy, vaginal irrigation, massage, acupuncture. In some cases, if the endometrium grows abnormally, the excess layer is removed by curettage.

The endometrium is a mucous membrane that lines the inside of the uterine cavity and has a well-developed network of blood vessels. The endometrium creates conditions favorable for the development of the fertilized egg. In addition, it has one of the most important roles in the mechanism of the menstrual cycle.
The endometrium consists of two layers - basal and functional. During menstruation, it is the functional layer that is rejected, which, thanks to the basal layer, is restored in the next cycle. The thickness and structure of the endometrium are completely subordinated hormonal influence. In the second phase of the monthly cycle, this mucous layer grows, its blood supply increases significantly. The uterine cavity is preparing for possible implantation fertilized egg. If pregnancy does not occur, the endometrium rejects the functional layer, and menstrual bleeding occurs.

During an ultrasound, the thickness of the endometrium can be determined. This indicator especially important for those planning a pregnancy. The thickness of the endometrium varies depending on the day of the menstrual cycle:
On days 5-7 of the cycle (early proliferation phase) average thickness the endometrium is 5 mm (from 3 mm to 6 mm).
By the 8-10th day of the cycle (medium proliferation phase), a gradual thickening of the layer is observed - from 5 to 10 mm (on average - 8 mm).
On days 11-14 of the cycle, late proliferation is observed, and the thickness of the endometrium reaches 7-14 mm.
The early secretion phase (15-18 days of the monthly cycle) is characterized by an endometrial thickness of 10-16 mm (average value - 11 mm).
The period of average secretion (19-23 days) is accompanied by maximum thickening of the endometrium, its average thickness is 14 mm, and ranges from 10 to 18 mm.
On days 24-27, the endometrium begins to thin, its average thickness is 12 mm.

Structural abnormalities of the endometrium can be characterized as thinning (hypoplasia) or thickening (hyperplasia) of the endometrium.

Endometrial hyperplasia:

Endometrial hyperplasia is accompanied by changes in the stroma and glands that make up the mucous membrane. In this case, the thickness of the endometrium is sharply increased, the mucous layer grows, which leads to a hyperplastic process.
Endometrial hyperplasia is caused by hormonal pathology, which is characterized by an excess of estrogens and a lack of progesterones. Most often women with diabetes mellitus and other metabolic disorders, as well as patients with arterial hypertension.
In most cases, endometrial hyperplasia is not accompanied by any symptoms, but there are dysfunctional uterine bleeding, anovulation. The hyperplastic process is often detected as a finding during examination for infertility.

Endometrial hyperplasia causes infertility for two reasons:
- lack of ovulation due to hormonal pathology;
- absence favorable conditions for embryo implantation.

Drug treatment endometrial hyperplasia suggests the appointment hormonal drugs. Surgical treatment is also used, which consists in removing the overgrown mucous layer. Severe, serious cases require removal of the uterus. Good results provides a combination treatment: removal of the thickened endometrium with further transfer to low-dose hormonal therapy.

Endometrial hypoplasia (“thin” endometrium):

Due to some gynecological diseases, the endometrium may remain thin throughout the entire monthly cycle. “Thin” endometrium occurs when chronic endometritis, pathologies of estrogen receptors in the endometrium, impaired blood supply to the internal uterine layer.
During ultrasound monitoring, the doctor has the opportunity to assess the thickness and structure of the endometrium and identify the problem of “thin” endometrium. Endometrial hypoplasia is difficult to treat effective therapy, and most often is temporary. Drug treatment involves the use of drugs with high doses of estrogens and low doses of aspirin. The endometrium responds well to the use of physiotherapy, acupuncture, treatment medical leeches. Sage also stimulates endometrial growth.
Remember, any endometrial pathology requires a competent approach to treatment, and this is only possible after identifying specific reasons diseases.

The endometrium is the inner mucous layer of the uterus, equipped with blood vessels. It is responsible for creating favorable conditions for the implantation of a fertilized egg. If pregnancy does not occur, the function of the endometrium is to remove the unfertilized egg from the body along with menstrual blood. Any pathologies of the mucous layer (thickening, thinning) lead to failure in pregnancy. On average, its norm for unhindered implantation of the egg is 0.7 cm.

