Issues with the Endometrium

What is the endometrium?

“Endometrium” is the medical name given to the lining of the uterus. It changes throughout the menstrual cycle, shedding during menstruation and then thickening before it sheds again. Pregnancy occurs when a fertilized egg successfully embeds in the endometrium. If pregnancy doesn’t occur, the uterus sheds the endometrium and begins another menstrual cycle.

How do I know if I have a problem with my endometrium?

Here are some indicators that there might be an issue with your endometrium:

Heavier and longer periods than normal
Menstrual cycles that are shorter than 21 days apart from start to start
Any bleeding after menopause
Painful cramping during periods
Pain with vaginal intercourse
Pain with bowel movements or urination, usually during the menstrual cycle

Two of the most common issues with the endometrium are endometrial hyperplasia and endometriosis. Both are serious disorders that can be treated.

What is the difference between Endometrial Hyperplasia and Endometriosis?

When the endometrium becomes too thick, it’s called “endometrial hyperplasia.” This condition is not cancer, but it can lead to uterine cancer.

“Endometriosis” is an often painful disorder in which endometrial tissue grows both inside and outside the uterus. The tissue usually surrounds ovaries, fallopian tubes, and the pelvic lining. Just like the endometrial tissue inside the uterus, the tissue on the outside also breaks down at the start of the menstrual cycle. But it has no way to exit the body and becomes trapped. Surrounding tissue can become irritated, eventually developing scar tissue, cysts, and adhesions.

There are risks associated with both endometrial hyperplasia and endometriosis. Besides living in pain and inconveniently heavy periods, if left untreated they can cause infertility and increased risk of ovarian and uterine cancer.

Fortunately, effective treatments are available once your doctor has properly diagnosed your condition.

How do doctors test the endometrium?

Many doctors gain a sample of the endometrium using a pipette. At its simplest, a pipette is similar to a thin baster. The doctor carefully inserts the pipette into the uterus and then sucks up tissue by pulling back on a small plunger at the proximal end. Suction pressure can be uncomfortable for some women, so MedGyn offers pipettes with 1, 2, and 4 holes. The more holes in a pipette, the lower the suction pressure. This can reduce discomfort while still allowing the doctor to obtain a viable sample.

However, it can be tricky to keep the pipette and the gathered endometrial sample uncontaminated. Backflow is a big problem, as is bumping the distal end of the pipette against the cervix or vaginal wall. A clean sample is needed for reliable testing. This is no longer a problem with MedGyn’s Endosampler™. The proximal end is a syringe with a lock. When enough tissue has been collected, the doctor can deposit the sample in a separate container without ever risking its integrity. The doctor can even stake a second sample without risking contamination. By collecting a viable sample the first time, patients and doctors can avoid repeat procedures.