There are several reasons as to why some women have thicker endometrial lining than others. Most of the time there is no cause for concern especially if they are young and asymptomatic. Depending on the time of the menstrual cycle, normal endometrial thickness can range from 5mm to 16mm.
In women with abnormally thick endometrium, they usually complain of heavy menses with blood clots, prolong menses, intermenstrual bleeding and more frequent menses or shorter menstrual cycles.
The common causes associated with these includes hormonal imbalances, endometrial polyps, fibroids, endometrial hyperplasia and endometrial cancer.
- Endometrial polyps and fibroids tend to be benign in the majority of cases and can be surgically removed.
- Endometrial hyperplasia (depending on whether it is simple or complex and with or without atypia) is associated with the risk of developing endometrial cancer (1% to 25%) in the long term and treatment can range from short term hormonal treatment after a dilatation and curettage (minor surgery to remove some endometrial tissues) to a hysterectomy (removal of the uterus) in order to prophylactically prevent endometrial cancer.
- In early stage endometrial cancers, it can be treated surgically while in advanced stage cancers, the disease has spread so extensively that chemoradiotherapy becomes the preferred treatment of choice over surgery.
In essence, women who experience any abnormal menstrual periods should see a gynaecologist for further evaluation and those above the age of 40 will usually require a hysteroscopy, dilatation and curettage to exclude endometrial cancer.
