Why does the endometrium thicken?

Many women have problems with heavy menstrual flow. When they go to the hospital for a check-up, the doctor will tell them that it is because their uterine wall is thicker. So, what causes endometrial thickening?

1. Body elements

The affected uterus is slightly larger, and the endometrium is significantly thickened, sometimes with diffuse polyp-like appearance. The amount of curettage material is large and may be stained with bright red, smooth polyp-like tissue. Microscopically, the lesions were focal, invading the functional layer and dermis of the endometrium, and the glandular ducts were not blocked due to the simultaneous proliferation of the stroma and the glandular ducts. The glandular ducts vary in size and have smooth outlines. The shape of glandular epithelial cells is similar to that of normal late reproductive stage and has no atypia.

2. Endocrine factors

In obese women, androstenedione, metabolized by adrenaline, is converted into estrone by aromatase in adipose tissue; the more adipose tissue there is, the stronger the conversion capacity is, and the higher the level of estrone in the blood is, thus causing a sustained estrogen effect. Women in menopause lack estrogen in their bodies, and the uterine wall proliferates due to the action of estrogen. Causes thickening of the endometrium.

3. Symptom elements

Primary disease factors: The etiology of complex hyperplasia is similar to that of simple hyperplasia, but because the disease is localized, it may also be related to the distribution of growth hormone protein kinase in the tissue. A very small number of complex hyperplasia may develop into intestinal metaplasia, which in turn affects the prognosis. The diseased uterine wall can become thick or thin and can also take on the appearance of polyps.

Unlike simple hyperplasia, the disease becomes a focal hyperplasia of the glandular duct components without invading the interstitial space. The amount of curettage material can be large or small, and is often contaminated with normal, atrophic or other types of hyperplastic uterine wall.

Secondary disease factors: Endocrine multifunctional tumors are rare tumors, accounting for 7.5% of endocrine multifunctional tumors. The gonadotropin function of the pituitary gland is abnormal, and uterine ovarian granulosa cell tumors are also tumors that continuously metabolize estrogen.