A thin layer of the endometrium is one of the common pathologies observed in women of reproductive age. Often this problem causes infertility.

Causes and signs of pathology

The thickness of the mucous layer can vary and depends on the day of the menstrual cycle. In the first days it does not exceed 0.5-0.9 cm, and a few days before the start of menstruation it reaches 1.3 cm. If the thickness is below 0.5 cm, we are talking about hypoplasia (thinning) of the endometrium.

Why is the endometrium thinned?

Predisposing factors include:

• hormonal imbalance;
• endocrine diseases;
• congenital disorders in the blood supply to the uterus;
• chronic inflammatory processes in the genitals;
• availability;
• underdevelopment of the uterus;
• frequent use of funds emergency contraception(Postinor).

It should be noted negative influence surgical manipulations that were performed on the uterus. The consequences of curettage performed during abortions are especially dangerous. Some women with thin endometrium experience underdevelopment of the mammary glands, narrow pelvis, short stature, later.

The disease does not have specific signs, so many women who are not planning a pregnancy may not even realize there is a problem. Typically, the diagnosis of hypoplasia is established in the process of determining the reason why pregnancy either does not occur or is terminated in the early stages.

Thinning may be indicated by scanty periods. You should also be wary of painful periods, the presence large clots in the blood, discharge in the middle of the menstrual cycle. Sometimes during reproductive age, uterine bleeding may occur. The listed symptoms should be the basis for a visit to the gynecologist.

The likelihood of pregnancy with this pathology

In most cases, thinning of the uterine mucosa worries women who are planning to conceive or those who have experienced long-awaited pregnancy after previous failures. What to do if the endometrium is thin and how does this affect the development of the fetus?

First of all, women's ability to become pregnant is reduced. naturally, since the thin mucous layer of the uterus prevents the implantation of the fertilized egg.

Is it possible to get pregnant with thin endometrium?

Medicine knows of cases where conception occurred even with a thickness of 0.4 cm. But if pregnancy does occur, the risk of its interruption in the early stages, the appearance of bleeding, and subsequent weakness increases. labor activity and other complications during childbirth.

After conception has occurred, the endometrium continues to grow. In the first trimester, its thickness reaches 2 cm or more. Often, it is its significant increase that allows the doctor to determine pregnancy on an ultrasound, since the fertilized egg itself may not yet be noticeable. In early pregnancy, the thin endometrium requires increased attention on the part of doctors and the appointment of immediate treatment, since it can occur at any time.

Separate mention should be made of the IVF procedure when diagnosing thin endometrium. This procedure is extremely undesirable for such a pathology, since the chances of the embryo being successfully implanted in the uterus are extremely low. The probability of pregnancy with a thickness below 0.7 cm is no more than 15%. Therefore, the patient is advised to postpone the procedure and take appropriate measures.

Diagnosis and treatment

After studying common symptoms The patient is prescribed:

• Ultrasound of the uterus, which is performed several times per different phases cycle;
• general urine and blood tests;
• responsible for the onset and successful course of pregnancy;
• Ultrasound of the pelvic organs;
• taking samples of uterine tissue for histological examination;
• biopsy of the uterine body.

These studies make it possible not only to establish the fact of endometrial thinning, but also to determine the causes of the pathology.

Treatment for thin endometrium depends on the reasons that caused it. In most cases, this is an imbalance of the hormonal system. Therefore, pregnant women with this pathology need hormonal therapy with drugs containing progesterone. Treatment regimens, dosage, and duration of therapy are carried out exclusively by the attending physician on an individual basis.

If hypoplasia is caused by chronic inflammatory diseases genital organs, drug therapy should be aimed at eliminating the source of inflammation. In some cases there may be indications for surgical treatment. It consists of removing the inner layer and further hormone therapy. These methods help to renew the mucous layer of the uterus and normalize its thickness.

For circulatory disorders, treatment with conservative methods, among them: massage, physiotherapy, hirudotherapy, acupuncture, therapeutic exercises.

Drug therapy

To provide normal pregnancy, it is necessary to increase the thin endometrium. The patient may be prescribed combination medications that normalize hormone levels, a course of treatment with estradiol, and medications containing progesterone (Utrozhestan, Duphaston).

