The norm of the size of the endometrium depending on the days of the cycle. Endometrium: is it possible to build up. Parameters of the normal thickness of the endometrial layer

The uterus is a unique organ in which future child. In order for the conditions to be the most comfortable, every month there is an update of the mucous membrane lining it, equipped with a network of blood vessels. Through them, the growing organism receives nutrients and oxygen. The embryo enters the uterus exactly when the thickness of the functional layer of the mucous membrane is maximum, and its structure is most suitable for implementation and fixation gestational sac. The fetus develops correctly only in a healthy, full-fledged endometrium.

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The structure of the endometrium and the stages of its development

Endometrium is called the mucous membrane of the uterus, which covers its wall from the inside. Due to the changes that regularly occur in its structure, a woman has menstruation. This shell is designed so that the fertilized egg can be held in the uterine cavity and develop normally. After it is implanted in the mucosa, the placenta grows, through which the fetus is supplied with blood and useful substances necessary for its growth.

The mucous membrane of the uterus consists of 2 layers: basal (directly adjacent to the muscles) and functional (superficial). The basal layer exists constantly, and the functional one changes in thickness every day due to the processes menstrual cycle. It depends on the thickness of the functional layer whether the embryo will be able to gain a foothold, how successful its development will be.

During the course of the cycle, changes in the thickness of the endometrium normally go through several stages. The following phases of its development are distinguished:

Bleeding (menstruation) - rejection and removal of the functional layer from the uterus, associated with damage to the blood vessels of the mucosa. This phase is divided into stages of desquamation (detachment) and regeneration (the beginning of the development of a new layer of basal cells).
Proliferation - the growth of the functional layer due to the growth (proliferation) of the tissue. This process occurs in 3 stages (they are called early, middle and late).
Secretion - the phase of development of the glands and the network of blood vessels, filling the mucosa with secretory fluids. The increase in the thickness of the mucosa occurs due to its swelling. This stage is also divided into early, middle and late stages.

The size is influenced by hormonal processes occurring in different periods cycle. The age of the woman matters physiological state. Deviations from the norm can appear in the presence of diseases and injuries in the uterus, circulatory disorders. Leads to pathology hormonal disbalance. The norm indicators have a rather large variation, since for each woman they are individual and depend on the length of the cycle and other characteristics of the body. A violation is considered a value that is outside the specified limits.

Why and how is the uterine mucosa measured

The measurement is carried out using ultrasound. The study is carried out on different days of the cycle. This allows you to establish the cause of menstrual disorders, detect tumors and other neoplasms in the uterus, which affect the thickness and density (echogenicity) of the mucosa, as well as its structure.

An important point is the determination of these indicators on the days of ovulation in the treatment of infertility. In order for the fetal egg to be able to gain a foothold in the uterus, the thickness of the functional layer should not be less than 7 mm. Its value in this case is determined approximately on the 23-24th day of the cycle, when it is maximum.

Such a study is performed when examining women of any age.

Normal thickness of the functional layer on different days of the cycle

During the cycle, the thickness of the mucosa changes literally every day, however, there are average thickness indicators that can be used to determine how much the condition reproductive health women are normal.

As can be seen from the table below, with the beginning menstrual bleeding(in the first two days of the cycle), the thickness of the mucosa reaches a minimum (up to about 3 mm), after which its gradual growth begins. At the stage of regeneration, a new layer is formed due to the division of basal cells. Maximum value(on average 12 mm) the thickness normally reaches a few days after ovulation. If fertilization has occurred (on the 15th-17th day of the cycle), then by this moment (after 21 days) conditions are created in the uterus that are most favorable for the implantation of the embryo into its wall.

Table of the thickness of the uterine mucosa is normal

Dimensions of the functional layer of the mucosa during pregnancy

If fertilization does not occur, then last days cycle, the thickness of the endometrium decreases as it exfoliates.

If conception has taken place, then normally its thickness remains at the same level in the first days, and then it begins to thicken, and at 4-5 weeks the figure is 20 mm. At this stage of pregnancy, a tiny fetal egg can already be seen on ultrasound.

If a delay occurs in a woman, even if the pregnancy test gives a negative result, its onset can be judged by an increase in the thickness of the mucosa, starting as early as 14-21 days after implantation of the embryo.

Dimensions of the functional layer with menopause

The onset of menopause is associated with sharp drop the level of female sex hormones in the body, which leads to a change in the state of the mucous membranes, a decrease in the thickness of the endometrium (up to its atrophy), and the disappearance of menstruation. During this period, the thickness of the functional layer normally does not exceed 5 mm. Exceeding the norm indicates the occurrence of pathological processes (the formation of cysts, polyps, malignant tumors).

