The endometrium, a critical element in female reproductive health, undergoes dynamic changes in response to the menstrual cycle. Composed of the basal and functional layers, its thickness is not static but varies cyclically. The basal layer remains constant throughout the cycle, unaffected by ovarian hormonal fluctuations. In contrast, the functional layer is subject to hormonal influences, undergoing necrosis and shedding during menstruation.

Consequently, the endometrial thickness varies with the menstrual cycle phases. Considering a typical 28-day cycle, these phases include the menstrual period, proliferative period, and secretory period. The menstrual period, spanning from the first to the fourth day, is when the endometrium shows a secretory response under progesterone influence.

Thin endometrium or endometrial inflammation can disrupt the menstrual cycle. Conditions such as endometritis require timely medical intervention, and treatments like the Fuyan pill have been suggested for management.

Causes of Thin Endometrium

Thin endometrium arises from systemic and local factors. Systemic factors involve endocrine disorders, including low estrogen levels, progesterone deficiency, ovulatory dysfunction, and growth hormone deficiencies. Local factors pertain to injuries or adhesions in the endometrium.

1. Induced abortion significantly contributes to thin endometrium, as it often leads to prolonged absence of menstruation, indicating severe endometrial damage. Recovery can be lengthy, and some patients may not fully recuperate. Hence, post-abortion patients are advised to seek medical evaluation if menstruation is delayed.

2. Severe endocrine disorders can cause hormonal imbalances, disturbing the endometrial cycle and leading to thinning. The endometrium, responsive to estrogen and progesterone, changes throughout the sexual cycle. Estrogen can cause uterine hypertrophy, while progesterone induces specific changes in the endometrium conducive to early pregnancy.

Uterine malformations, such as a bicornuate or septate uterus, especially after surgeries like hysteroscopic resection, can also result in thin endometrium. Additionally, age is a factor; older patients, particularly those over 40, often exhibit thin endometrium during ovulation induction. General health conditions like colds or fever may also contribute to thinning.

Impact on Pregnancy

The effect of thin endometrium on pregnancy depends on its thickness. An optimal thickness is between 8-10mm, with an average range of 8-12mm. A diagnosis of thin endometrium is made when it is less than 7mm. Clinical studies indicate that endometrial thickness below 8mm correlates with lower pregnancy rates (23%), higher spontaneous abortion (26.7%), and ectopic pregnancy rates (10.0%). For endometrium thickness between 8 and 11 mm, these rates are 37.2%, 23.8%, and 4.3%, respectively.

Thin endometrium first impedes conception. It's likened to an unstable house where fertilized eggs cannot implant effectively. Insufficient endometrial support can lead to unsuccessful conception and eventual infertility. A too-thin uterine wall also affects the nourishment of the embryo, increasing the risk of early miscarriage.

Patients with thin endometrium often have histories of multiple miscarriages, estrogen deficiency, or chronic weakness. Their symptoms include scanty menstruation, with kidney-deficiency patients showing delayed menarche and reduced menstrual flow. These patients experience symptoms like dizziness and back pain. Blood deficiency patients, typically in their 30s to 40s, present with poor nutrition, overwork, light menstrual flow, abdominal pain, dizziness, and a yellow complexion. Patients with blood stasis, often post-gynecological surgery, experience less menstrual flow with dark clots and lower abdominal pain.

Management Strategies

Patients are advised to maintain a calm and positive mindset, as stress can adversely affect hormonal balance. Warmth during menstruation is vital, using methods like heating pads to improve circulation and alleviate discomfort.

Lifestyle adjustments, including moderate exercise and a nourishing diet, can help restore endometrial health. Foods rich in blood-enriching nutrients, like black beans, black fungus, honey, walnuts, and sesame, are recommended.

In conclusion, understanding the causes of thin endometrium and adopting a comprehensive approach encompassing lifestyle, diet, and emotional well-being is crucial for improving endometrial health and enhancing pregnancy chances.