• Duphaston

Although this drug is an artificially synthesized hormone, it successfully performs all the tasks that are inherent in progesterone. The product effectively prepares the uterus for the upcoming pregnancy, relieves its muscle tone, and prevents epithelial detachment. The usual regimen for taking the drug is from the 11th to the 25th day of the cycle, but you cannot make a decision about taking it yourself. Admission is carried out only on the recommendation of a doctor.

• Melsmon

The placental drug Melsmon contains placenta taken from women whose births occurred without complications. It is widely used in cosmetology, but is also used to normalize the menstrual cycle and relieve syndrome chronic fatigue, eliminating the symptoms of inflammation.

The drug should not be used during pregnancy or in cases of malfunction endocrine system, renal or liver failure, high blood pressure.

• Actovegin

Actovegin is intended to maximize blood circulation in the genital area. Increasing blood circulation is the key to successfully overcoming hypoplasia. The standard dosage regimen involves taking 1-2 tablets three times a day. Typically, the course of treatment lasts 4-6 weeks, determined by the doctor individually. The drug can also be taken during pregnancy, starting from the 16th week, when the formation of the placenta ends.

• Gormel

This product belongs to homeopathic medicines. It activates the synthesis of estrogen. It consists of natural ingredients And alcohol tincture. The regimen for taking the drug is as follows: 10 drops are mixed with half a glass of water and the mixture is drunk half an hour to an hour before meals three times a day. The duration of treatment can vary from one to three times a month, depending on the results obtained.

Since the drug contains alcohol, it should not be taken during pregnancy. Contraindications also include brain injuries and diseases, renal failure. The drug should be completed before the stage of active pregnancy planning.

In case of thin endometrium, it should be carried out only as prescribed by a doctor and under his strict supervision. The use of the drug Clostilbegit can lead to even greater thinning, so it is usually taken simultaneously with the estrogen-containing drug Proginova.

Physiotherapy

Physiotherapy procedures indicated for thin endometrium have a number of advantages. They provide gentle therapeutic effect, do not call side effects, reduce drug dependence. They are usually prescribed as part of complex therapy.

Treatment uses magnetic therapy, ultrasound, ultraviolet light, massage, and mud baths. Most favorable period for treatment - the first days after the end of menstruation. You can enhance the effect of physiotherapy by following the rules of nutrition, taking walks fresh air, regularly doing therapeutic exercises.

Treatment with folk remedies

In addition to using medications, you can grow the endometrium using folk remedies.

1. Sage tea. A teaspoon of crushed plant is poured into 200 ml of boiling water and left to infuse for several hours. The resulting infusion is taken for four months in the first half of the menstrual cycle.
2. Infusion of boron uterus. 2-3 teaspoons of the plant or ready-made sachets purchased at the pharmacy are poured with a glass of boiling water. After infusion for a quarter of an hour, you can take it daily.
3. Pineapples and pumpkin, which are allowed to be eaten in unlimited quantities, provided that you are not allergic to these products. You can drink pineapple and pumpkin juices.
4. Raspberry leaf tea. The prepared leaves are poured with boiling water and the tea is drunk in small quantities several times a day.
5. A combined decoction prepared from elderberry inflorescences, yarrow herbs, mint, chamomile, nettle, and medicinal cap. A mixture of components taken in equal proportions is poured into 1 liter of boiling water, infused for an hour and taken half an hour before meals 3-4 times a day.

Regular treatment with folk remedies gives positive results in just a few months. However, the use of any means traditional medicine must be reinforced drug therapy and carried out in consultation with the attending physician. It should be noted that some herbs have contraindications for use if the patient has other diseases.

Diet

The basis of successful treatment is proper nutrition. It must include foods rich in vitamins A and E, as well as foods with high level salicylates. You should include in your diet fatty varieties fish, vegetables (tomatoes, sweet pepper, spinach, cucumbers, beans, cabbage), fruits and berries (grapes, apples, currants, raspberries), dried fruits, honey, red wine.

A variety of spices are useful, such as paprika, thyme, cinnamon, curry. At the same time, a woman needs to limit her intake of fatty and sweet foods, as well as fast food, strong coffee and tea.

Plays an important role in growing the endometrium active image life. It is useful to play sports and dance, visit the pool. It stimulates active blood circulation, which has a positive effect on his condition.