Video: Change in the state of the uterine mucosa during the menstrual cycle

Pathologies

During the development of the functional layer, the following disorders may occur:

excessive uneven growth (hyperplasia) of the endometrium;
insufficient thickening of the mucosa in the 2nd half of the cycle (endometrial hypoplasia);
endometriosis - the growth of the mucosa and the ingress of its particles onto neighboring tissues and organs, which leads to disruption of their functioning;
adenomyosis - germination of the epithelium in the muscular layer of the uterine wall;
violation of the structure of the mucosa due to the formation of polyps (its growth in separate foci), the formation cancerous tumors;
misdevelopment endometrium in the presence of foreign elements in the uterine cavity ( contraceptive spiral, threads left after the operation);
violation of the structure of the functional layer as a result of the formation of adhesions or scars left after curettage of the uterus;
abnormal growth of the mucosa around particles of the ovum not completely removed during abortion.

The main pathologies that, as a rule, lead to the occurrence serious illnesses and infertility are endometrial hyperplasia and hypoplasia. The causes of deviations from the norm are most often hormonal failure.

endometrial hyperplasia

If the thickness of the functional layer of the endometrium is too large (up to 26 mm), its density increases, the structure becomes heterogeneous, which makes it difficult for the implantation of a fertilized egg and the flow of other processes necessary for the normal development of the fetus.

The consequences of hyperplasia are cycle disorders, an increase in the duration and intensity of menstruation, the appearance of intermenstrual bleeding, anemia. Excessive growth of the endometrium can cause the formation of polyps, the occurrence of endometriosis.

Treatment for hyperplasia is carried out both medically and surgically(by scraping the uterine cavity). When choosing a technique, the woman's age, her desire to have children, and the degree of mucosal growth are taken into account.

Drug therapy (mainly for young women) is carried out using oral contraceptives, as well as drugs with high content progesterone. In this way, they achieve a decrease in the concentration of estrogen, which contributes to the growth of the endometrium. At the same time, the thickness of the endometrium is controlled by the days of the cycle.

Hypoplasia of the endometrium

If the shell is too thin, then pregnancy does not occur, since, firstly, the fetal egg cannot be fixed in the wall, and secondly, having no connection with circulatory system mother, the embryo does not receive nutrition, as a result of which it dies a few days after formation. If the thickness of the mucosa is too small, inflammatory and infectious diseases in the uterus, as it becomes less protected from the penetration of microbes.

If such deviations from the norm occur at a young age, this is manifested by a late onset of puberty, a weak development of external sexual characteristics. Hypoplasia is often the cause of ectopic pregnancy (fixation of the embryo in the neck, in the abdominal cavity).

Treatment for this pathology is carried out by restoring hormonal background with medications containing higher doses estrogen. To improve blood circulation, small doses of aspirin are prescribed, as well as various physiotherapy procedures.

Video: Why the endometrium is too thin. Consequences and treatment

Each organ of the female reproductive system has its own functions and purpose. The uterus has a special role, it is responsible for the secure attachment and full development of the embryo.

The endometrial layer lines the uterine cavity from the inside, creates optimal conditions for the fetal egg and supports the course of pregnancy. The normal thickness of the endometrium depends on the day of the cycle. The size of the mucosa may be lower and higher than normal. Both conditions are abnormal and require correction.

Women learn about the importance of the size of the endometrium during the menstrual cycle after problems with conception begin or are detected. gynecological diseases. This can be avoided. Modern diagnostic methods allow you to accurately and quickly assess the condition of the uterus and existing deviations. The endometrium can be brought back to normal. To do this, it is necessary to regularly undergo ultrasound, and in case of identified pathologies, be treated under the supervision of a doctor.

Ultrasound is the fastest, safest and most informative method determination of the thickness of the uterine mucosa. During a routine examination by a gynecologist, it is impossible to obtain accurate indicators. Only ultrasound allows you to analyze the echographic signs of the inner layer reproductive organ. Doctors observe how the endometrium grows and changes, and also detect pathological changes including tumor growths.

In the absence of contraindications, specialists resort to the transvaginal method, when the organ is examined through the vagina. The most important condition is the study on the day appointed by the doctor. This is due to the fact that the norm of the endometrium in each of the days of the menstrual cycle is different. Normal indicators of mucosal thickness during ovulation differ from the thickness parameters before menstruation. The difference is insignificant, but even the slightest deviation affects reproductive capabilities and health in general.

Signs of thinning

A healthy endometrium, the thickness and structure of which correspond to the day of the cycle, ensures reliable implantation of the embryo, but not all women understand the significance of the measured indicators and pay attention to signs of a decrease in the layer thickness. Specific manifestations have not been identified, but some symptoms should alert and become a reason to see a doctor.

One of the main signs of thinning of the mucosa is the failure of the menstrual cycle, when there are no periods at the right time, and delays are observed regularly.

In addition to cyclic deviations, a decrease in thickness may be accompanied by the following manifestations:

pain in the lower abdomen;
the presence of blood clots in the discharge;
bleeding outside of menstruation.

