Causes of poor endometrial morphology

The endometrium is an important component of the uterus. The endometrium has a certain shape. If the shape of the endometrium is poor, for example, the endometrium is too thin or proliferates, it will have a direct impact on women's fertility. There are certain reasons for these problems. Below, we will introduce to you the common causes of poor endometrial morphology!

1. No ovulation

Anovulation may occur in adolescent girls, perimenopausal women, those with a disorder in a certain link of the hypothalamus-pituitary-ovarian axis, polycystic ovary syndrome, etc., causing the endometrium to be continuously affected by estrogen for a longer period of time, without progesterone to counteract it, lacking the transformation of the cyclical secretory phase, and being in a state of hyperplasia for a long time. In patients with atypical endometrial hyperplasia under the age of 40, except for focal atypical hyperplasia, more than 80% of the other endometrium has no secretory phase; 70% of the basal body temperature measurement results are monophasic. Therefore, most patients do not ovulate.

2. Obesity

In obese women, androstenedione secreted by the adrenal glands is converted into estrone by aromatase in adipose tissue; the more adipose tissue there is, the stronger the conversion capacity and the higher the estrone level in the plasma, thus causing a sustained estrogen effect.

3. Endocrine functional tumors

Endocrine functional tumors are rare tumors, but in research statistics, endocrine functional tumors account for 7.5%. The gonadotropin function of the pituitary gland is abnormal, and ovarian granulosa cell tumor is also a tumor that continuously secretes estrogen.

4. Abortion and curettage damage the endometrium

The endometrium is divided into three layers. The top layer peels off every month, while the middle and bottom layers do not peel off. If the middle layer is damaged, the impact is not significant. If the bottom layer is damaged, the consequences will be more serious.

5. Estrogen replacement therapy

During the perimenopause or postmenopause period, there is menopausal syndrome due to estrogen deficiency, and there may also be osteoporosis, abnormal lipid metabolism, cardiovascular changes, and even changes in brain cell activity. Therefore, ERT has gradually been widely used and has achieved good results. However, ERT, with estrogen alone, can stimulate endometrial hyperplasia. One year of estrogen use alone can cause endometrial hyperplasia in 20% of women (Woodruff 1994). The use of ERT is often continuous for years, or even for a lifetime. If it is not combined with progestins for a long time, severe endometrial hyperplasia or even endometrial cancer will occur.