The normal thickness of the endometrium changes dynamically with the menstrual cycle and needs to be evaluated in conjunction with different physiological stages. The following are the reference range and exception handling suggestions for each period:
1. Normal thickness range
④ Menstruation period (days 1-5)
The intima began to shed and the thickness gradually decreased to 1-4 mm. At this time, ultrasound showed uniform echo in the intima, and if debris remained, irregular bleeding could be caused.
④ Proliferation period (Days 5-14)
Estrogen stimulates the thickening of the intima, which is about 4-5mm around the 10th day of menstruation and can reach 8-10mm before ovulation. At this stage, the endometrium shows a three-line sign (Type A), laying the foundation for embryo implantation.
④ Secretory period (days 15-28)
Progestogen promotes further thickening of the intima to 10-15mm, which can reach 15-20mm in some women in the late stages of secretion (before menstruation). At this time, the blood supply of the intima is abundant, which is conducive to the implantation of the fertilized egg.
④ Menopause
The thickness of the intima usually does not exceed 4-5 mm. If it exceeds, you need to be vigilant about the lesion.
2. Abnormal situations and risks
③ Too thin (<7mm)
It is common in repeated uterine cavity surgeries, endocrine disorders or decline in ovarian function, manifested by low menstrual flow and amenorrhea, which increases the risk of abortion.
③ Too thick (>15mm)
It may be related to endometrial hyperplasia, polyps or excessive estrogen, which may be manifested as increased menstrual volume and prolonged menstrual period. Malignant lesions need to be ruled out. However, when the thickening is simple without abnormal echo, the part is physiological change.
3. Diagnosis and treatment recommendations
● Reexamination timing: Reexamine ultrasound 3-7 days after menstruation is clean to rule out physiological fluctuations.
● Further examination: If there are repeated abnormalities, the lesion needs to be clarified through hysteroscopy or endometrial biopsy.
● Treatment direction: If the inner membrane is thin, estrogen can be supplemented (such as Progyalone). If the inner membrane is too thick, medication or surgical intervention is needed.
4. Matters needing attention
● Avoid excessive anxiety: There are individual differences in endometrial thickness, which needs to be comprehensively evaluated in conjunction with hormone levels and uterine cavity shape.
● Health management: Balanced diet (beans, deep-sea fish) and moderate exercise can improve pelvic blood flow and help maintain endometrial health.
Regular gynecological examinations are the key to early detection of endometrial abnormalities. Especially for those with a history of abnormal bleeding or infertility, it is recommended to monitor endometrial changes every year.