The internal cavity of the uterus, supplied with a large amount blood vessels is called the endometrium. It plays a crucial role in the menstrual cycle, as well as in the process of implantation of the fetal egg in the uterus. Consists of two layers:

• basal,
• functional.

During menstruation, the functional layer is rejected, but in the next cycle it is restored with the help of the basal layer. The endometrium is very sensitive to hormonal changes, so it thickens and is more abundantly supplied with blood, depending on the stage and phase of the cycle. In other words, the woman's body is preparing for the implantation of the embryo. If for some reason fertilization of the egg does not occur, the functional layer is rejected in the form of menstruation, if it does, the resulting embryo is implanted in the overgrown endometrium, from which the placenta will then form.

For the onset and successful development of pregnancy, an important indicator is the thickness of the endometrium, which varies depending on the specific phase of the cycle.

Endometrial thickness by cycle phases

1. Bleeding phase:
   • Desquamation stage (1-2 days of the cycle) - the thickness is 5-9 mm.
   • Regeneration stage (3-4 days) - 3-5 mm.
2. Proliferation phase:
   • Early stage (5-7 days) - the thickness reaches 3 - 6 mm.
   • The middle stage (8-10 days of the cycle) - 5-10 mm.
   • Late stage (11-14 days) - 7-14 mm.
3. Secretion phase:
   • Early stage (15-18 days) - thickness is 10 to 16 mm.
   • The middle stage (19-23 days of the cycle) - the maximum value of 10-18 mm is reached.
   • Late stage (24-27 days of the cycle) - the endometrium is slightly reduced to 10-17 cm, an average of 12 mm.

It is worth noting that with a long cycle, all of the above indicators may be below normal, since the transitions between phases occur with a delay.

Pathological conditions

Among the violations of the thickness of the endometrium are:

• thickening (hyperplasia);
• "thin" endometrium (hypoplasia).

Hyperplasia occurs due to disruptions in the hormonal background of a woman, namely an increase in the number of estrogens and a deficiency of progesterone. This is an increased growth of the endometrium, in which its thickness significantly exceeds the norm. Hypoplasia is characterized by the fact that throughout all phases of the menstrual cycle, the thickness of the endometrium remains too small. Reasons for the development of hypoplasia:

• Chronic endometritis.
• Improper blood supply.
• Decreased sensitivity of estrogen receptors.

Also very often there are cases of growth of endometrial tissue outside the uterine cavity (endometriosis), which leads to the formation of adhesions, the occurrence of severe pain during menstruation, disruption of the normal functioning of the entire reproductive system, thereby reducing the likelihood of pregnancy.

Endometrial thickness for conception

Both in the case of hyperplasia and hypoplasia, there is a discrepancy between its thickness and the phase of the menstrual cycle, which indicates the difficulties of conception and requires medical intervention and complex treatment.

If we talk about hyperplasia, then the impossibility of conception is due to:

1. Lack of ovulation due to hormonal imbalances.
2. The inability of the altered uterine mucosa to accept and implant the embryo.

If conception has occurred, there is a risk of developing pathologies in the fetus (including oncological ones). If we talk about hypoplasia, then the problem is the impossibility of a fertilized egg to attach to the uterine cavity due to the small thickness of the endometrium. And if attachment did occur, then in the future a pregnant woman will have a number of complications, such as:

• ectopic pregnancy;
• miscarriage;
• pronounced toxicosis;
• weak generic activity;
• profuse bleeding after childbirth.

If violations of the thickness of the endometrium are not treated in time, and the disease develops into complicated forms, this is fraught with infertility.

Attention! If your value is exceeded or, on the contrary, below the norm, be sure to consult a gynecologist.

Thickness of the endometrium during pregnancy

At the beginning of pregnancy, the size of the endometrium ranges from 9 to 15 mm. Along with the development of the embryo, it continues to thicken and reaches 20 mm at 4-5 weeks.

Thickness of the endometrium during menopause

During menopause, when there is a decline in reproductive function and a deficiency of sex hormones, pathological hyperplastic processes can develop on the inner surface of the uterus.

The thickness of the endometrium is 5 mm during this period. If it reaches 6-7 mm, then a woman is recommended to conduct an ultrasound examination every three months to exclude the development of pathological processes.

