Endometrial thickness after menopause may indicate malignancy when it is more than >4-5 mm.
The risk of cancer is approximately 4.6% in postmenopausal women with vaginal bleeding if the endometrium measures 5 mm or greater (see upper arrow, Table 2). In women without vaginal bleeding, a threshold of 10 mm (i.e. ≤ 10 mm is considered normal) is associated with a similar cancer risk (see lower arrow, Table 2).
Conclusions: In a postmenopausal woman without vaginal bleeding, if the endometrium measures > 11 mm a biopsy should be considered as the risk of cancer is 6.7%, whereas if the endometrium measures < or = 11 mm a biopsy is not needed as the risk of cancer is extremely low.
Endometrial hyperplasia most often is caused by excess estrogen without progesterone. If ovulation does not occur, progesterone is not made, and the lining is not shed. The endometrium may continue to grow in response to estrogen. The cells that make up the lining may crowd together and may become abnormal.
However, more recent research suggests a thin endometrium ( less than 7 mm ) has a detrimental effect on pregnancy outcomes. There may be increased risks of: hypertensive disorders of pregnancy.
A healthy endometrium is essential for a healthy pregnancy. An endometrial thickness of less than 14 mm is typically considered normal at any stage of the menstrual cycle. During menstruation, the endometrial thickness of pre-menopausal women ranges between two and four millimeters.
In women with post-menopausal bleeding, an endometrial echo of less than or equal to 4 mm is considered normal to effectively rule out cancer. In higher-risk patients with bleeding or patients who "re-bleed," even thinner endometrial echoes may require intervention.
Guidelines suggest that if results of pelvic ultrasound show endometrial thickness of 5 mm or more, it is advisable to perform an endometrial biopsy. If the lining thickness is less than 5 mm, likelihood of endometrial cancer is extremely low.
During menstruation- endometrium appears as a thin, echogenic line 1–4 mm in thickness. During the proliferative phase of cycle (day-5–14), the endometrium develops a trilaminar or striated appearance and measures 12–13 mm (10–16 mm) at ovulation.
Although changes in the endometrial thickness is common in a woman's life, it is important to consult with a doctor if you notice sharp pelvic pain, heavy or less bleeding, abnormal discharge, and other changes.
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