Is it okay to not have a curettage if the endometrium is thick?

The physiological structure of women is very complex, which can easily lead to some gynecological diseases in women. Some women have thin endometrium, and some women have thick endometrium. If the endometrium is thick, it will cause great harm to women's health. However, there are currently many methods to treat thick endometrium. Everyone must choose the treatment method that suits them under the guidance of a doctor.

Is it okay to not have a curettage if the endometrium is thick?

For women with thickened endometrium and over 45 years old, it is recommended that they undergo curettage as the first treatment, so that it is easier to obtain biopsies for testing. But since you are relatively young, you can avoid having a curettage and instead take medication to treat the condition.

First of all, under normal circumstances, if a younger female friend suffers from endometrial thickening, most of them belong to the type of anovulatory functional uterine bleeding, so the patient should measure the basal body temperature. If it is confirmed to be monophasic anovulation, then it is recommended that the patient can use ovulation induction treatment.

Secondly, it is found clinically that if the patient is already in the menopausal transition period and suffers from this disease, then in general it is anovulatory functional uterine bleeding. Therefore, we recommend that patients and friends here that if their menstruation is still infrequent and the amount of bleeding is relatively large, or the bleeding time is relatively long after curettage to stop bleeding, then they should receive progesterone treatment regularly every two months. Usually, it only takes 3 cycles of treatment to be cured.

In addition, for some female friends who are in the reproductive period and suffer from endometrial thickening, curettage is indeed the best treatment method. However, if the patient still has bleeding after curettage, she should undergo hysteroscopy. The purpose of this is to ensure that the submucosal fibroids have not developed lesions. If the clinical manifestation is polycystic ovary syndrome with anovulation, then it should be treated according to polycystic ovary syndrome.

Causes of endometrial thickness:

1. Obesity: The first cause of endometrial thickening is obesity. The adrenal glands of obese women secrete more androstenedione, which is converted into estrone through a substance called aromatase in the adipose tissue. The more fat on the body, the higher the estrone level in the plasma, the higher the female hormone level, and the thicker the endometrium.

2. Endocrine functional tumor: This is a less common tumor in clinical practice. The gonadotropin function of patients with endocrine functional tumors is abnormal, resulting in more estrogen being secreted and the endometrium gradually thickens.

3. Simple hyperplasia of the endometrium: The uterus of patients with simple hyperplasia of the endometrium is larger than the normal uterus. Sometimes polyps will appear inside, and the thickness will naturally increase a lot. The morphology of glandular epithelial cells in these patients is similar to that of normal late proliferative phase and does not show atypia.

4. Complex endometrial hyperplasia: Another cause of endometrial thickening is complex endometrial hyperplasia. Its cause is similar to simple hyperplasia, but its condition is much more complicated. If complex uterine hyperplasia is not treated in time, it will eventually turn into atypical hyperplasia. It differs from simple hyperplasia in that the lesion is a focal proliferation of glandular components without involving the stroma.