What Happens to the Endometrial Lining After Menopause?

When a woman is post-menopausal, which means fully menopausal (no menstrual periods for a year) the uterine lining, which is called the endometrium, should not be thicker than 4 to 5 mm, according to everydayhealth.com.

HRT and the Endometrium

• Taking hormone replacement therapy can thicken your endometrium. If you are not on hormone replacement therapy and your endometrial lining is above 4 to 5 mm your physician may want to take a biopsy.

Hyperplasia

• If you are in full menopause and yet are experiencing bleeding (after going a year or more without a menstrual period) this may be cause for concern. A thickened endometrium can be an indication of abnormal cell growth, which is called hyperplasia. Hyperplasia is excessive or unusual cell growth in the inner glandular lining of the uterus, according to womentowomen.com. This can be a sign of endometrial cancer.

Don't Ignore This Condition

• Recognize that hormonal imbalances and changes that occur during menopause can result in hyperplasia. This condition can get worse and lead to precancerous cellular changes.

Considerations

• Keep in mind that the thickness of the endometrial lining only has meaning in the detection of carcinoma or hyperplasia one year after menopause has set in or one year after your last menstrual period, according to Dr. Ronald Barentsen, Netherlands, chairman of the OBGYN.net Menopause Advisory Board.

Estrogen and Its Impact

• Dr. J. Glenn Bradley of OBGYN.net explains that most post-menopausal bleeding can be the result of hormone replacement therapy, because the endometrium is quite sensitive to estrogen, which is an essential component of your hormone therapy. Estrogen triggers the growth of the uterine lining. If you are not on hormone replacement therapy and are menopausal, you probably don't have enough estrogen, and this can cause the lining to atrophy. When atrophy occurs, the blood vessels in the endometrium become frail and break, and this can cause bleeding.

Inflammation

• Another consideration is that the endometrium can become inflamed during menopause, resulting in a condition called atrophic vaginitis. This is caused by the low levels of estrogen and can lead to bleeding.

Uterus Changes

• According to changeoflife.com, after menopause, the uterus will shrink, as will any existing fibroids. The uterus ends up being comparable to the size of a small pear.

Notify Your Doctor

• If you are menopausal and experiencing unexpected irregular or heavy bleeding you need to bring this to the attention of your physician.