endometrial thickness
Introduction
Introduction to endometrial thickness The thickness of the endometrium is different in different periods of the menstrual cycle. It is recommended to do a vaginal B-ultrasound three days after the menstruation is clean to understand the specific thickness of the endometrium. If the endometrium is thick, it is easy to be painful during menstruation, and the fertilized egg is not easy to be implanted! The inner membrane of the uterus is thicker than normal. The thick inner membrane cannot determine whether it can be pregnant. Whether or not ovulation is the key to pregnancy. Normal is generally 0.2--1.0 cm. The endometrium is the mucosa covering the uterine cavity, which is one of the most differentiated tissues in the human body. The thickness of the normal endometrium is constantly changing with the menstrual cycle and is not constant. basic knowledge The proportion of illness: 0.03% Susceptible people: women Mode of infection: non-infectious Complications: endometrial cancer
Cause
Endometrial thickness cause
Endocrine factors (40%):
In obese women, androstenedione secreted by the adrenal gland is converted to estrone by aromatase in adipose tissue; the more adipose tissue, the stronger the transformation ability, the higher the level of estrone in plasma, thus causing persistent estrogen Impact.
Primary disease factor (15%):
The etiology of complex hyperplasia is similar to that of simple hyperplasia, but because the lesion is focal, it may also be related to the distribution of hormone receptors in tissues. A small number of complex hyperplasia can develop into dysplasia, which affects the prognosis. The endometrium of the lesion can be thickened or thin, or it can be polypoid. Unlike simple hyperplasia, the lesion is a focal hyperplasia of the glandular component without involving the stroma. The amount of curettage can be more or less, often mixed with normal, atrophic or other types of hyperplasia of the endometrium.
Secondary disease factors (15%):
Endocrine functional tumors are rare tumors, accounting for 7.5% of endocrine functional tumors. The gonadotropin function of the pituitary gland is abnormal. Ovarian granulosa cell tumor is also a tumor that continuously secretes estrogen.
Body factor (10%):
The diseased uterus is slightly larger, the intima is thickened, and sometimes it is diffuse polypoid. The amount of curettage is large, and it can be mixed with red smooth polypoid tissue. The lesions under the microscope are diffuse, involving the functional layer of the intima and the basal layer, and the gland is not crowded due to the simultaneous proliferation of the interstitial and gland. The glands are of different sizes and have a smoother outline. The morphology of glandular epithelial cells is similar to the normal late proliferative phase and has no atypia.
Prevention
Endometrial thickness prevention
Pay attention to the menstrual cycle, menstrual flow, etc. If the menstrual disorder occurs, seek medical attention as soon as possible. The thickness of the endometrium is different in the two periods of the menstrual cycle. It is recommended to do a vaginal B-ultrasound to investigate the detailed thickness of the endometrium after three days of menstrual cleansing. If the endometrium is thick, it is easy to pass through during menstruation, and the fertilized egg is not easy to implant. That is, the intima of the uterus is thicker than the strong one, and the intima is thin and should not be treated for pregnancy. Whether or not ovulation is the key to pregnancy. Strong is generally 0.2--1.0 cm.
Complication
Endometrial thickness complications Complications endometrial cancer
First, the ovarian hormone disorder, easily lead to abnormal endometrial thickening, due to a large number of estrogen stimulation of the endometrium.
Second, the irregular amount is one of the hazards of endometrial thickness. After a long period of amenorrhea, continuous bleeding occurs, showing a shortened cycle and a bleeding time of up to 1 month.
Third, the normal endometrial thickening, is harmful to the body, pathological examination of the extent of endometrial proliferation and the severity of bleeding is not completely consistent.
Fourth, the endometrium is grayish white, the surface is flat or polypoid-like protrusions, and the cut surface sometimes shows the cystic space formed by the dilated glands.
Symptom
Endometrial thickness symptoms common symptoms uterine bleeding pain amenorrhea female infertility
The normal endometrial thickness of women is generally 2-10 mm, but there will be different changes in different periods. If a female friend finds abnormality of endometrial thickness after pre-pregnancy examination, it is necessary to timely treat the disease. Otherwise it will affect the future birth.