The mucous layer of the uterus promotes the attachment of the embryo and is the structure that supplies the embryo with nutrients. When the endometrium does not correspond to the phase of the cycle and its thickness is insufficient, pregnancy is impossible. There is simply no chance for an egg to implant safely in the uterus. The fertilized egg is rejected, and doctors in such cases diagnose a miscarriage on early dates. For those who want to get pregnant, such expert opinions are another missed opportunity to have a baby. The situation could have turned out differently if the corrective measures thin endometrium were received on time.

Norms of the endometrium by phases

The endometrium is updated monthly and has a two-layer structure. The basal (deep) layer does not change and contributes to the regeneration of the functional layer, the thickness of which is not constant.

The size of the mucosa in the first days of the cycle averages 3-4 mm. The endometrial layer reaches its maximum thickness after the egg has formed and left the follicle. During the period of ovulation, the indicators may vary, on average they are 12-19 mm. With successful fertilization, these parameters are optimal for successful attachment and further implantation of the embryo.

In cases where pregnancy does not occur, the overgrown endometrial layer is rejected and comes out during menstruation.

The indicators that are studied to assess the size and structure of the mucosa are considered average, but when comparing the result with the norm of the thickness of the endometrium of the uterus, they allow drawing conclusions about the state of the inner lining and the prospects for conception.

If the hormonal background is in order, the process of mucosal growth successively goes through three periods: menstruation (bleeding), proliferation, secretion. Each phase has its own terms, features and functions.

Bleeding phase

In the phase of menstruation with a failed conception, the functional layer is torn off and comes out with the blood. The onset of bleeding is considered the first day of a new cycle. Menstruation lasts 3-7 days. Rejection begins in the first 2 days, the size of the endometrium during this period ranges from 6 mm to 9.

On the 3-5th day of the menstrual cycle, gradual tissue regeneration begins. The thickness grows and reaches 3 mm by the end of the bleeding phase. The compliance of the mucous layer with these parameters is considered the norm.

proliferative phase

Lasts 2 weeks. During this time, the follicles responsible for the production of estrogen have time to mature. This hormone stimulates active growth uterine membrane. As a result, the functional layer thickens and by the end of the period its size reaches 11–13 mm. In parallel with the increase in size, the sound permeability of the mucosa changes. By the end of proliferation this indicator is 9–11 mm.

Proliferation begins on the fifth day of the cycle. The phase includes early, middle and late stages. All 3 periods should always take place in a clear sequence. The absence or failures in the course of any of the stages indicate the development of pathological processes in the body.

The thickness of the uterine endometrium of 7 mm is considered the threshold for possible fertilization. If the size is smaller, conception does not occur.

In the proliferation phase, the thickness is almost twice as large, but this is not the most successful period for fertilization. The woman's body is vulnerable, reacts to any negative phenomena and irritants. Diseases, stress, overwork can stop the natural maturation of the follicle and provoke untimely rejection of the inner layer of the uterus.

Most auspicious time for fertilization, this is the third (secretory) phase, which begins after the proliferation of the endometrium.

Secretory

Secretion is a period of intensive growth of the mucous membrane. The phase lasts from the 15th to the 30th day and is accompanied by the active production of progesterone, which stimulates the growth of endometrial tissues. Slime layer increases, swells, becomes dense, spongy and vascular. The shell size can reach 21–26 mm. This is a normal thickness, sufficient for secure attachment and nourishment of the embryo.

The secretory phase includes three stages:

Early is the 15-18th day. The normal thickness parameter for this period is 12 mm.
In phase medium secretion(from the 19th to the 23rd day) the maximum size of the endometrial layer is observed, after which the thickening stops. The norm for this period is 15–21 mm.
The late period of the secretory phase occurs on the 24th day from the onset of menstruation and lasts 3–4 days. The size of the endometrium begins to decrease and reach 10–17 mm.

If fertilization does not occur, the menstrual phase begins again, and the uterine mucosa is shed during menstruation. This sequence is considered physiological norm. All women have reproductive age these periods repeat regularly.

Thickness by day of cycle

The hormonal background is responsible for the thickness of the functional layer of the endometrium. If an imbalance is not observed, on different days of the cycle, the size of the mucosa will correspond to the norm.

With menstruation, the endometrium changes markedly:

in the first days it is seen as an inhomogeneous structure 5–9 mm thick. There is no clear layered composition of the inner lining. This is explained by the fact that in given period cells are arranged irregularly;
3-4th day of menstruation - cells acquire a clear structure, echogenicity increases, and the thickness of the endometrial layer decreases to 3-5 mm;
5th–7th - normal performance the thickness of the endometrium is from 6 to 9 mm. With the onset of the proliferative stage of the cycle, sound conductivity increases, echogenicity decreases, and the size of the endometrium grows;
8–10th - gradual thickening of the mucosa continues. A clear hyperechoic structure appears in the center of the endometrial layer. Indicators of the norm of thickness vary within 8-10 mm;
11-14th - the echographic picture almost does not change. This is a late stage of proliferation with a characteristic increase in echogenicity and thickening of the endometrium of the uterus up to 9–13 mm;
15-18th - the functional membrane of the uterus thickens up to 10-15 mm. Significant changes in the echogenicity and structure of the endometrium are not observed;
19–23rd - the normal parameter varies from 10 to 18 mm. This is the highest figure for the entire period. After this, the thickening of the endometrium stops;
on the 24th–28th day of the monthly cycle, a decrease in the size of the endometrium is observed. Its thickness is reduced to 12 mm, during ultrasound, heterogeneity of the structure and increased echogenicity are noticeable.

