Possible causes of a thin endometrium include inflammation , medical treatment, or the structure and nature of the endometrium itself. Treatments for excessive endometrial thickness include progestin , a female hormone that prevents ovulation and hysterectomy. Studies show that it is more difficult for a pregnancy to progress when readings for endometrial thickness are low.
Treatments for a thin endometrium can include:. However, research shows that these treatments are not consistently effective. People experiencing pelvic pain of unknown origin should see a doctor for evaluation and to rule out endometrial cancer. Other symptoms to watch out for are bloating and a feeling of fullness without eating much. Paying attention to endometrial thickness can help women who are trying to become pregnant understand the best way to optimize their chances of successful conception.
However, if someone notices abnormal bleeding, discharge, pelvic pain, or other changes in the way their body feels, they should consult a doctor to receive proper treatment.
However, endometrial cancer has a good survival rate if diagnosed early. Some people with endometriosis experience weight gain and bloating. In this article, we look at the possible reasons why and explain how to manage…. Endometrial ablation is a procedure to remove the uterine lining.
It may help women who have heavy or long periods, or bleeding in between periods. While typical treatment for endometriosis includes surgery, hormone therapy, and pain medications, some people also use essential oils. Learn whether…. A look at tilted uterus, a condition where the uterus is tipped backward.
Included is detail on symptoms, fertility, and how it is diagnosed. In this article, learn about enlarged uterus, how this condition is caused, the complications and risks associated with it, and the treatment options.
What to know about endometrial thickness. Normal thickness Measurement Causes of thin or thick lining Symptoms Treatments Seeing a doctor Outlook The endometrium is the lining of the uterus. If a fertilized egg implants into the uterus, it sends a signal to the ovary to keep making progesterone, which will help sustain a pregnancy by keeping the uterine lining thick and nourishing.
If no pregnancy occurs, the corpus luteum is reabsorbed into the ovary after two weeks and the hormone levels drop; this is the trigger that causes menstruation. The egg disintegrates or flows out with the vaginal secretions. The kind of mucus or fluid produced by your cervix changes throughout the menstrual cycle in response to fluctuations in estrogen and progesterone.
The cervical fluid is a kind of gatekeeper for the uterus. At ovulation, the cervical fluid becomes slippery and thin, like egg white. The cervical fluid also nourishes the sperm and changes their structure to prepare them to fertilize an egg. Sperm can live up to five days in midcycle cervical fluid. After ovulation, as progesterone levels increase, cervical fluid thickens into a kind of plug that makes it difficult for sperm to enter the uterus.
The vagina gradually becomes drier, too. If you look at your cervix with a speculum or feel it with your fingers, you may notice that at about the time of ovulation, the cervix is pulled up high into the vagina.
It may also enlarge and soften, and the os the opening to the uterus may open a little. The lining of the uterus, called the endometrium, thickens and then thins over the course of a menstrual cycle and thickens considerably during pregnancy. Embedded in this lining are glands that can secrete a fluid that will help nourish a pregnancy until a placenta is formed.
In a typical menstrual cycle, estrogen made by the maturing ovarian follicle causes the glands to grow and the endometrium to thicken partly through an increased blood supply. This thickening of the uterine lining is called the proliferative phase of the menstrual cycle. If endometriosis has caused infertility, you have several treatment options, including surgery, drugs to stimulate ovulation, typically administered with intrauterine insemination or in vitro fertilization.
The appropriate approach would be based on the results of a complete evaluation including an assessment of the male partner. In general, medicines that suppress the painful symptoms of endometriosis, such as GnRH agonists, oral contraceptives and danazol, do not improve the likelihood of pregnancy. The only possible exception would be that the use of a course of GnRH agonists before in vitro fertilization may improve outcomes in certain endometriosis patients, according to several recent studies.
There is no known way to prevent endometriosis. However, some health care professionals believe there might be a certain level of protection against the disease if you begin having children early in life and have more than one child. Additionally, you may prevent or delay the development of endometriosis with an early diagnosis and treatment of any menstrual obstruction, a condition in which a vaginal cyst, vaginal tumor or other growth or lesion prevents endometrial tissue from leaving your body during menstruation.
There also is some evidence that long-term birth control pill users are less likely to develop endometriosis. Review the following Questions to Ask about endometriosis so you're prepared to discuss this important health issue with your health care professional:. For information and support on coping with Endometriosis, please see the recommended organizations, books and Spanish-language resources listed below.
Parker, Rachel L. The most lead-contaminated neighborhoods in cities are often the poorest and home to the highest percentage of nonwhite children. Your Health. Your Wellness. Your Care. Real Women, Real Stories. Home endometriosis. Medically Reviewed. Overview What Is It? Others include: Diarrhea and painful bowel movements, especially during menstruation Intestinal pain Painful intercourse Abdominal tenderness Backache Severe menstrual cramps Excessive menstrual bleeding Painful urination Pain in the pelvic region with exercise Painful pelvic examinations Infertility It is important to understand that other conditions aside from endometriosis can cause any or all of these symptoms and other causes may need to be ruled out.
Diagnosis Gynecologists and reproductive endocrinologists, gynecologists who specialize in infertility and hormonal conditions, have the most experience in evaluating and treating endometriosis. Among the ways doctors diagnose the disease are: Laparoscopy. Treatment There is no universal cure for endometriosis. The most common medical therapies for endometriosis are nonsteroidal anti-inflammatories NSAIDs , hormonal contraceptives in oral, patch, and intrauterine or injectable applications and other hormonal regimens, such as GnRH agonists gonadotropin-releasing hormone drugs.