For large values, radical methods must be used:

• Diagnostic curettage (8 mm).
• Separate curettage (10-15 cm) with a mandatory study of the obtained material for the presence of cancer or precancerous changes.

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 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.

The endometrium is the lining inside the uterine cavity. It consists of two layers: functional and basal. The functional layer is a structure that changes with the ovarian cycle and that responds to the concentration of hormones in a woman's body. The basal layer has a constant thickness and structure, it consists of stem cells responsible for the restoration of both layers. The endometrium increases on the days of the cycle and it is thanks to its growth that menstruation occurs, which is considered an important indicator women's health.

Inner layer thickness

Figuratively speaking, the growth of the endometrium on the days of the cycle occurs in order to comfortably accommodate a fertilized egg in this cavity. If conception does not occur, then the functional layer separates in order to recover again after menstruation. During menstruation, the epithelial membrane is only 0.3-0.9 mm thick. If a woman has menopause, then there should not be more than five mm. Even a slight deviation from this norm is a sufficient reason for regular examinations by a gynecologist.

Endometrium by days of the cycle within the normal range (changes)

1. The phase of initial proliferation (5-7th day of the cycle) - the thickness is not more than 5 mm.
2. Average proliferation (8-10th day) - the endometrium thickens up to 8 mm.
3. Late proliferation (11-14th day) - up to 11 mm.
4. Secretion phase (15-18th day) - growth continues and reaches 11-12 mm.
5. Endometrium on the 21st day of the cycle reaches a maximum thickness of 14 mm.
6. By the 24-27th day, the endometrium becomes a little thinner - on average, up to 10 mm.

Deviations from the norm

If the endometrium on the days of the cycle increases below the norm, then the diagnosis of "hypoplasia" is made. The cause of such a violation may be inflammatory processes or insufficient blood supply in the uterus. Also, the thickness of the endometrium is affected by frequent abortions, infectious processes, disease of the pelvic organs and the use of an intrauterine device for a long time. In most cases, hypoplasia causes infertility. In order to restore the thickness of the endometrium, physiotherapeutic procedures are used, high doses of estrogen or aspirin are prescribed at a low dosage. If the thickness of the mucosa has increased to normal, but pregnancy does not occur within two years, then, as a rule, treatment is stopped and a decision is made on the need

If the endometrium on the days of the cycle increases more than the prescribed norm, then in this case we are talking about hyperplasia. The reasons this disease, as in the case of hypoplasia, lie in a violation of the hormonal level. There may also be a hereditary factor. Excessive is also diagnosed in diseases of the thyroid gland, ovaries, adrenal glands. Hyperplasia is common in women who suffer from arterial hypertension, diabetes, uterine polyps, fibroids.

Hyperplasia is dangerous due to uncontrolled cell growth, which can cause it. Excessive thickness of the changing layer of the endometrium is also reflected in the ability to bear children. For the treatment of hyperplasia, medications are prescribed or, in some cases, surgical intervention is used.

The reproductive function of a woman is supported by a complex mechanism that ensures the relationship of processes in the organs of the genital area with hormonal indicators. In order to prepare the reproductive organ for the possible implantation of the embryo, during each menstrual cycle, the structure and thickness of the uterine tissue changes. Most of the changes relate to the intrauterine mucous layer - the endometrium, which undergoes modifications throughout the cycle.

It is important that the thickness of the endometrium before menstruation and immediately after their termination is normal.

This makes it possible to ensure physiologically normal restoration (regeneration) of the functional sublayer of the uterus in subsequent menstrual cycles, and in case of successful conception, it allows the fertilized egg to gain a foothold inside the uterine cavity and create all conditions for the full development of pregnancy.

Information about the general structure of the endometrium

Anatomically, the female uterus is represented by three main layers:

• external - perimetry;
• medium - myometrium;
• internal - endometrium.

The endometrial uterine layer has a two-level structure and is represented by functional and basal epithelial sublayers. Purpose basal layer, located next to the myometrium - to create conditions for the cell growth of tissues of the functional sublayer, which is rejected in the process of monthly bleeding if fertilization has not occurred.

The greatest changes during the entire menstrual cycle occur in functional layer, which contains many receptor cells that are highly sensitive to the produced hormones: estrogen and progesterone.

