hyperplasia of the endometrium. Types of hyperplasia, causes, symptoms and diagnosis. Treatment of various forms of hyperplasia. What should be the norms of endometrial thickness on the days of the cycle
Content
Many diseases in the field of gynecology are associated with the pathology of the body of the uterus. From the inside, the cavity 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 the formation of suitable conditions for the introduction of a fertilized egg into it.
The endometrium consists of two layers: functional and basal. The functional layer builds up each month during the menstrual cycle and is shed by the uterus at the end of it, influenced by the complex interaction of the hormones estrogen and progesterone. The rejected layer comes out through the cervix, which is ajar during menstruation, in the form of spotting. 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 due 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 is possible to measure its thickness with the help of ultrasound with a vaginal probe of the pelvic organs.
The thickness of the mucous membrane of the inner layer of the uterus is a non-constant value. It varies in women of reproductive age depending on the day of the cycle. In 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 mucosa 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 fixed from the nineteenth to the twenty-third day;
- from the twenty-fourth day of the menstrual cycle, there is a decrease in the thickness of the mucous layer of the uterus.
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 postmenopausal women, the thickness of the functional endometrium should not exceed eleven millimeters.
Under the influence of various factors and causes, the endometrium undergoes changes that cause its pathological conditions. Among the most common pathologies of the inner layer of the uterine mucosa, hyperplasia of its endometrium can be distinguished. Endometrial hyperplasia is a pathological thickening of the inner layer of the uterus in excess of the established norm. This overgrowth is the result of changes that occur in the glands and stroma of the endometrium. Over time, the mucosa becomes much thicker than required for its normal functioning.
As a rule, hyperplasia is characteristic of hormonal imbalance and some concomitant diseases in the body. For example, diseases such as diabetes mellitus and high 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 decrease in progesterone levels. The result of such an incorrect interaction of hormones is hyperplasia of the 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.
The thickness of the functional endometrium with different types of hyperplasia
It should be noted that the endometrium with hyperplasia can grow unevenly with the preservation of healthy areas. In this case, one speaks of 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 surface of the mucosa is smooth.
The thickness of the functional endometrium also depends on the type of hyperplasia.
- With glandular hyperplasia, the mucosa thickens with the help of the multiplication of cells that are in the connective and glandular tissue. There are two forms of the disease: acute and chronic.
- Glandular cystic hyperplasia is manifested by blockage of the glands of the tissue, which causes the formation of cysts.
- Atypical hyperplasia or adenomatosis is manifested by pathological cell proliferation with a change in the structure of the nucleus. This phenomenon may indicate the presence of oncology.
Symptoms of thickening of the uterine mucosa
This pathological condition of the uterine mucosa is characterized by asymptomatic progression. A woman can suffer from hormonal disorders for years and not be aware of the presence of endometrial hyperplasia.
Symptoms of hyperplasia usually includes:
- profuse bleeding 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 the thickness of the inner layer of the uterine cavity does not play a big role in the study.
Normally, the thickness can vary up to eighteen millimeters, depending on the day of the menstrual cycle. If necessary, it is recommended to measure the thickness of the mucosa before the onset of ovulation.
Often in gynecological practice, there is a lack or violation of ovulation and the cycle while maintaining the normal thickness of the functional endometrium. Such an inner layer of the uterine cavity may not always be of good quality for fertilization.
Women after menopause may experience spotting and even bleeding. In such cases, an examination is indicated with a mandatory measurement of the thickness of the mucous layer. In healthy women of this category, the thickness does not exceed five millimeters. If the excess according to the results of ultrasound is insignificant, then in the absence of complaints, the patient is under the control of a doctor and is regularly examined. In the presence of concomitant pathologies, for example, cysts and a significant excess of the normal thickness of the functional endometrium, a diagnostic curettage procedure is required.
Diagnostic curettage with hysteroscopy is one of the most valuable methods used in gynecology.
