Irregular Menstruation: Thick Endometrium and When to Seek Help

Menstrual issues

Hello, doctor.
I would like to ask two questions: 1.
Since my menstrual cycle is irregular and I only get my period once every six months, I consulted a traditional Chinese medicine doctor who told me that my endometrium is thick because I haven't menstruated for a long time, and I need to wait for it to shed gradually (as my period has not ended since April 22).
Is it true that the endometrium can become thick due to a long absence of menstruation? 2.
Should I just let it shed gradually, or is there a specific time when I should see a gynecologist? Currently, the flow is quite heavy, similar to the amount on the second or third day of a typical period, but it’s not to the extent that I need to change sanitary pads very frequently.
Thank you!

Hsu, 10~19 year old female. Ask Date: 2023/05/04

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, a thick endometrium may be related to a missed period.
It is recommended to visit a gynecologist after your menstruation has cleared to check if the endometrium has improved.
Wishing you good health.

Reply Date: 2023/05/04

More Info

Irregular menstruation can be a complex issue, and understanding the underlying causes and appropriate responses is crucial for maintaining reproductive health. Your questions touch on important aspects of menstrual health, particularly regarding the thickness of the endometrium and when to seek further medical advice.

1. Thick Endometrium Due to Irregular Menstruation: Yes, it is possible for the endometrium (the lining of the uterus) to become thickened due to prolonged periods without menstruation. When menstruation is irregular or absent for an extended period, the endometrium continues to grow in response to hormonal stimulation, particularly estrogen. If the menstrual cycle does not resume, this thickened lining can lead to a condition known as endometrial hyperplasia, which can sometimes progress to more serious conditions, including endometrial cancer. Therefore, while it is common for the endometrium to thicken when menstruation is infrequent, it is essential to monitor this condition closely.

2. When to Seek Help: Given that you have not had a menstrual period for six months and are currently experiencing prolonged bleeding, it is advisable to consult a gynecologist. While your traditional medicine practitioner may suggest waiting for the body to naturally expel the thickened endometrium, it is important to ensure that there are no underlying issues that require medical intervention. If you are experiencing heavy bleeding, especially if it is similar to the flow you would expect during the peak days of your menstrual cycle, this could be a sign of a more serious condition.
In general, you should seek medical attention if:
- You experience prolonged bleeding that lasts more than a week.

- You have bleeding that is heavier than your normal menstrual flow.

- You experience any other concerning symptoms, such as severe pain, dizziness, or fatigue.

A gynecologist may recommend a pelvic ultrasound to assess the thickness of the endometrium and rule out any abnormalities. If the endometrial lining is significantly thickened, they may suggest a biopsy to check for hyperplasia or other conditions.
In conclusion, while it is possible for the endometrium to thicken due to irregular menstruation, it is crucial to monitor your symptoms and seek medical advice, especially given the duration and nature of your bleeding. Regular check-ups can help ensure that any potential issues are addressed promptly, allowing for better management of your menstrual health.

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