The endometrium, due to the presence of an extensive system of blood vessels in it, increases its volume under the action of hormones. Gradually thickening deep into the uterus, it becomes loose, so that it is easier for the fetal egg to gain a foothold in the tissues. If fertilization does not occur, the exfoliation of the endometrial layer is physiologically ensured, menstruation begins and the processes that provide a new cycle are resumed.

Cycle phases

In a healthy woman, the lining of the uterus goes through 3 main phases. The thickness of the endometrium during these phases has its own standard indicators, which can be seen in the photo in the gynecological office.

When observing the process under ultrasound control, and establishing the level of thickness of the endometrial layer with the days of the cycle, one can form an opinion about the absence of hormonal disorders and the normal course of cyclic changes in the female body.

In the menstrual cycle, there are:

• proliferative phase;
• secretory phase;
• directly the phase of bleeding, that is, the period of menstruation (desquamation).

During each phase, changes occur in the tissues of the ovaries and endometrium due to fluctuations in hormones. Because of this, the thickness of the endometrial layer changes according to the days of the cycle. Before the onset of menstruation, the thickening becomes maximum. Usually the whole cycle takes about 27-29 days. During this time, the mucosa is modified from a minimum thickness to the state of an overgrown, loose structure that is rejected with menstruation.

Proliferation phase

It should begin immediately after the end of menstruation, approximately on the 5th day from the onset of menstruation, and last from 12 to 14 days. During this phase, the endometrial layer grows from its minimum thickness of 2-3 millimeters, its preparation for the ovulatory process and possible fertilization starts.

The proliferation phase has 3 stages:

• on the early stage(until the 7th day) the norm of the endometrium is from 4-5 mm to 7 mm thick, the density is reduced (hypoechoic), the layer is relatively uniform, looks pale pink and thin;
• in the middle stage, the mucosa continues to thicken and grow, the endometrium of 9 mm grows by the 9th day, by the 10th - up to 10 mm, acquires a rich pink hue;
• the final stage (late proliferation) lasts from 10 to 14 days, the endometrial layer acquires a folded structure, characterized by thickening in the areas of the bottom and posterior wall of the uterus, on average, the endometrium is 13 mm.

For favorable fixation of a fertilized egg, the functional layer should be at least 11 mm-12 mm, this is the norm. Only with such a thickness of the endometrium will reliable implantation of the fetal egg begin.

Secretion phase

With the onset of the secretion phase, which starts a couple of days after ovulation, the endometrial layer no longer builds up at such a pace. On ultrasound, you can see that significant structural changes have begun under the action of progesterone, which produces the corpus luteum of the ovary.

This phase also consists of 3 stages:

• at an early stage of secretion, the mucosa grows slowly, and restructuring begins in it. Thick endometrium swells even more, acquires a yellowish tint. On ultrasound, hyperechogenicity can be noted along the edges of the endometrium, which reaches 14-15 mm;
• in the middle stage of secretion, which lasts from the 24th to the 29th day, the endometrium undergoes pronounced secretory transformations, thickens to the maximum and reaches a maximum thickness of 15-18 mm - this is the norm. The picture on ultrasound reveals the appearance of a dividing line between the endometrium and myometrium, which is a zone of exfoliation;
• the late stage precedes the onset of menstruation. The corpus luteum involutes, the level of progesterone decreases, and the process of trophic changes in the overgrown layer begins. The endometrium has a thickness limit before menstruation - 1.8 cm. On ultrasound, you can see areas of dilated capillaries and the onset of thrombotic processes, which later lead to necrotic phenomena in the tissues, preparing them for rejection.

What is the maximum endometrial thickness considered normal? Doctors state that the endometrium 12 mm, 14 mm, 16 mm, 17 mm are variants of the norm. But 19 mm is already considered to be in excess of the normative indicators.

Desquamation phase (directly the period of menstruation)

During menstruation, the functional layer is destroyed and rejected, coming out in the form of menstrual bleeding. This phase lasts, on average, 4-6 days and is divided into 2 stages - rejection and recovery.

