Understanding Endometrial Function and Abnormalities That Can Arise

Function of the Endometrium – Sinaumed’s, did you know that the endometrium is one of the most important parts of the female reproductive system? The function of the endometrium in a woman’s body is closely related to the reproductive process. This section has an important role in the menstrual cycle during pregnancy.

The endometrium or uterine wall has three layers named perimetrium (outer layer), myometrium (middle layer) and endometrium (inner layer). The endometrium consists of tissues that are arranged into layers of the uterine wall from the outermost layer to the innermost layer. This disorder can develop into serious conditions such as endometriosis, hyperplasia, and even cancer.

If there is no embryo attached to the endometrial lining, the embryonic lining will be damaged and cause bleeding. This bleeding is what we call menstruation. Before knowing the function of the endometrium, consider the following explanation about the function of the endometrium and the menstrual phase that causes changes in the endometrium.

Menstrual Cycle

1. Menstrual or Menstrual Phase

This cycle begins with the discharge of menstrual blood through the cervix and vagina. Menstrual blood is a mixture of old blood and decaying uterine lining tissue. The normal duration of menstruation is 2 to 8 days with an average of 5 to 6 days

2. Proliferative Phase

In this phase when the ovaries mature the follicles (follicular phase) which contain the egg, the uterus responds to the estrogen produced by the follicles. Estrogen triggers the lining of the uterus to thicken again after it decays during menstruation. This phase is called the proliferative phase.

In fact, the endometrium is at its thinnest during menstruation and gets progressively thicker during this phase until ovulation occurs. This phase is the preparation of the uterus for the implantation and growth of the fetus in case there is a fertilized egg during ovulation.

3. Secretory Phase

In this phase, the lining of the uterus prepares itself to support the pregnancy process or decays as menstrual blood. This phase itself is commonly referred to as the secretory phase because the lining of the uterus secretes or produces and releases many types of chemicals. When the egg is fertilized, substances secreted by the endometrium function to assist the implantation process in early pregnancy. If the egg is not fertilized, the substances released will trigger the lining of the uterus to decay.

In parallel with this phase, the ovary enters the luteal phase and the follicle that has released the egg (ovulation) turns into a corpus luteum. The corpus luteum will then produce the hormones progesterone and estrogen.

If there is no fertilization, the corpus luteum will stop producing progesterone and estrogen. However, if fertilization occurs, the corpus luteum will continue to produce progesterone to support the pregnancy process.

Endometrial function

From the explanation above, it can be seen that the endometrium is the tissue where implantation occurs. Implantation is the process that occurs when the fertilized egg attaches to the wall of the uterus. This process is an early marker of pregnancy.

In addition, during pregnancy, the glands and blood vessels in the endometrium can provide oxygen, nutrients and other substances for the fetus to continue to develop. The endometrium fuses and forms the placenta with the outer layer of the embryo.

Abnormalities that can arise in the endometrium and their causes

If the function of the endometrium above cannot run properly, it means that the endometrium is considered to have a disorder or abnormality in it. This condition is characterized by the emergence of problems with menstruation. The following is an explanation of the abnormalities that may arise in the endometrium that you need to be aware of

1. Endometriosis

Endometriosis is a condition that occurs when endometrial tissue that is supposed to grow in the uterus actually grows outside the uterus. This condition can cause severe pain, especially during menstruation. Endometriosis most often involves the ovaries, fallopian tubes and pelvic tissue.

Endometriosis can also cause problems with female fertility. This condition can get treatment such as taking drugs, hormone therapy to surgery. To avoid endometriosis you can also do regular exercise, maintain an ideal body weight, reduce caffeine and alcohol consumption.

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The exact cause of endometriosis is still unknown, but there are several things that are thought to trigger this condition, such as:

a. Retrograde menstruation

this condition is a condition when menstrual blood does not flow out of the body through the vagina but reverses direction and enters the pelvic cavity through the fallopian tubes or fallopian tubes.

