Thickening of the Uterus

In medical parlance, thickening of uterus is known as Endometrial Hyperplasia. The endometrium is the lining of the uterus, that grows and thickens every month, in sexually mature women. It is shed during the menstrual period, in the absence of pregnancy. All changes in the uterine lining are due to the female hormones; estrogen and progesterone. Estrogen builds or thickens the lining of the uterus, and progesterone controls its growth. Mid-cycle ovulation occurs and the egg is released from the ovary. In case the egg is not fertilized, it can result in a drop in the hormonal levels, causing a regular menstrual period. The unfertilized egg and uterine lining are then shed through menstrual blood. At times due to reasons like unhealthy lifestyle, certain health issues and stress, menstrual cycle tends to become irregular. If this condition recurs, it can also be an indication of some problem in the uterus. The endometrial cells, which are not shed can accumulate in the lining, leading to thickening of the uterus. In the following paragraphs, let us discuss the causes, signs and treatment options for this uterine disorder.

What Causes Thickening of the Uterus Lining?
Any imbalance between the hormones (high levels of estrogen and low levels of progesterone), may lead to an unusual or excessive cell growth in the inner glandular lining of the uterus. Untreated and unchecked, the cells of the lining tend to grow in an abnormal manner, leading to the progression of cancer in the uterus (uterine cancer). This can be life-threatening and in the absence of proper diagnosis and treatment, can prove to be fatal. There are various reasons as to why hormonal imbalance can occur. Some of the factors which may give rise to this health problem, are mentioned below.

• Menopause
• Irregular menstrual cycle
• History of obesity in the family
• Diabetes
• Ovary related health conditions
• Hormone replacement therapy (HRT)

Symptoms of Thickening of the Uterus
Being an internal organ, thickening of the uterine wall cannot be physically noticed. However, there are symptoms that one can observe and consult a physician immediately. These symptoms should not be ignored and should be brought to the notice of a gynecologist to avoid unwanted complications.

• Lower abdominal pain
• Intense cramping
• Spotting or bleeding between menstrual periods
• Excessive vaginal discharge, which may be smelly or discolored
• Heavy and/or prolonged menstrual cycle.

Treatment for Thick Uterus Lining
Treatment depends upon the severity of the condition, which is determined by a host of tests. It is essential to visit a gynecologist for the correct diagnosis and treatment for this uterine disorder. The initial test, generally done is a pap smear, which helps identify any cellular changes in the cervix, followed by an evaluation of the uterus and endometrium. Mentioned below are some other diagnostic tests, that are carried out to assess the intensity of endometrial hyperplasia.

• Pap smear: A simple and relatively painless test in which a sample of cells from a woman's cervix is collected and observed under a microscopic slide to check for signs of malignancy or other changes that may indicate the presence of any abnormality.
• Ultrasound: Ultrasound uses sound waves to get a picture of the uterine lining. This helps to determine the thickness of the endometrium and the spread of infection.
• Biopsy: Biopsy for a uterine lining involves insertion of a narrow tube inside the uterus to take a sample of cells. These cells are then scrutinized under a microscope for detecting the presence of cancer.
• Curettage: In this test, a special device called a 'curette' is used to loosen and remove a sample tissue from the uterine lining. This sample is then sent to a lab for testing.
• Hysteroscopy: A narrow telescope-like device is inserted into the uterus to look for areas that seem a little abnormal. Cells are then removed from the lining and sent for diagnosis.

Endometrial hyperplasia can either be treated with medication or surgery. Medication involves the use of the hormone progesterone, which triggers the shedding of the old uterine wall and prevents abnormal growth. It will often cause vaginal bleeding. Surgery, on the other hand, involves hysterectomy (uterus removal surgery). This is generally done when uterine cancer is detected.

Understanding this disorder of the uterus, how and when it can occur, and the role played by hormones, is what this article has attempted to do. Endometrial hyperplasia, by itself, is not cancerous, but women diagnosed with this condition are considered to be at a higher risk for contracting cancer. It can be treated, and an early detection, timely intervention and proper medication for this uterine abnormality will help one lead a healthy life.