Delay rate

Are considered the main hormonal disorders. The influence of other factors, such as stressful situations, gynecological diseases, Problems endocrine system, unbalanced diet.

The cyclic period with late menstruation is lengthened. The production of hormones is disrupted. As a result, the size of the endometrium after ovulation does not change and corresponds to the natural level of the secretory phase (12–14 mm).

Possible pathologies

If we analyze the results of ultrasound studies, the digital values of the thickness of the endometrium by day of the cycle show an increase trend. Growth is gradual - and this is normal. But, unfortunately, not all women have such an ideal picture. The size of the uterine mucosa often differs from the normative indicators. This happens under the influence of different reasons and factors including:

hormonal disorders;
injuries of the mucous and uterine cavity;
impaired circulation;
inflammatory and infectious diseases uterus.

Pathologies of the endometrium are detected by ultrasound and during additional laboratory examinations. After the cause of the deviation is determined and confirmed, the doctor prescribes treatment taking into account the stage and type of disease, as well as age, physiological characteristics and state of the body.

The discrepancy between the thickness of the endometrium is usually divided into 2 types: hypoplasia and hyperplasia.

Hyperplasia

Hyperplasia is the pathological growth of the endometrium. Anomaly in the thickness of the mucous layer of the uterus is reflected in the density. It increases, and the structure becomes heterogeneous. Such changes make it difficult for the fetus to implant and other processes that contribute to normal development germ.

The disease is dangerous because the rapidly growing endometrium before menstruation does not come out during menstruation. This can lead to perforation (breakthrough), heavy bleeding and hospital treatment.

Hyperplasia can be glandular and atypical. The latter form is more dangerous and is considered as a precancerous condition.

The main reason for the inconsistency of the endometrium with the norms is hormonal disruptions. Thickening is provoked by the active production of estrogen and a deficiency of progesterone. Other causes include tumors and polycystic ovaries, diseases of the endocrine system, metabolic disorders, prolonged hormone therapy, weakened immunity, abortion and uterine trauma.

hypoplasia

Abnormally thin endometrium in medicine is defined by the term "". This disease belongs to congenital pathologies arising from insufficient synthesis of hormones.

Hypoplastic endometrium has no symptoms. The disease does not manifest itself until the woman has a desire to become pregnant. This can be difficult, and experienced doctor able to determine what provoked the development of endometrial pathology. Among the signs of the disease are:

long absence of pregnancy;
frequent miscarriages;
late menstruation (after 16 years);
pathological discharge from the vagina;
irregular periods.

For life, hypoplasia does not pose a danger, but with a thin endometrium, there is practically no chance to bear a child. The thinned shell prevents the onset of pregnancy and the full attachment of the embryo.

Thickness Mismatch

Indicators of the normal thickness of the endometrium are individual, depending on the state of the reproductive system, age and other characteristics of the body. Parameters that go beyond the established limits are considered to be a violation. Similar phenomena are noted during miscarriage and the development of gynecological diseases.

The only pleasant reason for the discrepancy in the thickness of the endometrium may be the conception that has taken place. Growth stimulates the active production of progesterone (pregnancy hormone). The mucous membrane becomes overgrown with vessels, the secretion becomes more abundant, and the endometrial layer increases to 20 mm or more. In other cases, any deviations from the norm are usually attributed to pathological conditions.

Complications and consequences

If no abnormalities are detected on ultrasound and the thickness of the endometrium is normal, the woman has a chance to become pregnant and give birth healthy baby. Unfortunately, not everyone is attentive to their health. Rare visits to the doctor, ignoring anxiety symptoms and self-medication often lead to the development gynecological pathologies dangerous for the reproductive system. Most grave consequence is infertility. The inability to conceive develops due to untimely diagnosis and treatment of progressive diseases.

With hyperplasia in women, the cycle is disrupted, the intensity and duration of monthly discharge increases. Frequent bleeding, which are observed between menstruation, lead to anemia. In addition, the abnormal growth of the inner lining of the uterus causes endometriosis, cysts, polyps and other neoplasms.

No less dangerous complications of hypoplasia. As a rule, they do not appear in the first days and months after the diagnosis of the disease. Vulnerability of the thin endometrium promotes unhindered penetration pathogenic microorganisms into the uterine cavity. This causes infectious and inflammatory processes, provokes ectopic pregnancy and frequent miscarriages.

