The inner lining of the uterus, called the endometrium, thickens every menstrual cycle. For a healthy pregnancy, the thickness of the endometrium is important. The thinning of the uterine wall is a cause of infertility. In those who have uterine thinning problems, the embryo may not be able to hold to the uterus or pregnancy may result in miscarriage. In other words, for a healthy pregnancy ending up with a live birth, the uterine wall must reach the most appropriate level of thickness.
This article includes the causes, symptoms and treatment methods of the uterine wall thinning.
Why is the uterine wall thin?
The uterine lining or endometrium, is the inner layer of the uterus. The thickness of this layer varies throughout the cycle with hormonal changes. For a possible pregnancy to occur, in the early days of the cycle, the uterine wall thickens in response to estrogen hormone. In the middle of the cycle, after the egg is released (ovulation), progesterone hormone is released. Then the uterine wall is ready to feed the embryo. In the absence of embryo or pregnancy, progesterone hormone levels decrease, menstruation bleeding begins. The uterine wall begins to fall out and the endometrial thickness reaches the measurement which is like 3-5 mm at the beginning of the cycle. The new menstrual cycle and endometrium follows the same pattern every month.
The thickness level of the uterine wall does not directly affect the formation of embryo. However, in order to maintain pregnancy in a healthy way, the thickness of the uterine wall must be at the optimal level. At the end of a menstrual cycle, the thickness of the uterus wall decreases to approximately 1-2 mm. In new cycle hormones thicken uterine wall and it reaches the range of 8 mm to 15 mm. Thereafter, it is possible for pregnancy to continue with health. However, it should be remembered that these data are general data and may vary from person to person and the time of cycle. Research shows that for embryo implantation, if the uterine wall thickness is less than 8 mm, then the probability of pregnancy drops. As can be understood from these, the thickness of the uterine lining (endometrium) plays an important role in the embryo attachment to the uterus. The uterine lining must have reached the necessary thickness to feed the embryo from the vessels.
Estrogen and progesterone hormones, lead to a change in the thickness of the uterine wall and thus the creation of the appropriate environment for the continuation of pregnancy. In this respect, it can be said that the thinning of the uterine wall is experienced in women who enter the period of menopause where the hormonal balance is disrupted or using birth control pills. On the other hand, although hormonal secretion is normal and the patient does not use birth control pills, the uterus thinning can be detected. The underlying reasons for thin endometrium are the absence of the release of reproductive hormones, abortions that damage the intrauterine layer, the presence of intrauterine adhesions, the existence of intrauterine damage due to infections.
How to understand that there is a thinning of the uterine wall?
The most common symptom of thinning of the uterine wall is low amount of menstrual bleeding. Since the amount of bleeding and the length of the period varies from person to person, the person must follow her own menstrual pattern for the clarification of the phrase “less than usual”. In cases with thinning of the uterine wall, the bleeding usually last 1-2 days, spotting like bleeding occurs or there is no bleeding at all. The lack of menstrual bleeding is the most serious symptom among all. Mild bleeding/spots experienced during the cycle period, the painful menstruation period and delayed periods are some of the other symptoms. In women with thin endometrium, the major problem is infertility. Therefore, if one or more of the symptoms occur, all women should visit gynecologist without wasting time. In particular, women who experience symptoms and or those who end up with miscarriage, or patients who want to be a mother, needs urgent treatment.
Uterine thinning treatment
Treatment of the uterine wall thinning is carried out by gynecologists and fertility specialists. Before the treatment, the medical history of the patient, the current health status is examined, and the most appropriate treatment method is selected according to the results.
Treatment of thinning of the uterine wall varies according to the patient. If there is a lack of hormonal stimuli, then hormonal supplements are given to monetarize the endometrial thickness. If there is an adhesion or endometrial damage in the medical history, hysteroscopy is performed to evaluate the inner cavity. After the hysteroscopy hormonal supplementation can be given in long term to heal the inner lining and to observe the thickness of the endometrium.