A woman's reproductive he alth depends on many factors. Of great importance in the ability to conceive and bear a child is the endometrium, which has the ability to change during the woman's menstrual cycle. But there are situations in which, under the influence of various factors, pathological conditions arise in the endometrium, for example, its heterogeneity. What does this mean and what treatment is used for this disease, we will analyze in the article.
Determination of the endometrium
Endometrium is the lining 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 hormonal levels. Normally, it has a relatively uniform structure, the same density and approximately the same thickness. Immediately after menstruation, the endometrium thickens in preparation for the attachment of a fertilized egg. If this does not happen, the functional layer is rejected and leaves the body together with the blood, afterwhat is the restoration of the basal layer.
But sometimes there are situations in which, during ultrasound diagnostics, the doctor determines untimely heterogeneity of the endometrium. What does it mean? This condition indicates hormonal failures or serious inflammatory processes.
Types
Currently, experts distinguish two types of endometrial heterogeneity, depending on the causes of this condition and its impact on the woman's body. Let's take a closer look:
- 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. Heterogeneous endometrium in the second phase of the cycle may indicate the development of certain diseases. Additional diagnostics needed.
- Pathological heterogeneity of the endometrium. It does not depend on the menstrual cycle and the presence of pregnancy. Requires the early establishment of the cause of development and the determination of effective therapy.
Sometimes a heterogeneous structure of the endometrium of a congenital form is revealed.
Norms
Let's consider the normal indicators of the endometrium depending on the phase of the menstrual cycle (see table).
| Cycle days | Endometrial thickness, mm | Echogenicity |
| 1–2 | 5–9, patchy | Reduced |
| 3–4 | About 5 | Good |
| 5–7 | Up to 6 | Slightly reduced |
| 8–10 | Up to 10 | Increased |
| 11–18 | 8–15 | Average |
| 19–23 | 12–16 | Increased |
| 24–26 | 9–12 | Increased |
| Menopause | About 6 | Increased |
Reasons
Heterogeneity of the endometrium can be the result of both physiological processes occurring in the body and pathological processes that require immediate treatment. Consider the most common factors in the development of endometrial inhomogeneous thickness.
Physiological causes include:
- Specific 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. Medical supervision required.
Pathological causes of heterogeneous thickness of the endometrium of the uterus are much larger. 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 lining within the normal range, estrogen begins to act, which prevents the excessive growth of the endometrium. If the hormonal background fails, there is a high probability of developing dangerous diseases.
- Inflammatory processes in the appendages.
- Impaired circulation in the uterus andother organs of the female reproductive system.
- Underdevelopment of the reproductive organs.
- Adenomyosis, characterized by the occurrence of cystic neoplasms of various sizes in the uterine cavity.
- Submucosal fibroids. In this case, tissue grows around itself, the uterus increases. Heterogeneity of the endometrium is detected locally.
- Polyps, in which uneven growth of the mucous layer of the uterus occurs.
- Poor-quality curettage of the uterine cavity.
- Endometrial disorders (such as endometriosis, hypoplasia, or endometritis).
- Traumatic effect on the uterus.
- Abortions.
- Taking hormonal drugs.
- Benign tumors on the uterus.
- Malignant formations, which, however, develop much rarely.
Symptomatics
The initial stage of the condition in which endometrial heterogeneity develops does not show characteristic signs. The clinical picture can be quite blurred. As the underlying cause of the condition progresses, the symptoms become more severe. Consider the most common signs:
- Disturbances of the menstrual cycle, in which long delays, painful periods and their profusion are possible.
- Infertility.
- Separation of mucus from the genitals.
- Miscarriages.
In the future, the manifestations of the pathological condition will depend on the cause that caused it. If the above symptoms appear, it is recommendedconsult a doctor and take the necessary tests.
Diagnosis
Endometrial heterogeneity cannot be determined by a 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 mucous layer of the uterus. On ultrasound, 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.
Very important laboratory tests, which include:
- Urine analysis.
- Complete blood count.
- A blood test for hormones, which is performed on certain days of the cycle.
- Smears for infection.
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 non-steroidal anti-inflammatory drugs (for example, Diclofenac).
- The use of hormonal drugs, which are prescribed only after receivingnecessary analyses. In this case, drugs such as Yarina, progesterone (for example, Utrozhestan, Duphaston), as well as estrogen (Estrogel) are often used.
Surgical treatment is used in case of severe endometrial growth, complications, or in the absence of a result from drug therapy.
Preventive measures
To prevent the development of endometrial heterogeneity, certain rules must be followed. Consider them in more detail:
- First of all, you need to carefully monitor your he alth and not neglect planned visits to the gynecologist, especially during pregnancy.
- Even slight symptoms should go to the hospital and undergo an ultrasound examination as soon as possible.
- Monitor the level of hormones in the body, periodically taking tests, especially for women in menopause and during pregnancy, as hormonal changes occur in the body.
- Keep intimate hygiene.
- Use contraception.
- Follow all the recommendations of the attending physician.
Possible Complications
In the absence of adequate and timely treatment, the pathological conditions that led to the heterogeneity of the endometrium can lead to the development of dangerous complications. These include:
- Infertility.
- Miscarriages.
- Rebirth of pathological areas inmalignant form.
- Bleeding.
- Endometrial ruptures.
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 changes in the endometrium at an early stage. This will allow timely detection of the cause that provoked the appearance of mucosal heterogeneity, and begin treatment. In this case, the prognosis in most cases will be positive. Otherwise, serious complications may develop.
With heterogeneity of the endometrium, self-treatment is prohibited. Therapy is prescribed only by the attending physician after establishing the cause of this condition and strictly on an individual basis.