Treatment of disorders

The thickness of the endometrium is successfully corrected. If during an ultrasound examination, deviations are detected by the days of the cycle up or down, the doctor determines the type, stage and echo signs of the pathology.

Treatment of hyperplasia can be medical and surgical. dosage and suitable medications the specialist prescribes after determining the type and extent of the disease. Hormone therapy with the use of progesterone preparations is considered the most effective. With a decrease in estrogen levels, the endometrium reaches normal levels.

To surgical intervention resorted to when conservative methods are not effective. Doctors may remove the endometrium. In difficult cases of atypical hyperplasia, hysterectomy is performed.

The use of hormonal agents nice results and in the treatment of hypoplasia. Thin layer the endometrium is corrected by means in which the doses of the hormone estrogen are exceeded. If the disease is due to inflammatory processes reproductive organs, therapeutic measures are aimed at stopping and eliminating the focus of inflammation. severe forms hypoplasia require surgical intervention.

The reproductive health of a woman depends on many factors. The indicator of endometrial thickness is one of the most important and significant parameters, since it is with it that the possibility of becoming pregnant, bearing and giving birth to a child is associated. Regular ultrasounds will help track the normal and abnormal conditions of the endometrium, as well as identify other gynecological abnormalities.

The inner lining of the uterus is called the endometrium and plays a major role in the fertile period. The normal thickness of the endometrium varies by day of the cycle. What should it be in this or that period? Let's try to answer this question.

How is the layer thickness determined, and why is it needed?

The norms of the thickness of the endometrium on the days of the cycle change under the influence of female sex hormones. This creates optimal conditions for the introduction of the embryo into the wall of the uterus.

For the onset and successful course of pregnancy important role belongs to the thickness of the inner layer of the uterus. To determine it, ultrasound is performed and echographic signs are analyzed. It must meet certain indicators, because it is under such conditions that the fetal egg will attach and penetrate into the wall of the uterus. It is implanted with subsequent germination of the placenta.

If the condition of the mucous layer in thickness does not correspond to the cycle, then they speak of the impossibility of pregnancy against the background of endometrial insufficiency. And in such cases painstaking hormone therapy is required.

The basal and functional are the two layers that form the very inner lining of the uterus. At the beginning of menstrual bleeding, the functional layer dies and is rejected, but due to the regeneration of the basal layer, it is restored by the beginning of the next menstrual cycle. The necessary thickness of the inner layer for productive implantation is gradually formed.

The mucous membrane of the uterus is sensitive to the level of sex hormones, which varies from day to day. menstrual period. By the end of the cycle, the basal part reaches its maximum size, and then, after menstruation, it becomes very thin. Due to regeneration processes, the thickness of the endometrium changes during the cycle.

Standards for the thickness of the endometrial layer

Let's see how the state of the uterus changes on different days of the cycle. For clarity, consider a pivot table.

Thus, it can be seen that during the cycle the state of the mucous layer changes. However, it happens that these figures may be less than normal. This is possible with a long cycle.

For long cycle the norm is a lag in the development of the endometrium and transitions from one phase to another with a delay depending on individual characteristics female body. The beginning of menstruation is the phase of desquamation, the phase of bleeding. During this period, on the 2nd day of bleeding, the inner lining of the uterus has a thickness of 0.5 to 0.9 cm.

But already on the 5th day of menstruation, regeneration begins, and the thickness basal department already reaches 0.3-0.5 cm. On average, the norm of endometrial thickness should not exceed 2 cm in the final stage of menstruation.

In the middle, the proliferation phase begins (after completion early proliferation, which falls on the 5-7th day). Usually on the 6th day the basal layer corresponds to a thickness of 6 to 9 mm.

Due to the action of progestogen hormones, on the seventh day of the cycle, the endometrium should not be too developed. But already on the 8th day of the cycle, the second begins - middle stage, which is noted with a thickness of 8 mm to 1 cm. Sometimes this period may occur on the 10th day, or it may be that the thickness does not correspond to the day of the cycle.

Then there is a premise that monthly cycle 30 days menstruation will not start on the 30th day. In such situations, there may be up to 9 days of delay or more.

Follicular stage

Detailed information about this stage is given in the video:

The third - late stage, also called follicular, occurs on the 11th, sometimes on the 14th day of the cycle, and the inner layer uterus in this phase has an indicator of 0.9-1.3 cm medium thickness 11 mm. Thus, it can be seen that the norms of endometrial thickness change according to the phases of the cycle.

After these phases, the second period begins - the phase of secretion or excretion. At the first stage of this phase, which begins on the 15th day, the endometrium begins to grow rapidly. This is the most favorable day of the cycle for the conception of a new life. This period of fertility ends on the 18th day. By the way, the period of fertility often changes in different cycles. Sometimes it comes already on the 12th day of the cycle with a short monthly period. It is important to consider these features if a procedure is planned. artificial insemination, since this affects the day of transplantation, which is chosen for IVF.