1. At the stage of rejection (days 1-2 of the cycle), the endometrial layer is normally 5-9 mm, its hypoechogenicity (decrease in density) is noted, the capillaries are deformed, burst, menstruation begins.
2. At the stage of regeneration, starting from the 3rd to the 5th day, the endometrium has a minimum thickness - from 3 to 5 mm.

Delayed start of menstruation

In the absence of pathological processes, the menstrual cycle is characterized by regularity and moderate blood loss. During puberty, fluctuations in the duration between menstruation are possible. Sometimes you can not accurately calculate when the next period will come.

In the absence of pregnancy, there may sometimes be a delay from the schedule for the onset of menstruation, due to hormonal failure. If there was an imbalance in the production of hormones, then the thickness of the uterine epithelium remains at the level of 12-14 mm with a delay. It does not decrease, there is no rejection, and there is no menstruation.

In some diseases of the uterus, there is a slowdown in the rejection of the functional layer, which affects the intensity and duration of menstruation. Abundant blood loss can be observed after a spontaneous abortion, when there was an incomplete separation of the fetal egg, and parts of it remained in the uterus.

Among other factors contributing to the appearance of delays in the onset of menstruation, there are:

• hormonal imbalance;
• malfunctions of the endocrine system;
• thyroid disease;
• excessive level physical activity leading to a decrease in the production of sex hormones;

• gynecological pathologies, for example, ovarian diseases;
• a condition after an abortion, when, due to the curettage, the endometrium recovers much more slowly than usual;
• the use of oral hormone-containing contraceptives, the abolition of which sometimes affects the regularity of the cycle for some time.

How long can there be a delay? Doctors tend to consider a delay in menstruation within 7-10 days as the norm. If a delay of more than two weeks is noted, you need to make sure that pregnancy has not occurred.

If a woman's period did not come according to schedule, this is not a reason to panic. When there is an irregularity in the monthly cycles, excessive scarcity, or vice versa, the intensity of blood discharge, a woman needs a consultation with a gynecologist. Proper treatment of pathologies will normalize the functioning of the reproductive organs and bring the size of the endometrium in line. Normal indicators of the endometrium throughout the cycle are evidence of women's health and hormonal balance, which positively affects the ability to conceive and bear a healthy child.

When medical examination establishes that your endometrium is 7 mm - what does this mean? Is this a sign of a pathological condition, and if so, what risks and threats to health and life does it pose? Let's try to answer these questions in this article.

The endometrium is an internal mucous membrane in the uterine body that lines the surface of the organ. In the tissue layer under consideration, there is a dense network of blood vessels. The structure of the endometrium is determined by the peculiarities of the course of the menstrual cycle, but the main functional purpose of the tissue remains the implantation of the embryo into the tissue surface of the uterine cavity.

The tissue under consideration has a unique regenerating structure and consists of two layers: basal and functional. The functional part of the tissue is rejected during menstruation, but the basal layer contributes to its complete restoration during the next menstrual cycle.

Since the endometrial epithelium is sensitive to changes in the hormonal background, the second phase of the menstrual cycle is characterized by thickening of the uterine endometrium. In addition, blood flow increases significantly in the mucous membrane of the uterine cavity. So the body prepares for a possible conception and the introduction of the embryo into the walls of the uterine cavity. If fertilization does not occur, the functional layer dies and is brought out along with menstrual flow.

Thickening of the endometrial layer: a sign of hormonal changes

Under normal conditions of life, the thickness of the layer is about 3-6 millimeters.

Thick endometrium in itself is not an indicator of the disease, unless its value exceeds the recommended values ​​established by the laboratory.

Indicators of the thickness of the endometrial layer are important for future pregnancy, and it is possible to determine them using ultrasound diagnostics. If the mucous layer is very thick, this may be the first symptom indicating the spread of pathological processes in the uterus.

It is worth noting that the indicator of interest to us is a variable value, and fluctuates depending on the phases of the menstrual cycle.