During the procedure, the doctor, using special tools, scrapes the uterine cavity with a sample of material for further research. The procedure can be used both for diagnosis and as a treatment. If curettage of the uterine cavity and cervical canal is required, they talk about 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 growth of the mucosa occurs at the level of cells and tissues, which can be detected by examination under magnification. According to the results of only an ultrasound examination of the pelvic organs using a vaginal probe, it is not enough to reveal the pathology. It is not uncommon for the thickness of the mucosa to be measured incorrectly. Endometrial hyperplasia is also sometimes accompanied by cysts and polyps, which cannot be carefully studied with the help of equipment. It is possible to judge their good quality only after special histological studies.
Endometrial hyperplasia is a rather insidious disease. If untreated, this pathology can cause.
- Abundant nature of menstruation. Regular blood loss negatively affects health in general: over time, general well-being worsens, anemia develops.
- Infertility. The altered endometrium is not able to provide normal nutrition to the embryo during implantation. Often, the introduction of the fetal egg into the walls of the uterus is not at all possible due to the pathological growth of the mucosa.
- Pathology of the fetus during developing pregnancy. There are frequent cases of oncological disease in a fetus that develops in conditions of endometrial hyperplasia.
- The development of cystic formations in the uterine cavity. The endometrium thickens unevenly in the uterine cavity, some areas are converted into cysts and polyps of various sizes.
- Malignant tumors. Some forms of thickening of the functional endometrium over time can degenerate into cancer.
Endometrial hyperplasia is often complicated other pathologies of the female genital area. The growth and thickening of the tissue leads to various disorders: fibroids, endometriosis, chronic inflammation in the reproductive system.
In order to determine the thickening of the mucosa, 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, diabetes mellitus should be extremely attentive to their health and well-being, and also be examined for hyperplasia or thickening of the functional layer of the uterus. This pathology can be quite successfully eliminated by adequately selected treatment, including mandatory hormonal therapy. It must be remembered that the proliferation of the mucosa, which is not cured in time, can eventually degenerate into a malignant tumor.
The thickness of the endometrium is a relative value, but nevertheless, it is an indicator of ongoing processes and hormonal balance in the female body. Knowing the thickness of the inner lining of the uterus, it is possible to determine the phase of the menstrual cycle, age, and also draw preliminary conclusions about the general state of a woman's health.
But, as a rule, gynecologists go from the opposite, or rather, compare the actual value with the established norms. Each age group is characterized by its own indicators, for example, the thickness of the endometrium, which is considered the norm during menopause, is not suitable for conceiving a child and indicates obvious violations.
We will talk in more detail about the norms of the endometrium characteristic of a certain age period in this article.
The norm of the endometrium for conception
The endometrium of a woman of reproductive age regularly undergoes cyclic changes. The thickness of the functional layer of the inner membrane changes mainly, which actively thickens, up to the onset of ovulation and several days after it, and then gradually atrophies and is rejected during menstruation.
This complex process is completely regulated by hormones, so it immediately reacts to the slightest hormonal disruption.
The thickness of the endometrium is of fundamental importance for women planning a pregnancy. Since normally, the thickness of the endometrium reaches its maximum value at ovulation, thereby creating favorable conditions for the implantation of a fertilized egg. In addition, in order for the embryo to attach and begin to develop, the mucosa must be mature, and its structure must be appropriate.
So, depending on the phase of the menstrual cycle, the thickness of the endometrium varies:
If pregnancy has occurred, and the fetal egg is securely in the uterine mucosa, then the latter continues to actively develop. Normally, the endometrium thickens during pregnancy, enriched with blood vessels. For a period of 4-5 weeks, its value will reach 20 mm, and even later it will be converted into which will serve as protection and supply the fetus with nutrients and oxygen.
The norm of the endometrium in menopause
First of all, menopause is characterized by a decrease in estrogen production, which cannot but affect the organs of the reproductive system. In particular, the uterus, ovaries, vagina and mammary glands react to changes.