This condition causes endometrial cells to stick to the pelvic wall and the surface of the pelvic organs. These cells will then continue to grow thick and cause bleeding during the menstrual cycle.

b. Immune system disorders

In this condition, the body’s immune system fails to recognize and instead gives up endometrial cells that mistakenly grow outside the uterus.

c. Immature cell changes

These immature cells can turn into endometrial cells during puberty. This can occur due to hormonal changes in the body, one of which is the hormone estrogen.

d. Endometrial cell migration

This condition is because endometrial cells can move to other parts of the body through the blood and lymph, which are the main part of the immune system.

e. Operation

Procedures such as caesareans and hysterectomies can cause endometrial cells to stick to the incision area so that endometriosis can occur.

2. Endometrial Hyperplasia

Endometrial hyperplasia can occur due to excessive thickening of the endometrial lining. This disorder is believed to occur due to hormonal imbalances in the body in the form of excess production of the hormone estrogen

These hormonal abnormalities can trigger the thickening of the endometrial lining. The condition of unbalanced hormones is also characterized by the lack of production of the hormone progesterone which disrupts the process of egg fertilization.

For women who experience endometrial hyperplasia, the endometrial lining does not shed even if fertilization does not occur. This can cause the cells contained in it to multiply continuously.

Symptoms that can be seen in this condition include irregular menstruation, too much menstrual blood volume, menstrual pain, prolonged menstruation or more than 10 days, less than 21 days between the first menstruation this month and the next month’s first menstruation, menopause but experiencing vaginal bleeding.

There are ways to cure or do some treatments such as progestin preparations, this drug can be given in the form of tablets that are taken orally, injected or in the form of creams for the vagina.

Other treatments can also be done, such as performing a curettage by ‘scraping’ the endometrial tissue to reduce its thickness. This condition can also lead to cancer, so the process of removing the uterus can also be done. This is done if the consideration is not wanting to have children.

3. Endometrial cancer

Endometrial cancer can also be referred to as uterine cancer. Because uterine cancer generally appears more often in the lining of the uterine wall or the endometrium.

In some cases uterine cancer can also start from abnormalities in the muscles in the uterine wall. This type of uterine cancer is also known as uterine sarcoma. Just like other abnormalities that occur in the endometrium, endometrial cancer can also occur due to hormonal imbalances in the body. This can be characterized by excess levels of the hormone estrogen. Other conditions can also occur such as obesity which can cause this disease to occur.

Usually some people with this cancer can experience some of the following signs:

  1. Abnormal bleeding, after menopause or between menstrual cycles.
  2. Pelvic area pain, or pelvic heaviness.
  3. Drastic weight loss
  4. Prolonged fatigue
  5. Easy nausea
  6. Feel pain during sexual intercourse
  7. Pain in several parts of the body including the legs and back.

All women have the potential to develop endometrial cancer, but there are several factors that can increase the risk, such as:

a. Changes in the balance of female hormones

The amount of the two hormones estrogen and progesterone produced by the ovaries is not always stable. The hormones estrogen and progesterone can experience ups and downs or fluctuations that can cause changes in the endometrium

When the hormone estrogen increases but the hormone progesterone does not, a woman can be at risk for endometrial cancer

The conditions that most often cause an increase in the hormone estrogen are irregular ovulation in diabetics, obesity and polycystic ovary syndrome.

b. Having long menstrual periods

A woman who starts having menstruation or menstruation before the age of 12 and menopause at an advanced age or above 55 years can be at risk of experiencing endometrial cancer.

This is because the longer the menstrual period, the more exposure to estrogen will disrupt your endometrium.

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c. Never been pregnant

Women who have never been pregnant have a higher risk of endometrial cancer. Meanwhile, women who have conceived at least once in their lifetime can avoid the risk of this cancer.

d. Elderly

With increasing age, the risk of endometrial cancer also increases. Endometrial cancer most often occurs after menopause or stopping menstruation.

e. Obesity

Overweight or obesity can also increase the risk of endometrial cancer. This is because excess fat in the body can change a woman’s hormonal balance.

f. Hormone therapy for the treatment of breast cancer

Women who have just recovered from breast cancer treatment are at increased risk of developing endometrial cancer. That’s because of the side effects of hormone therapy during breast cancer treatment.