Thin endometrium means that under the action of certain estrogens, the inner membrane cannot reach 8 mm when doing ultrasound. These factors can cause the egg to not be implanted well, so that it cannot be conceived as originally planned.
Generally, the thickness of normal endometrium varies from 2 to 10 mm, and the thickness of the endometrium is different at different times:
Proliferative phase
In the early stage of hyperplasia, the endometrium is a thin echo line with a thickness of about 4-6 mm. In the mid-proliferation stage, the endometrium gradually shows three strong echo lines, in which the hypoechoic area is a two-layer functional intima with an intima thickness of about 8-10 mm. In the late stage of hyperplasia, the three-line and two-zone are more clearly visible, and the thickness of the intima is widened, about 9-10 mm.
Secretory phase
Early secretory phase: the 15th to 19th of the menstrual cycle. During this period, the membrane glands are longer and the flexion is more pronounced. Glycogen-containing vesicles begin to appear under the nucleus of glandular epithelial cells, and are called vacuoles under the nucleus, which is an early histological feature of secretion.
Mid-secretory period: 20-23 of the menstrual cycle. The inner membrane is thicker and serrated than the front. The apical membrane of the secretory epithelial cells in the gland is broken, and the glycogen in the cells is discharged into the human gland. During this period, the body is highly edematous, loose, and the spiral arterioles proliferate and curl.
Late secretory phase: 24-28th of the menstrual cycle. This period is the premenstrual period of menstruation. The endometrium is thickened in a sponge shape. The endometrial gland opening faces the official cavity, and there are secretions such as glycogen spilling out. The interstitial is more loose and edematous. The interstitial cells under the surface epithelial cells differentiate into hypertrophic aponeurotic cells. In this period, the spiral arterioles rapidly grow beyond the thickness of the intima, and are also more curved, and the lumen of the blood vessels also expands. When the secretion is advanced, the thickness of the endometrium is about 5 to 6 mm.
Menstrual period
The 1-4th day of the menstrual cycle. At this time, the levels of estrogen and progesterone are decreased, and the synthesis of prostaglandins in the intima is activated. Prostaglandins can stimulate the contraction of the myometrium and cause the spiral arterioles of the intimal functional layer to continue to paralyze, and the intimal blood flow is reduced. The area of necrotic tissue damaged by ischemia is gradually enlarged. Tissue degeneration, necrosis, increased permeability of the blood vessel wall, rupture of blood vessels leading to the formation of hematoma at the bottom of the intima, promoting tissue necrosis. The degenerated, necrotic intima is mixed with blood and discharged to form menstrual blood. The endometrial thickness can reach 8-10mm.
The menstrual cycle is mainly regulated by the hormones of the ovaries. If the ovarian hormones are disordered, it will also cause menstrual disorders, and the endometrium also has corresponding morphological changes. The endometrial changes caused by various reasons are mainly manifested as amenorrhea and "dysfunctional uterine bleeding" in clinical practice. Need to go to a specialist hospital for treatment in time.
Examine
Endometrial thickness examination
The thickness of the endometrium is different in the two periods of the menstrual cycle. It is recommended to do a vaginal B-ultrasound to investigate the detailed thickness of the endometrium after three days of menstrual cleansing. If the endometrium is thick, it is easy to pass through during menstruation, and the fertilized egg is not easy to implant. That is, the intima of the uterus is thicker than the strong one, and the intima is thin and should not be treated for pregnancy. Whether or not ovulation is the key to pregnancy. Strong is generally 0.2--1.0 cm.
Diagnosis
Diagnosis and differentiation of endometrial thickness
Diagnosis can be made based on the results of the examination. The thickness of the endometrium is different in the two periods of the menstrual cycle. It is recommended to do a vaginal B-ultrasound to investigate the detailed thickness of the endometrium after three days of menstrual cleansing. If the endometrium is thick, it is easy to pass through during menstruation, and the fertilized egg is not easy to implant. That is, the intima of the uterus is thicker than the strong one, and the intima is thin and should not be treated for pregnancy. Whether or not ovulation is the key to pregnancy. Strong is generally 0.2--1.0 cm.