During menopause, the inner layer of the uterus becomes thin and loose, and eventually completely atrophies. Normally, the thickness indicators during this period are 3-5 mm. If the actual values are increased, then we are talking about pathological hypertrophy. The symptoms of this condition can be different in intensity of bleeding, starting with a brown daub, ending with profuse blood loss. In the first case, the condition is corrected by hormonal therapy, in the latter - by surgical intervention.
- This is the inner layer of the uterus, very sensitive to hormonal changes in the body. Many women know a disease called endometriosis. It is accompanied by many complications and is difficult to treat.
Growth or pathological thinning of the endometrium is a problem that a huge number of women face. During menopause, hormonal changes begin, which can affect the endometrium, causing changes.
Endometrium: functions and normal thickness in menopause
Causes and signs of endometrial thickness deviation in menopause
During menopause, they only talk about endometrial hyperplasia, since a decrease in this layer during menopause is normal.
However, if the endometrium during menopause has a thickness of more than 5 mm, they speak of a pathological condition that requires.
Almost always, the reason is a violation of the hormonal background, which controls the growth of the endometrium. This condition can be asymptomatic for a long time or manifest as breakthrough pain in the lower abdomen.
It is possible to determine endometrial hyperplasia, like endometriosis, only with the help of.
There are varieties of endometrial hyperplasia:
- glandular. Glandular hyperplasia of the endometrium is considered a benign disease, accompanied by the growth and thickening of the glandular tissue due to the incorrect location of the glands. With timely treatment, the prognosis is favorable.
- Cystic. A more serious disease that may be a consequence of the glandular form. At the same time, neoplasms are also formed in the endometrium, which can eventually degenerate into a malignant tumor.
- Basal. This is a very rare and serious condition that is difficult to treat. The basal layer of the endometrium rarely grows, as a rule, it is unchanged, and is also difficult to treat with hormone therapy.
- Polypoid. With this disease, the endometrium thickens not over the entire surface of the uterus, but focally. The foci are located where the endometrium is formed. This condition is often accompanied by bleeding and is treated with curettage, which is also a diagnostic procedure.
- Atypical. The most dangerous hyperplasia, which is rare, but still occurs in women during menopause. At the same time, the endometrium grows very actively, and the cells quickly degenerate. It is difficult to treat such a disease, often it is necessary to resort to surgical removal of the uterus in order to avoid cancerous tumors.
Diagnostics
If a woman goes to the doctor with complaints of bleeding and pain during menopause, she must undergo a series of diagnostic procedures before diagnosis and treatment. In the case of endometrial hyperplasia, it should be complex.
It includes an examination on a gynecological chair, and some invasive procedures that will help clarify the diagnosis and type of hyperplasia:
- . This procedure is considered the main one in the diagnosis of endometrial hyperplasia. To assess the thickness of the endometrium, a transvaginal ultrasound is performed. The procedure is carried out using a special nozzle, which is painlessly inserted into. If the endometrium is larger than 5 mm during menopause, the ultrasound procedure is repeated several more times within six months. With an endometrial thickness of 8-10 mm, as a rule, treatment and curettage are already prescribed.
- Diagnostic curettage. This procedure is both diagnostic and therapeutic. It is performed under anesthesia. The entire uterine cavity is scraped, after which, after a while, the woman stops bleeding. The contents are sent for histology to determine the presence of cancer cells.
- . An endometrial biopsy will be informative only if the endometrium did not grow in foci, but completely over the entire surface of the uterus. This procedure will help determine the exact thickness of the endometrium, pathological processes in it, and oncological diseases. The procedure is carried out using a pipel, which is a flexible thin tube with a piston. Once in the uterus, the pipel sucks up small particles of the endometrium.
- uterus and fallopian tubes. This procedure is very informative in detecting tumors, polyps in the uterus and adhesions in the fallopian tubes. The procedure is invasive, as the uterine cavity is filled with a contrast agent before the image is taken. The procedure is unpleasant, but should not cause pain.
Medical and surgical treatment
Serious diseases such as endometritis and are not recommended to be treated exclusively with folk remedies at home. They can be cured only with the help of hormone therapy, and sometimes with the help of surgery.