• Early proliferation occurs on the 5th-7th day of the cycle - while the thickness of the layer averages about 5 millimeters.
• Upon reaching the average proliferation (eighth - tenth days of the cycle), the mucous tissue thickens up to 8 mm. Possible fluctuations - 6-12.
• Late proliferation occurs on days 11-14 of the cycle and is characterized by an endometrial thickness of about 11 mm. The oscillation amplitude is 7-14.
• Starting from the 14th day of the cycle, early secretion occurs (on the 15th-18th day). The thickness of the fabric ranges from 10 mm to 15 mm. The average is 12 mm.
• The average secretion - on the 19-23rd day of the cycle - is characterized by the achievement of a maximum thickening - 14 mm. The oscillation amplitude is from 11 to 18.
• During the period of late secretion (24-27 days), the thickness of the mucous membrane decreases to 12 millimeters. The average figure is 10-18 mm.

It should be noted that fluctuations in the thickness of the endometrial epithelium caused by menstrual cycle, are completely natural, and do not contain any threat to the health and life of a woman. However, if during the monthly cycle the thickness of the mucous tissue reaches 19 mm or more, this is already a reason to consult a doctor.

Pathological changes in the endometrium

In addition to changes in the thickness of the uterine tissue caused by the menstrual cycle, which are normal, there are a number of pathological changes caused by diseases caused by hormonal disorders. Among these pathologies, the main forms of damage are hyperplasia (when the endometrium is enlarged) and hypoplasia (thinning of the specified membrane).

What to do if you suspect a thickening of the uterine tissue? First of all, it is worth contacting a specialist who will advise and draw up the correct treatment, if necessary. A large volume of the tissue layer is not a sentence, but it is a significant enough reason to pay attention to the state of your own body.

Hyperplasia is accompanied by a pathological expansion of the tissue and an increase in its volume, caused by benign changes in the glands and stroma of the mucous membrane of the uterine tissue. Thick endometrium is not always a direct symptom of hyperplasia, but almost always accompanies it.

The thickness of the endometrium will help to identify ultrasound - normally this figure should not exceed 6 mm. A layer thickness of 6 to 8 mm is a reason to repeat the study, since exceeding the norm by even 1 millimeter is already a cause for concern. With an endometrial thickness of 10 and even 12 millimeters, a diagnostic curettage is prescribed, based on the results of which a course of therapeutic measures is prescribed.

If the thickness of the tissue fluctuates in an amplitude of 10-12, this already indicates the presence of a developed pathology. From 12 to 15 - the thickness of the endometrium with hyperplasia is symptomatic for the development of cancers.

If the endometrium continues to thicken and the indicator exceeds 15 millimeters, this is directly related to the need to amputate the uterus due to the risk to the patient's life.

From 15 to 21 millimeters is a critical thickness that is directly related to the risk to the patient's life. The size of the endometrium is 17 mm - this is a direct reason for urgent surgical intervention.

An increase in the endometrium up to 21 mm should cause alarm among doctors, since it directly indicates the development of oncological pathology. In some particularly serious cases, endometrial thickness up to 24 millimeters was diagnosed (the highest recorded figure). What to do in such extreme situations? Treatment in such cases involves not only the immediate amputation of the affected organ, but also an intensive course of anticancer therapy.

Pathological growth of the endometrium: causes and treatment options

Changes in the thickness of the endometrial epithelium are directly related to hormonal disorders that develop in the body. Therefore, for the treatment of pathology, hormonal therapy is prescribed, aimed at stabilizing the hormonal background in the body, in combination with a surgical intervention that eliminates the lesion of the uterine tissue.

The causes of thickened endometrium can be very different - from transferred infectious diseases urinary tract to hereditary tendencies. There are also many diseases of the hormonal cycle, the comorbidity of which is uterine hyperplasia.

The thickness of the endometrium is only one of the diagnostic indicators to determine the presence of an extensive lesion. Not always individual figures can specifically determine the scale of the spread of the pathology.

When the size of the endometrium is 7 mm, what does this mean? Does this indicator mean that you should pay attention to the state of your own body, or should you not worry about such a minor issue?

The answer is that the slightest deviation from the norm in such an organ as the uterus needs a comprehensive study, finding out the causes and eliminating possible negative consequences. After all, we are talking about one of the main functions of the female body - reproductive.

Thickening of the endometrium in pathological forms of transformation of the mucous tissue of the uterine cavity is accompanied by changes in cellular level, which can only be discovered by special research.

Therefore, the diagnosis of hyperplasia does not depend on the determination of an increase in the endometrial epithelium alone and is a complex laboratory process that takes into account many additional factors.