Then, on the 19-23rd day, the next stage comes, while on the 22nd day, the maximum thickening of the layer is observed - from 1.0 to 2.1 cm. This time is the ideal moment for attaching the fetal egg. And already at a later stage of the secretion phase, approximately on the 24-27th day, the endometrial membrane begins to thin and reaches a level of 1.0-1.8 cm.

Let's try to streamline the restructuring in the female genital area at different days of the cycle:

The first phase is the proliferation phase. This is the initial stage (the first three days after the end of menstruation). In the 1st phase of the cycle, the layer thickness is 2 mm. Its structure is homogeneous, one- or two-layer. On the 7th day of the cycle, the endometrium will be equal in thickness to 4-5 mm, and its structure will acquire the inherent follicular phase three layer structure. Such structural changes occur in the first half of the cycle.
The second middle phase lasts 6-7 days, during which there is a change in the structure of the endometrium.
The third late phase (3-4 days). The follicular layer increases in thickness by another 2 or 3 mm, and before the ovulatory moment its maximum thickness is 8 mm. Continuously with the growth of the endometrium, estrogens contribute to the development secretory mechanism in the mucous lining and to its full function at the end of the cycle.

Phase thickness mismatch

In the photo - the phases of the menstrual cycle of a woman

During menopause, the maximum thickness of the endometrial layer in a woman should be no more than 5 mm. In this case, the size of 8 mm is considered critical, and it is necessary to carry out diagnostic curettage. During menopause, a woman begins to experience age-related changes, at which extinction is observed reproductive function, and there is a deficiency of sex hormones. As a result of this, the development of pathological hyperplastic processes is possible inside the uterine cavity.

Many women are at a loss as to which day of the cycle doctors check the thickness of the endometrium ... The day of the cycle depends on what exactly the gynecologist is going to reveal. If a woman has functional bleeding, then to diagnose their cause, ultrasound is performed several times, various days, tracking the dynamics of changes. For example, ultrasound is done on the 9th day, and then on the 25th day, while the structural changes that occurred during this period are clearly visible, and it can be concluded whether they correspond to the phase.

The main violations of the structure of the endometrial layer are considered hyperplasia and hypoplasia. In the first case, there is a significant excess of the thickness of the endometrial layer compared to typical indicators. With a 21-day cycle, or if the cycle is 30 days, such a progressively increasing thickness indicates the progressive development of the blastula in early pregnancy.

Otherwise we are talking thinning of the endometrial layer. For example, on an ultrasound scan, you can see that the indicator is 6 mm in the middle of the cycle, at a rate of 10-14 mm. In both cases, such violations are marked by the fact that there is a discrepancy between the thickness of the phase of the cycle, and require medical intervention and treatment.

If the endometrium of a heterogeneous structure is observed, then, perhaps, a pathological process takes place. In medicine, it is called endometriosis.

If on the 28th day menstruation does not begin, fertilization may have occurred. Despite the fact that manufacturers of tests for determining pregnancy claim their effectiveness from the 1st day of delay, as statistics show, in many women the test shows positive result when the delay is 7 days or more, i.e. an average of 40 days. It is worth noting that there are cases when there is pregnancy, and the test shows a negative result, even when the delay is 10 days or more. In this case, if there is clinical manifestations If you suspect pregnancy, you need to see a doctor as soon as possible.

Why are hormonal contraceptives prescribed?

Another reason for the discrepancy may be a change in the hormonal background, which will clinically manifest itself as a lengthening of menstruation. In this case, for correction appoint hormonal contraceptives, for example Regulon. The essence of their reception is that the drug is taken for 21 days, with a seven-day break. After the 21st day of taking Regulon, menstruation occurs, and then on the 29th day you need to start taking a new course of the drug again. Thus, for example, with a cycle of 36 days, it gradually normalizes and becomes 28 days.

In conclusion, we want to note that all the above materials are provided for informational purposes only. They cannot serve as a basis for self diagnosis health status of your body.

Why is information about the thickness of the endometrial layer of the uterus needed? The fact is that the endometrium - the inner mucous uterine layer, plays a leading role in the formation of a comfortable atmosphere inside the uterus for the development of the fetal egg. At first, it is through him that the fetus will receive oxygen from the mother's body and a set of all necessary nutrients. Changes that occur cyclically in the endometrium under the action of sex hormones ensure its quality and maturity. The thickness of the endometrium by day of the cycle is important for assessing general condition endometrial layer of the uterus and detection possible pathologies, as well as to determine the most favorable time for conception and pregnancy.

The endometrium is a layer of epithelial cells that lines the inside of the uterus. It is in contact with the middle uterine layer - the myometrium. In the endometrial layer, 2 levels are distinguished:

basal, adjacent to the myometrium;
functional.

AT basal level many connective tissue cells provided with glands. They are the basis for the regeneration of the functional sublayer, which undergoes structural changes during the menstrual cycle.