Before starting treatment, the doctor determines the cause of the disease and the type of hyperplasia. Since the endometrium is very sensitive to changes in the hormonal background, it is also necessary to treat various pathologies with the help of.
Women's hormones during menopause fail. With an increased amount of estrogen and a reduced one, the endometrium thickens. The risk group includes women with and overweight, who often have problems with the hormonal background.Hormonal contraceptives such as Logest, Regulon, etc. are prescribed as hormonal therapy. They are prescribed in courses up to six months to normalize hormonal levels. It has been proven that taking these drugs does not provoke.
Often, with thickening of the endometrium, drugs such as Duphaston, Utrozhestan are prescribed.
These are hormonal drugs, analogues of progesterone. As mentioned above, the endometrium is sensitive to hormones and grows with a lack of progesterone. They are considered safe and are prescribed to normalize hormonal levels even during pregnancy. The dosage is prescribed by the doctor. The course of treatment for endometriosis lasts a long time from six months to 9 months.
More information about what endometrial hyperplasia is can be found in the video:
Surgical intervention is resorted to only in extreme cases. First, scraping is prescribed. If there is no progress, laparoscopy may be prescribed, in which the foci of endometrial growth are cauterized with a laser.
If the treatment does not work, there is a risk of cancerous tumors, the uterus is removed. There are several types of such operations. Depending on the severity, either only the uterus, or the uterus and cervix, or the cervix and all nearby lymph nodes are removed.
Consequences and prevention
In reproductive age, endometriosis can lead to. During menopause, this disease is dangerous degeneration into a malignant neoplasm. With age, the risk of cancer increases, and thickening of the endometrium, its inflammation and polyps are a precancerous condition. complications.
It is worth remembering that with any manifestations of endometriosis or endometritis, you need to consult a doctor. Uterine bleeding is always an alarming symptom, which is not recommended to be ignored.
Norms of endometrial thickness
1 - 2 day of the cycle– 0.5 – 0.9 cm
3 - 4 day of the cycle– 0.3 – 0.5 cm
5 - 7 day of the cycle– 0.6 – 0.9 cm
8 - 10 days of the cycle– 0.8 – 1.0 cm
11 - 14 days of the cycle– 0.9 – 1.3 cm
15 - 18 days of the cycle– 1.0 – 1.3 cm
19 - 23 day of the cycle– 1.0 – 1.4 cm
24 - 27 day of the cycle– 1.0 – 1.3 cm
Thickness of the endometrium for conception, on average, it should be about 7 mm or more, of course, there have been cases of pregnancy with an endometrium of 5 mm, but in such cases, support is needed in the form of duphaston or utrozhestan for several weeks of pregnancy, many wrote that when they became pregnant with a small enometrium, they were prescribed insert utrozhestan vaginally, as it is more quickly absorbed into the uterine layer, thereby helping to strengthen the endometrium.
To build up a layer of the endometrium usually doctors prescribe hormonal preparations containing estradiol - this Proginova
(pills), Femonston
(tablets containing estradiol and a small amount of progesterone), Divigel
- dosed gel in sachets of 0.5 g and 1 g each (rubbed into the lower abdomen, lower back, buttocks, absorbed and absorbed through the skin layer into the blood)
Folk ways to build up the endometrium -
Gormel - geomeopathy
Gynocochel- homeopathy
From 5 d.c. raspberry leaves are brewed and drunk in the first phase as tea.
Also in the first phase they eat fresh pineapples, some eat canned ones, but they contain less natural vitamins. The girls who wrote that Pineapple helped them said that they ate a lot of it fresh and the result was significant compared to other cycles.
Follicle diameter on
*10th day of the cycle- 10 mm,
*on the 11th day- 13.5 mm,
*on the 12th day- 16.6 mm,
*on the 13th day- 19.9 mm,
*on the 14th day- 21 mm - Ovulation Peak
Deviation from the norm is also the norm! - The follicle can grow early, up to 10-12d.c., or, on the contrary, late, after 14d.c., such cases are not rare.
