What should you know?
The endometrium is the inner lining of the uterus. Its thickness changes naturally across the menstrual cycle, so a number cannot be interpreted without age, cycle day, hormone use and symptoms.
Before menopause, the lining normally grows from the early to late cycle. After menopause, any bleeding is clinically important and may require targeted ultrasound and sometimes tissue sampling.
Common symptoms and signs
- Irregular or prolonged bleeding
- Bleeding between periods
- Any bleeding after menopause
- An incidental ultrasound finding without symptoms
Diagnosis and the role of ultrasound
Transvaginal ultrasound measures the endometrium in the mid-sagittal plane and assesses uniformity, borders, intracavitary fluid and focal lesions. Saline sonography or hysteroscopy may clarify a suspected polyp.
- Cycle day and hormonal status
- Thickness and uniformity
- Focal polyp or submucosal fibroid
- Fluid within the uterine cavity
Treatment and next steps
Next steps depend on age, bleeding pattern, risk factors and morphology. Observation, hormonal evaluation, endometrial biopsy or hysteroscopy may be appropriate.
When is urgent care needed?
- Heavy bleeding with dizziness or weakness
- Any postmenopausal bleeding needs timely evaluation
- Possible pregnancy with pain and bleeding