The endometrium of the uterus performs its main task in the body, which is to create conditions for fixing the fetal egg inside the uterus. Healthy condition endometrial mucosa is the key to reliable implementation of the zygote and its full evolution. That's why normal structure and indicators of the thickness of the endometrium, which vary depending on the cyclicity of the phases and the action of sex hormones, are very important.

If fertilization has not taken place, the overgrown functional sublayer exfoliates and is removed from the uterine cavity with menstrual flow.

Parameters of the normal thickness of the endometrial layer

The norm of the thickness of the endometrium of the uterus fluctuates in the phases of the cycle, and the size of the endometrium either increases or decreases.

What is its level is considered normal, what are the norms of thickness? How long does it take for the development of the endometrium during the different phases?

The endometrial layer undergoes a series of transformations during several stages of the menstrual cycle:

Stage of direct menstrual bleeding(desquamation), when the functional layer, due to the absence of the process of fertilization of the egg, is rejected and leaves the uterine cavity. At this stage, 2 stages are distinguished: the stage of rejection, in which the functional mucosa with a damaged circulatory network of vessels and a loose structure exfoliates, and the recovery stage, when the process of regeneration of the inner layer from epithelial basal cells begins.
Proliferation stage(growth), in which there is a gradual growth of the internal mucous membrane, which prepares the uterus to strengthen the egg. At this stage, changes occur in 3 stages: early, middle, late proliferation.
Stage of secretion, which is characterized by secretory changes in the endometrial tissue. It swells, enriched with a special secret from the glands, increases the thickness of the endometrium. At this stage, the modification of the structure of the endometrium also goes through different stages(early, middle, late secretion).

Any local gynecologist will tell you about the thickness of the endometrium in the norm. In each antenatal clinic there is a table containing the information that should be in healthy woman thickness of the uterine endometrium.

It is worth considering in more detail how the norm of the endometrium changes under the influence of different levels sex hormones during certain phases of the cycle.

Stage of menstrual bleeding

During the period of monthly bleeding in women, the functional layer of the uterus is destroyed, and being rejected, leaves the uterine cavity through the genital tract. This period lasts, on average, from 4 to 6 days, passing through 2 stages - peeling and restoration:

at the stage of exfoliation (1-2 days from the beginning of the cycle), the endometrium normally has a thickness of 4 to 8 mm, reduced density, blood vessels in its structure they become brittle, undergo destruction, and thus menstruation begins;
the regeneration stage falls on the 3rd, on the 5th day, the layer acquires a minimum thickness and should be 3-5 millimeters.

proliferative stage

Begins after 4-5 days, less often on the 7th day, from the beginning uterine bleeding and lasts 12-14 days. During this time, there is an active growth of the endometrium, starting from 2-3 millimeters. Thus, the uterus prepares for potential conception. The stage can be divided into 3 stages:

Early proliferation (approximately on the sixth day), the mucosa becomes thicker by 5 mm, 6 mm or 7 mm, has a slightly pink tint, reduced compaction and relative uniformity.
In the stage of medium proliferation, the endometrial layer increases its thickening, increasing by 8 mm on day 8, by 9-10 mm on day 10, saturated with a more pink color.
At late proliferation lasting from the 11th to the 14th day of the cycle, the formation of folded structures is noted in the endometrial layer, on the 12th day thickening areas are more noticeable in the area of the uterine fundus and its rear wall, on average, the endometrium increases by 13 mm, this is the optimal thickness of the endometrium during ovulation.

Gynecological experience shows that the most favorable level of the endometrium is not less than 12 millimeters. This is a normal thickness, enabling the fertilized egg to successfully attach.

secretory stage

At the secretory stage, which begins two to three days after ovulation, the endometrial mucosa does not grow as actively. With the help of an ultrasound machine, it is noticeable that it begins to change significantly in terms of correcting its structure. This is due to the action of progesterone, the production of which is carried out by the corpus luteum. The stage also includes 3 stages:

The first (early) stage of secretion increases the functional layer slowly. The growing endometrium, rebuilding structurally, swells by 14 mm, by 15 mm, casts a yellowish tint, its edges on the ultrasound monitor are reflected by hyperechogenicity.
At the stage of medium secretion, which lasts between the 24th and 28th day of the cycle, the endometrial layer undergoes a pronounced secretory modification, becoming even more dense, increasing to a maximum thickness of 15-18 mm; ultrasound indicators reveal the occurrence of a boundary strip between the endometrial layer and the myometrium, which is a place of detachment.
In the stage of late secretion, preceding the start of menstruation, corpus luteum undergoes an involutionary process, progesterone levels decrease, which gives rise to the process of atrophy of the overgrown layer. The limit of the thickness of the functional layer on the eve of menstruation is 1.8-2.0 cm (less often 22 mm), this is considered the norm. On ultrasound, islands of expansion of the capillary network and the resulting blood clots are noticeable, leading to tissue necrosis, preparing them for detachment and the onset of menstruation.