Several cycles per year (1-2) ovulation may not be and this is the norm.
If ovulation is not observed for several cycles in a row, then you should go to the doctor and donate blood for the hormones responsible for the growth of the follicle, these are the hormones Lg + Fsh, Prolactin and thyroid hormones. In the case when the treatment does not help restore ovulation, then they resort to ovulation stimulation, mainly pills Clostilbegit. In this case, additional support for the growth of the endometrium and support for the second phase are prescribed, as well as injection hcg (chorionic gonadotropin) (drugs: Gonakor; Pregnil; Profazi; Horagon;). The required dosage is selected at the discretion of the doctor (usually it is about 5000-10000 IU). with a dominant follicle.
There are also more expensive drugs for ovulation stimulation, but they are mainly prescribed for stimulation in IVF protocols or with artificial insemination.
Some scheme stimulation -
1 scheme - :
Klostilbegit with 5 d.c. by 9d.ts (in some cases from 3d.ts. to 7d.ts.)
Proginova or Divigel. In some cases, support for endometrial growth is not prescribed.
HCG injection, usually 5000 units. or 10000 units. In some cases, injections are prescribed in several stages at the discretion of the doctor, for example, injections of 1500 units every two days until ovulation.
Duphaston or utrogestan. In some cases, progesterone injections are prescribed.
2 scheme -:
Puregon, menogon, Gonal-f- drugs of the gonadotropic series (gonadotropins - hormones produced in the anterior pituitary gland of the brain that stimulate the growth and maturation of follicles in the ovaries).
Unlike the first stimulation schemes, the second one is more gentle on hormones, that is, clostilbegit inhibits the growth of the endometrium in most cases, while Gonal-f and other drugs do not require parallel intake of estrogens, only if indicated.
Gonal-f, for example, is injections in the stomach, a syringe pen in which you can put the injection dosage. Any dosage is prescribed by a doctor. In a normal cycle, 500 units (+ -) of the total dosage may be enough, and in Eco protocols 2 times more.
The size of the uterus, ovaries:
It is believed that the upper limit of the normal size of a non-pregnant uterus are:
The length of the uterus70mm
The width of the uterus60mm
Anterior-posterior size of the uterus -42mm
Normally, the ovaries have the following dimensions:
Width - 25 mm
Length - 30 mm
Thickness - 15 mm.
The size of the ovum by week
3 weeks - 0.1-0.2 mm.
4 weeks - does not exceed 0.5 mm
5 week - 1.5 mm.
6 weeks - 4mm.
7 weeks - 1.5 cm.
8 weeks - 2.2 cm.
9 weeks - 13-17 mm.
10 weeks - 27-35 mm.
11 weeks - 55 mm.
12 weeks - 70-90mm.
13 weeks - 10.5 cm.
14 weeks - 12.5-13 cm.
15 week - 93-103 mm.
16 weeks - 16cm.
17 weeks - 15-17cm.
18 weeks - 20.5 cm.
19 weeks - 20-22 cm.
20 weeks - 25 cm.
21 weeks - 25 cm.
22 weeks - 27-27.5 cm.
23 weeks - about 30 cm.
24 weeks - about 30 cm.
25 weeks - 31cm.
26 weeks - 32.5-33 cm.
27 weeks - 34 cm.
28 weeks - 35cm.
29 weeks - 36-37 cm.
30 weeks - about 37.5 cm.
31 weeks - 38-39 cm.
32 weeks - 40cm.
33 weeks - about 42 cm.
34 weeks - about 42 cm.
35 weeks - about 45 cm.
36 weeks - 45-46 cm.
37 weeks - 48 cm.
38 weeks - about 50 cm.
39 weeks - about 52cm.
40 weeks - about 55cm. average weight 3000-3500kg.
But also by the time of birth, the child can weigh 4000 kg or more, it all depends on the physiology.
