Inhomogeneous endometrium: causes, structure, what it means

A woman's reproductive health depends on many factors. Of great importance in the ability to conceive and bear a child is the endometrium, which has the property to change during a woman's menstrual cycle. But there are situations in which, under the influence of various factors, pathological conditions in the endometrium arise, for example, its heterogeneity. What this means and what treatment is used for this disease, we will analyze in the article.

Endometrial determination

The endometrium is the mucous membrane of the uterus that lines its inner surface. It is rich in multiple blood vessels. The thickness of the endometrium changes throughout the cycle under the influence of a hormonal background. Normally, it has a relatively uniform structure, the same density and approximately the same thickness. Immediately after menstruation, the endometrium thickens, preparing to attach a fertilized egg. If this does not happen, the functional layer is rejected and together with the blood leaves the body, after which the basal layer is restored.

But sometimes there are situations in which during an ultrasound diagnosis the doctor determines the late heterogeneity of the endometrium. What does it mean? This condition indicates hormonal malfunctions or serious inflammatory processes.

Types

Currently, experts distinguish two types of endometrial heterogeneity, depending on the causes of this condition and its effect on the woman's body. Let's consider in more detail:

• Normal heterogeneity of the uterine mucosa, which is characteristic of a certain phase of the menstrual cycle or stage of pregnancy. It is a variant of the norm and does not require adjustment. A heterogeneous endometrium in the second phase of the cycle may indicate the development of some diseases. Additional diagnostics are needed.
• Pathological heterogeneity of the endometrium. It does not depend on the menstrual cycle and the presence of pregnancy. It requires an early identification of the causes of development and determination of effective therapy.

Sometimes a heterogeneous structure of the endometrium of the congenital form is detected.

Norms

Consider the normal endometrial parameters depending on the phase of the menstrual cycle (see table).

Causes

The heterogeneity of the endometrium can be a consequence of both physiological processes occurring in the body, and pathological, which require immediate treatment. Consider the most common factors for the development of endometrial heterogeneous thickness.

Physiological reasons include:

• A certain phase of the menstrual cycle.
• Pregnancy. In this case, careful medical supervision is necessary, since this condition may indicate a pathological process that threatens the normal course of pregnancy.
• Menopause. A doctor’s control is required.

The pathological causes of the heterogeneous thickness of the uterine endometrium are much greater. These include:

• Hormonal disorders. During menstruation, progesterone plays an important role, under the influence of which the endometrium increases. Then, to maintain the thickness of the uterine mucosa within the normal range, estrogen begins to act, which prevents the excessive growth of the endometrium. With hormonal disruptions, the likelihood of developing dangerous diseases is high.
• Inflammation in the appendages.
• Violation of blood circulation in the uterus and other organs of the reproductive system of women.
• Underdevelopment of reproductive organs.
• Adenomyosis, characterized by the appearance of cystic neoplasms of various sizes in the uterine cavity.
• Submucous myoma. In this case, the growth of tissues around itself occurs, the uterus increases. Endometrial heterogeneity is detected locally.
• Polyps in which there is an uneven proliferation of the uterine mucosa.
• Poor curettage of the uterine cavity.
• Endometrial diseases (e.g., endometriosis, hypoplasia, or endometritis).
• Traumatic effect on the uterus.
• Abortion
• Taking hormonal drugs.
• Benign neoplasms on the uterus.
• Malignant formations, which, however, develop significantly rarely.

Symptomatology

The initial stage of the condition in which the heterogeneity of the endometrium develops is not manifested by characteristic signs. The clinical picture can be quite blurred. As the underlying cause of this condition progresses, the symptoms begin to manifest more strongly. Consider the most common signs:

• Disorders of the menstrual cycle, in which prolonged delays, soreness of menstruation and their profusion are possible.
• Infertility.
• Separation of mucus from the genitals.
• Miscarriages

In the future, manifestations of a pathological condition will depend on the cause that caused it. If the above symptoms appear, it is recommended to consult a doctor and pass the necessary tests.

Diagnostics

Endometrial heterogeneity cannot be determined by routine medical examination. The most informative diagnostic method in this case is ultrasound diagnostics, during which the specialist is able not only to assess the condition of the endometrium, but also to identify neoplasms and other factors that led to changes in the uterine mucosa. On ultrasound, a heterogeneous endometrium can be diagnosed as accurately as possible.

In addition to ultrasound examination, it is possible to prescribe curettage, which is both a diagnostic tool and a treatment method.

Laboratory studies are very important, which include:

• Analysis of urine.
• General blood analysis.
• A blood test for hormones that is performed on certain days of the cycle.
• Smears for infections.

Treatment

In the treatment of heterogeneous endometrium, it is very important to get rid of the underlying disease that led to this pathological condition.

• If the changes were caused by inflammatory processes occurring in the body of a woman, then antibiotic therapy is prescribed (for example, "Ceftriaxone").
• It is also possible to prescribe anti-inflammatory non-steroidal drugs (for example, "Diclofenac").
• A large role in restoring the endometrium of a heterogeneous structure is played by the use of hormonal drugs, which are prescribed only after obtaining the necessary tests. At the same time, such drugs as Yarina, progesterone (for example, Utrozhestan, Dufaston), and also estrogen (Estrozhel) are often used.

With a strong proliferation of the endometrium, the appearance of complications or in the absence of a result from drug therapy, the surgical method of treatment is used.

Preventative measures

To prevent the development of heterogeneity of the endometrium, it is necessary to adhere to certain rules. Let's consider them in more detail:

• First of all, you need to carefully monitor your health and not neglect the planned visits to the gynecologist, especially during pregnancy.
• If even slight signs appear, you should contact the hospital as soon as possible and undergo an ultrasound examination.
• Monitor the level of hormones in the body, periodically passing tests, especially for women in menopause and during pregnancy, since hormonal changes in the body occur.
• Observe intimate hygiene.
• Use contraception.
• Follow all recommendations of your doctor.

Possible complications

In the absence of adequate and timely treatment, pathological conditions that led to heterogeneity of the endometrium can lead to the development of dangerous complications. These include:

• Infertility.
• Miscarriages
• The degeneration of pathological sites into a malignant form.
• Bleeding.
• Endometrial tears.

If the structure of the uterine endometrium is heterogeneous, the possible consequences depend on the cause that led to the change in the mucosa.

Forecast and Conclusion

With a systematic visit to the doctor, it is possible to detect an endometrial change at an early stage. This will allow you to timely detect the cause that provoked the appearance of heterogeneity of the mucosa, and begin treatment. Moreover, the forecast in most cases will be positive. Otherwise, serious complications may develop.

With endometrial heterogeneity, self-medication is prohibited. Therapy is prescribed only by the attending physician after establishing the cause of this condition and strictly individually.