This therapy is in the form of taking the oral drug tamoxifen. Indeed, this is still rarely found, but if Sinaumed’s is undergoing this treatment then you should consult a doctor.

g. Lynch syndrome

This syndrome is a disorder in people that causes the risk of colon cancer. This syndrome is caused by a gene mutation that is passed from parent to child.

If any of your offspring are diagnosed with this syndrome, immediately discuss this with the doctor.

In addition to colon and rectal cancer, people who have this syndrome can also range from ovarian cancer, stomach cancer, kidney cancer, breast cancer, to endometrial cancer.

4. Too Thin Size

Thick and fertile endometrium is needed so that implantation or pregnancy can occur. Generally, the endometrium is about 8-13 millimeters thick. Even so, some cases of women experience abnormal size of the endometrium.

The size becomes too thin if the thickness is under 7 millimeters. If the endometrium is too thin, implantation will not run optimally. The embryo will experience nutritional deficiencies so that the pregnancy cannot continue and can pose a risk of miscarriage.

5. Hormonal Disorders

Hormonal disorders or imbalances can occur at any time. It often affects women who are overweight or obese or who suffer from PCOS. Estrogen levels in women with one of these conditions are usually out of balance with the hormone progesterone.

When the endometrium does not have stable hormones, it will make it difficult for the fertilization process.

6. Uterine Polyps

Excessive growth of the lining of the uterus can result in polyps. Polyps are growths like “fingers” attached to the wall of the uterus. They can be as small as a sesame seed or larger than a golf ball.

The exact cause of endometrial polyps is still not known with certainty. However, it tends to grow when the hormone estrogen in the body exceeds its limits.

There are several other factors that can increase the risk of endometrial polyp disorders such as being overweight or obese, tamoxifen or treatment for breast cancer, postmenopausal hormone replacement therapy, family history of lynch syndrome, cowden syndrome.

The symptoms that initially appear in sufferers of this condition can vary. However, in general, uterine polyps can be recognized by the following symptoms.

  • Irregular menstrual cycles
  • Excessive length or volume of menstruation
  • Bleeding from the vagina between two menstrual cycles
  • Spotting and bleeding appear after menopause
  • Bleeding after intercourse
  • Difficult or unable to get pregnant.

Uterine polyps can certainly be cured with several treatments, such as using drugs to balance hormones, hysteroscopy or curettage, hysterectomy or uterine removal surgery.

Most cases of polyps are not cancerous, but the correct diagnosis is when Sinaumed’s goes to the doctor.

7. Asherman’s syndrome

This syndrome is a fairly rare genetic disorder of the uterus. It is characterized by the presence of bands of scar tissue that line the uterine wall. The cause can be triggered by various factors such as uterine tissue surgery and endometrial infection

A person may experience a variety of different symptoms depending on the severity of the disease including reduced menstrual flow, increased cramping and abdominal pain, missed periods (amenorrhea), infertility.

Treatment options for this syndrome are hysteroscopic surgery, insertion of a Foley catheter, and restorative therapy (hormone treatment).

8. Pelvic Inflammation

It could be that bacteria or microbes enter the cervix and spread to the upper female reproductive tract.

The infection can affect one or more of the pelvic organs, including the uterus, cervix and fallopian tubes.

There are several symptoms starting from the occurrence of pelvic inflammation or (PID) such as pelvic pain, urgent need to urinate, pain when urinating.

Treatment that can be lived is to take drugs such as antibiotics.


So, that was Sinaumed’s’ explanation of the function of the endometrium and also the abnormalities that might occur. As previously explained, this endometrium can cause several abnormalities.

Even so, the disorder can be prevented by undergoing reproductive health. So, women must maintain the health of their reproductive organs, Sinaumed’s, to avoid these problems.