Implantation
Speaking about the fact that implantation usually occurs 7-10 days after ovulation, you need to know that sometimes early and late implantation occurs. The probability of implantation depending on DPO is presented in the list:
* 3-5 dpo - 0.68%
* 6 dpo - 1.39%
* 7 dpo - 5.56%
* 8 dpo - 18.06%
* 9 dpo - 36.81%
* 10 dpo - 27.78%
* 11 dpo - 6.94%
* 12 dpo - 2.78%
The inner lining of the uterus is called the endometrium and plays a major role in the fertile period. The normal thickness of the endometrium varies by day of the cycle. What should it be in this or that period? Let's try to answer this question.
How is the layer thickness determined, and why is it needed?
The norms of the thickness of the endometrium on the days of the cycle change under the influence of female sex hormones. This creates optimal conditions for the introduction of the embryo into the wall of the uterus.
For the onset and successful course of pregnancy, an important role belongs to the thickness of the inner layer of the uterus. To determine it, ultrasound is performed and echographic signs are analyzed. It must meet certain indicators, because it is under such conditions that the fetal egg will attach and penetrate into the wall of the uterus. It is implanted with subsequent germination of the placenta.
If the condition of the mucous layer in thickness does not correspond to the cycle, then they speak of the impossibility of pregnancy against the background of endometrial insufficiency. And in such cases painstaking hormone therapy is required.
The basal and functional are the two layers that form the very inner lining of the uterus. At the beginning of menstrual bleeding, the functional layer dies and is rejected, but due to the regeneration of the basal layer, it is restored by the beginning of the next menstrual cycle. The necessary thickness of the inner layer for productive implantation is gradually formed.
The mucous membrane of the uterus is sensitive to the level of sex hormones, which varies on different days of the menstrual period. By the end of the cycle, the basal part reaches its maximum size, and then, after menstruation, it becomes very thin. Due to regeneration processes, the thickness of the endometrium changes during the cycle.
Standards for the thickness of the endometrial layer
Let's see how the state of the uterus changes on different days of the cycle. For clarity, consider a pivot table.
Thus, it can be seen that during the cycle the state of the mucous layer changes. However, it happens that these figures may be less than normal. This is possible with a long cycle.
For a long cycle, the norm is a lag in the development of the endometrium and transitions from one phase to another with a delay depending on the individual characteristics of the female body. The beginning of menstruation is the phase of desquamation, the phase of bleeding. During this period, on the 2nd day of bleeding, the inner lining of the uterus has a thickness of 0.5 to 0.9 cm.
But already on the 5th day of menstruation, regeneration begins, and the thickness of the basal section already reaches 0.3-0.5 cm. On average, the norm of endometrial thickness should not exceed 2 cm at the final stage of menstruation.
In the middle, the proliferation phase begins (after the completion of the early proliferation, which falls on the 5-7th day). Usually on the 6th day the basal layer corresponds to a thickness of 6 to 9 mm.
Due to the action of progestogen hormones, on the seventh day of the cycle, the endometrium should not be too developed. But already on the 8th day of the cycle, the second begins - the middle stage, which is marked by a thickness of 8 mm to 1 cm. Sometimes this period may occur on the 10th day, or it may be that the thickness does not correspond cycle day.
Then there is a premise that with a monthly cycle of 30 days, menstruation will not begin on the 30th day. In such situations, there may be up to 9 days of delay or more.
Follicular stage
Detailed information about this stage is given in the video:
The third - late stage, also called follicular, occurs on the 11th, sometimes on the 14th day of the cycle, and the inner layer of the uterus in this phase has an indicator of 0.9-1.3 cm with an average thickness of 11 mm. Thus, it can be seen that the norms of endometrial thickness change according to the phases of the cycle.
After these phases, the second period begins - the phase of secretion or excretion. At the first stage of this phase, which begins on the 15th day, the endometrium begins to grow rapidly. This is the most favorable day of the cycle for the conception of a new life. This period of fertility ends on the 18th day. By the way, the period of fertility often changes in different cycles. Sometimes it occurs already on the 12th day of the cycle with a short monthly period. It is important to take into account these features if an IVF procedure is planned, as this affects the day of transplantation, which is chosen for IVF.