These drugs, such as ibuprofen, naproxen and aspirin, are often the first step in controlling endometriosis-related symptoms. They may be used long-term in a non-pregnant patient to manage symptoms, in part because they are effective at reducing implantation, are cheaper and easier to use than other options and have fewer side effects than hormonal treatments.
However, some patients may experience severe gastrointestinal upset from these agents, particularly if they are administered for prolonged periods and at high doses. They are more effective when taken before pain starts. Contraceptive hormones birth control pills. This option also costs less and has fewer side effects than other hormonal treatment options and may be recommended soon after diagnosis. Birth control pills stop ovulation, thus suppressing the effects of estrogen on endometrial tissue.
In most cases, women taking hormonal contraceptives have a lighter and shorter period than they did before taking them. Often physicians will recommend using birth control pills continuously as opposed to cyclically to eliminate regular menstrual flow, which can be the cause of increased pain in some women with endometriosis. Medroxyprogesterone Depo-Provera. This injectable drug, usually used as birth control, effectively halts menstruation and the growth of endometrial tissue, relieving the signs and symptoms of endometriosis.
Side effects include weight gain, depressed mood and abnormal uterine bleeding breakthrough bleeding and spotting , as well as a prolonged delay in returning to regular menstrual cycles, which can be of concern to women who want to conceive.
These drugs block the production of ovarian-stimulating hormones, which prevents menstruation and lowers estrogen levels, thus causing endometrial implants to shrink. GnRH agonists usually lead to endometriosis remission during treatment and sometimes for months or years afterward.
However, GnRH agonists have side effects, including menopausal symptoms like hot flashes, vaginal dryness and reversible loss of bone density. Add-back hormone therapy, which typically consists of a synthetic progesterone progestin administered alone or in combination with a low-dose estrogen, is typically prescribed along with GnRH agonists to alleviate these side effects.
This reproductive hormone is a synthetic form of a male hormone androgen and is available as Danocrine. It is used to treat endometriosis and works by directly suppressing endometrial tissue and suppressing ovarian hormone production.
A woman taking danazol will typically not ovulate or get regular periods. Side effects may include weight gain, hair growth and acne, among others. Some of the side effects are reversible. Danazol is typically given for six to nine months at a time. Danazol is not a contraceptive agent, and it is critical that any woman taking this drug also use a barrier contraceptive condoms, diaphragm, IUD if she is sexually active.
Progestin-containing intrauterine device. Several studies have shown that an intrauterine device IUD containing a synthetic type of progesterone progestin can also reduce the painful symptoms and extent of disease associated with endometriosis. If effective, the IUD can be left in the uterus for three to five years and can be removed if a woman wants to conceive.
There are currently three FDA-approved brands—Mirena, Skyla, and Liletta—and each has different characteristics; Mirena can be left in place the longest. It should not be used in women with multiple sexual partners, those with an abnormal uterus fibroids or those with prior sexually transmitted disease.
Side effects include cramping and breakthrough bleeding. Aromatase inhibitors. This class of drugs inhibits the actions of one of the enzymes that forms estrogen in the body and can block the growth of endometriosis. It is important to understand that this class of drugs is not approved for use in the treatment of endometriosis by the U. Food and Drug Administration; it is under investigation.
Side effects include hot flushes, bone loss and the potential for increased risk of birth defects if a woman conceives while taking these medications and remains on them. Their use should be limited to women participating in research trials or after obtaining written consent from a physician who is thoroughly familiar with this class of drugs. The goal of any surgical procedure should be to remove endometriotic tissue and scar tissue.
Hormonal therapies may be prescribed together with the more conservative surgical procedures. Surgical treatments range from removing the endometrial tissues via laparoscopy to removing the uterus, called a hysterectomy, often with the ovaries called an oophorectomy. Surgery classified as "conservative" removes the endometrial growths, adhesions and scar tissue associated with endometriosis without removing any organs.
Conservative surgery may be done with a laparoscope or, if necessary, through an abdominal incision. During a laparoscopy, an outpatient surgery also referred to as "belly-button surgery," the surgeon views the inside of the abdomen through a tiny lighted telescope inserted through one or more small incisions in the abdomen. From there, the surgeon may destroy endometrial tissue with electrical, ultrasound-generated or laser energy or by cutting it out.
There is a risk of scar tissue, which could lead to infertility, making pain worse, or damaging other pelvic structures. Surgery to remove endometriosis involving the ureters and bowel can be especially complex and requires a high degree of surgical skill. A laparotomy is similar to a laparoscopy but is more extensive, involving a full abdominal incision and a longer recovery period.
During a hysterectomy, your uterus is removed. This leaves you infertile. Hysterectomy alone may not eliminate all endometrial tissue, however, because it can't remove tissue outside of the uterus or ovaries.
Additionally, surgery to remove the uterus may not relieve the pain associated with endometriosis. Removing the ovaries with the uterus improves the likelihood of successful treatment with hysterectomy because the ovaries secrete estrogen, which can stimulate growth of endometriosis.
It also renders you infertile, however. If you wish to preserve your fertility, discuss other treatment options with your health care professional and consider seeking a second opinion. There has only been one comparative study of medical and surgical therapies to see which approach is better.
This trial demonstrated improved outcomes with GnRH agonist and add-back therapy alone or after surgery in comparison to surgery alone.
Each approach has advantages and disadvantages. Often, your plan of care will be a combination of treatments with medical therapy recommended either before or after surgery. Alternative treatments.
Alternative treatments for relieving the painful symptoms of endometriosis include traditional Chinese medicine, nutritional approaches, exercise, yoga, homeopathy, acupuncture, allergy management and immune therapy.
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