How thickness indicators are determined, and for what purposes

It is possible to identify the norm or deviations from it in terms of the thickness of the endometrial layer ultrasound. It is performed in different periods cycle. This makes it possible to determine the source of menstrual disorder, to identify formed neoplasms inside the uterus, changes in the structure of the mucous layer.

The results of the study of the norm of the thickness of the endometrium of the uterus are important criteria when carrying out measures to cure infertility. To do this, they try to identify during the period of ovulation a favorable thickness of the inner functional layer so that it corresponds to the norm, and this, in turn, will contribute to the reliable implantation of a fertilized egg.

Thickness deviations and their possible causes

In the practice of gynecology, there are cases when the endometrium does not correspond to the phase of the cycle. This discrepancy is revealed during an ultrasound examination. Why does it occur? For example, a thick endometrium at the beginning of the cycle may indicate the presence of pathology.

If immediately after the menstruation has passed, the thickness of the endometrial layer has not decreased to normal values, but significantly exceeds them (from 8 mm or more), then we can talk about hyperplasia of the endometrial mucosa.

This is a condition that requires medical measures, since the abnormal growth of the internal mucosa of the uterus is an obstacle to successful conception and bearing a child. Similar pathology triggered by a number of factors, including:

hormonal imbalance;
diseases of the endocrine system;
consequences of the inflammatory diseases genital organs.

When, in the middle of the menstrual cycle, according to ultrasound, the dimensions of the layer are fixed at the level of 5-6 mm instead of the standard 12-14 mm, this is evidence of thinning of the endometrium, called hypoplasia.

In addition, heterogeneous endometrium is one of the signs of development pathological process e.g. endometriosis, polyposis.

During menopause, a number of changes occur in the endometrium, which must be monitored regularly, periodically examined by a doctor.

Tracking the parameters of the thickness of the endometrial layer for their compliance with the level of the norm will allow not only to save for a long time reproductive functions women, but also to prevent the development of possible pathological processes.

Collapse

The main purpose of the inner layer of the uterus is to provide a place for the embryo to attach. The onset of pregnancy directly depends on the indicator of the size of this layer. It is divided into: basal and functional. It is the functional layer that is rejected every month in the form of menstruation. For a woman to fulfill her main function- conceived a child, the thickness of the endometrium on the days of the cycle should correspond to the norm. Let's find out what the norms of the indicators of the inner layer are and why they sometimes deviate from the standard.

Standard thickness of the endometrium by day of the cycle

Every month a woman goes through a cycle. During this, the shell goes through three phases of development:

proliferation;
secretion;
desquamation.

During these phases of development of the uterine layer, each of them is subdivided into three more:

early;
average;
late.

Let's take a closer look at what happens to this layer during each of these periods.

The thickness of the endometrium in the first days of the cycle

In the first days of menstruation, the obesity of the uterine layer will be from 5-9 mm. During this period, ultrasonography shows hyperechoic structures. Simply put, the ultrasound depicts blood clots, and the organ cavity is slightly expanded due to the fact that it contains menstrual fluid.

For 5-7 days

This is the early proliferation phase. On ultrasound, the layer has a small echogenicity. The structure is homogeneous. The indicator of the standard width of the inner layer ranges from 0.3-0.5 cm. On average, it is 0.5 cm. An ultrasound will show the contact of two layers of the uterine coating - new and old.

For 8-10 days

This period is commonly referred to as the intermediate proliferation phase. These days, the tissue begins to grow and thicken. The limits of the norm are 8-10 mm. The echogenicity on ultrasound is similar to that shown by the early proliferation phase.

For 11-14 days

late proliferation period. The inner layer continues to grow and reaches a value of 9-13 mm. average value 11 mm. On ultrasound, an increase in the echogenicity of the hidden layer of the uterus is noticeable.

For 15-18 days

Corresponds to early secretion in time. During this period, the growth of the functional layer slows down, but a slight thickening still occurs. On average, the width of the layer reaches about 1.2 cm, while the fluctuations are 10-1.3 cm. On ultrasound, it takes the form of a “drop”. That is, in the uterine cavity, the membrane is wide, and narrows towards the cervix. Echogenicity is increased compared to late proliferation.

for 19-23 days

Average secretion. This is the maximum width of the inner layer of the uterus for the entire period. Reaches an average of 1.4 cm. Acceptable values range from 10-14 mm. There is an increase in echogenicity.

for 24-28 days

The period of late secretion. The size of the endometrium begins to decrease to an average size of 1.2 cm. During this period, hyperincreased echogenicity and heterogeneity of the structure are observed. Ultrasound clearly shows the boundaries between the new and old reservoir.

As you can see, there are optimally acceptable gaps in the compaction of the uterine layer, which do not affect the health and pregnancy of a woman. However, there are times when it does not meet the standards. What does this mean?