Then, on the 19-23rd day, the next stage comes, while on the 22nd day, the maximum thickening of the layer is observed - from 1.0 to 2.1 cm. This time is the ideal moment for attaching the fetal egg. And already at a later stage of the secretion phase, approximately on the 24-27th day, the endometrial membrane begins to thin and reaches a level of 1.0-1.8 cm.
Let's try to streamline the restructuring in the female genital area at different days of the cycle:
- The first phase is the proliferation phase. This is the initial stage (the first three days after the end of menstruation). In the 1st phase of the cycle, the layer thickness is 2 mm. Its structure is homogeneous, one- or two-layer. On the 7th day of the cycle, the endometrium will be equal in thickness to 4-5 mm, and its structure will acquire a three-layer structure inherent in the follicular phase. Such structural changes occur in the first half of the cycle.
- The second middle phase lasts 6-7 days, during which there is a change in the structure of the endometrium.
- The third late phase (3-4 days). The follicular layer increases in thickness by another 2 or 3 mm, and before the ovulatory moment its maximum thickness is 8 mm. Continuously with the growth of the endometrium, estrogens contribute to the development of the secretory mechanism in the mucous lining and to its full function at the end of the cycle.
Phase thickness mismatch
In the photo - the phases of the menstrual cycle of a woman During menopause, the maximum thickness of the endometrial layer in a woman should be no more than 5 mm. In this case, the size of 8 mm is considered critical, and diagnostic curettage is necessary. During menopause, a woman begins to experience age-related changes, in which there is a decline in reproductive function, and there is a deficiency of sex hormones. As a result of this, the development of pathological hyperplastic processes is possible inside the uterine cavity.
Many women are at a loss as to which day of the cycle doctors check the thickness of the endometrium ... The day of the cycle depends on what exactly the gynecologist is going to reveal. If a woman has functional bleeding, then to diagnose their cause, ultrasound is performed several times, on different days, tracking the dynamics of changes. For example, ultrasound is done on the 9th day, and then on the 25th day, while the structural changes that occurred during this period are clearly visible, and it can be concluded whether they correspond to the phase.
The main violations of the structure of the endometrial layer are considered hyperplasia and hypoplasia. In the first case, there is a significant excess of the thickness of the endometrial layer compared to typical indicators. With a 21-day cycle, or if the cycle is 30 days, such a progressively increasing thickness indicates the progressive development of the blastula in early pregnancy.
Otherwise, we are talking about thinning of the endometrial layer. For example, on an ultrasound scan, you can see that the indicator is 6 mm in the middle of the cycle, at a rate of 10-14 mm. In both cases, such violations are marked by the fact that there is a discrepancy between the thickness of the phase of the cycle, and require medical intervention and treatment.
If the endometrium of a heterogeneous structure is observed, then, perhaps, a pathological process takes place. In medicine, it is called endometriosis.
If on the 28th day menstruation does not begin, fertilization may have occurred. Despite the fact that manufacturers of pregnancy tests claim their effectiveness from the 1st day of delay, statistics show that in many women the test shows a positive result when the delay is 7 days or more, i.e. an average of 40 days. It is worth noting that there are cases when there is pregnancy, and the test shows a negative result, even when the delay is 10 days or more. In this case, if there are clinical manifestations that make it possible to suspect pregnancy, you should consult a doctor as soon as possible.
Why are hormonal contraceptives prescribed?
Another reason for the discrepancy may be a change in the hormonal background, which will clinically manifest itself as a lengthening of menstruation. In this case, hormonal contraceptives, such as Regulon, are prescribed for correction. The essence of their reception is that the drug is taken for 21 days, with a seven-day break. After the 21st day of taking Regulon, menstruation occurs, and then on the 29th day you need to start taking a new course of the drug again. Thus, for example, with a cycle of 36 days, it gradually normalizes and becomes 28 days.
In conclusion, we want to note that all the above materials are provided for informational purposes only. They cannot serve as a basis for self-diagnosis of the state of health of your body.