What is Proliferative Endometrium?

What’s the relationship between your endometrium and menstruation?

Menstruation is usually associated with the week or so of the month when vaginal bleeding happens. But if you’re of reproductive age, your menstrual cycle is actually ongoing. It’s a whole series of hormonal changes that lead to pregnancy or your monthly period.

In the early stages of your menstrual cycle, your reproductive organs work to make your body a hospitable place for conception to occur. For example, the mucus membrane in your uterus — also called the endometrium — will thicken in preparation of a fertilized egg.

If a fertilized egg isn’t implanted in your uterus, your body will shed these extra cells. This process of shedding unused cells from your endometrium happens every 21 to 35 days, depending on the length of your cycle.

Proliferative endometrium stage

The proliferative endometrium stage is also called the follicular phase. The term “proliferative” means that cells are multiplying and spreading.

During this phase, your estrogen levels rise. This causes your endometrium to thicken. Your ovaries also prepare an egg for release. This phase lasts for half your cycle, usually 14 to 18 days.

Secretory endometrium stage

Your ovaries release a mature egg, and the next phase of menstruation begins. The new endometrial cells mature and become ready for an egg to be implanted. For about a week, your uterus is waiting for a fertilized egg to arrive. If it doesn’t, your body prepares to shed and discard your endometrial lining.

This stage lasts for the second half of your cycle, usually another 14 to 18 days. On the first day of your period, this stage ends.

What does it mean if proliferating is disordered?

Sometimes a doctor may refer to the proliferation of your endometrial cells as disordered. This could mean a number of different things, depending on your individual diagnosis.

For example, if your endometrial tissue in your uterus grows too fast, the cells can become malignant. If the lining doesn’t thicken quickly enough, an egg may have trouble implanting in your uterus to begin a pregnancy.

Your doctor is the only one who can explain what this diagnosis means for you.

Disordered proliferative endometrium is usually associated with these conditions:

  • Endometrial hyperplasia. This is endometrial tissue that keeps growing because of excess estrogen. Instead of shedding, the cells keep multiplying in your uterus.
  • Uterine polyps. Endometrium overgrowth can lead to the formation of polyps. These polyps are more common after menopause, but younger women can develop them, too.
  • Atrophic endometrium. This condition occurs most often during and after you reach menopause. It’s the result of a loss of estrogen in your body. Atrophic endometrium can cause you to experience bleeding even after you’ve stopped having your period.
  • Endometrial cancer. According to the American Cancer Society, almost all uterine cancers are endometrial. This kind of cancer starts in the cells lining your uterus.

Symptoms associated with disordered proliferative endometrium

If your endometrial cells aren’t growing and being shed at the rate they should, you may experience:

  • breakthrough bleeding between periods
  • heavy bleeding during your period
  • extremely painful periods
  • menstrual cycles that are shorter than 24 days or longer than 38 days
  • difficulty getting pregnant

If your doctor suspects that your symptoms are connected to your endometrium, they may recommend certain tests:

  • An ultrasound will allow your doctor to detect whether there are growths in your uterus that shouldn’t be there.
  • In an endometrial biopsy, your doctor will remove a small piece of endometrial tissue. This will allow them to examine your cells and determine the rate at which they’re growing.

Talk with your doctor

If you’re experiencing any unusual symptoms, see your gynecologist. You can discuss your symptoms at your yearly pelvic exam, but you shouldn’t wait until then if your symptoms are new or unexpected.

You should also talk with your gynecologist if you have questions about your Pap smear or other test results. They can answer any questions you may have and help you better understand what’s happening inside your body.

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