What Most Women Don't Understand About Their Uterine Lining

What Most Women Don't Understand About Their Uterine Lining

Most people think of the uterus as a super-flexible sac designed expressly to house and protect a developing fetus. But your uterus is a lot more complex than that, and a lot of its function relies on the endometrium, the layer of tissue that lines the inner surface of the organ. 

Developing an understanding of what the endometrium is, how it functions, and what problems it can develop is essential for maintaining optimal health throughout every stage of life. 

In this post, Rafael J. Perez, MD, FACOG, and our team at the Center for Urogynecology and Advanced Laparoscopic Surgery offer a brief overview of the endometrium, including what symptoms could indicate a serious problem.

What the endometrium does

The endometrium is a mucus membrane composed of two distinct layers of tissue: 

Because the upper layer changes during your cycle, it’s sometimes referred to as the functional endometrium.

The functional layer of your endometrium gets thicker just before you ovulate, preparing for the possible implantation of a fertilized egg (and, ultimately, pregnancy). The endometrium is also where the placenta develops, and as the tissue thickens prior to ovulation, dozens of tiny blood vessels grow in response.

If an egg doesn’t implant during your cycle, the endometrium sheds, creating your menstrual flow and helping your uterus reset for the next cycle. Your period fluid is composed of endometrial tissue, along with blood and other byproducts produced by changes in your endometrium.

Changes in estrogen and progesterone — the sex hormones — trigger these endometrial changes. Prior to puberty and again during menopause, low levels of these hormones allow your endometrium to remain thin and stable, so periods don’t occur. Hormonal birth control methods can have the same effect.

Potential problems you should know about

The endometrium can experience health problems just like the other parts of your body. Knowing what those problems are can help you seek treatment as soon as possible.


Endometriosis develops when endometrial tissue grows outside the uterus. These growths are called implants, and they can form in many areas, including the outer uterine wall, the ovaries or fallopian tubes, the bowel wall, or even in your chest cavity.

Endometrial tissue responds to changes in your hormone levels, and even though these implants are outside your uterus, they still thicken, swell, and bleed during your cycle. 

Women with endometriosis have considerable pain, along with heavy periods, fatigue, bloating, and other symptoms. 

Some women develop scar tissue (adhesions) that interferes with normal tissue movement and function. Adhesions can also impair fertility or interfere with pregnancy.

Endometrial hyperplasia

Endometrial hyperplasia develops when the endometrium becomes thicker than normal, typically due to a hormonal imbalance. While it can happen at any time, it often occurs in the months and years leading up to menopause when estrogen levels change dramatically.

Some women develop endometrial hyperplasia during menopause or in response to hormonal medications. Obesity and polycystic ovary syndrome also increase the risk of developing an unusually thick endometrium.

Endometrial hyperplasia is associated with very heavy periods, bleeding between periods, or bleeding during menopause. It can also increase your risk of developing endometrial cancer.

Endometrial cancer

Endometrial cancer occurs when the cells comprising the endometrium grow at abnormal rates. 

This type of cancer is almost always accompanied by abnormal vaginal bleeding, including bleeding between periods and bleeding during menopause. You might also have pelvic pain or heaviness or unusual vaginal discharge.

The most common type of reproductive organ cancer in women, endometrial cancer responds very well when treated in its earliest stages. Scheduling a visit at the first sign of abnormal bleeding or other symptoms is essential for preserving your health.

Stay empowered, stay healthy

As a woman, you have specific health needs, and those needs change with every stage of life. Having regular exams with our team is one of the best things you can do to stay healthy as you get older, so you can continue to enjoy optimal health and wellness.

If you’re having unusual symptoms or if it’s been a while since your last pelvic exam, call us today at 305-240-6047 to request an appointment with Dr. Perez and our team at the Center for Urogynecology and Advanced Laparoscopic Surgery in South Miami, Florida.

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