PROLIFERATIVE

ENDOMETRIUM

Submitted by:
Dela Cruz, Kristine M.
BSN 2Y2-3B

Submitted to:
Ms. Evangeline Orata
What is proliferative endometrium?
The layer of tissue lining of the inner side of the uterus is called
the endometrium. It provides a suitable environment for the
implantation of a fetus. However, if pregnancy does not occur,
this lining is shed off, resulting in bleeding or menstruation. The
monthly shedding of the endometrium is followed by the growth
of a fresh layer that prepares an environment for implantation if
an egg is fertilized.
A womans menstrual cycle has two phases: proliferative and
secretory. The proliferative phase occurs under the influence of
the hormone estrogen, which stimulates endometrial growth and
thickening. During this phase, the proliferative endometrium
undergoes cell multiplication and tissue growth. If ovulation
occurs, the corpus luteum (yellow body) secretes a hormone
called progesterone, which makes the endometrium thicker,
creating an ideal environment for implantation of a fertilized egg.
This is known as secretory endometrium phase.

Whats Disordered Proliferative Endometrium?

At the time of perimenopause, hormone levels fluctuate. Because
of the irregularity of hormone production, endometrial growth
becomes irregular, leading to irregular cycles. This is what some
people call disordered proliferative endometrium, which simply
implies that the growth of the lining of the uterus is not regular,
nor is the lining shedding off regularly. This does not necessarily
mean malignant changes are occurring.
Another potential cause of disordered changes in the proliferative
endometrium is the use of birth control pills like Loestrin 20. This
may be corrected by taking cyclical hormone therapy. If not
corrected, this condition may progress to abnormal thickening of
the endometrium (endometrial hyperplasia), one of the factors
that increases your risk of developing endometrial cancer.
However, this is rare, but it is important for you to keep
hypertension, diabetes, and weight under control to avoid
increasing your risk.

More About the Uterine Cycle and Endometrium

Changes
The menstrual cycle involves the monthly or cyclical changes in
the uterus. The uterus undergoes changes in preparation for
implantation of the fertilized egg. This consists of three phases:
The Menstrual Phase
The first phase of the menstrual cycle is the menstrual phase,
which is the beginning of the uterine cycle. During this phase, the
thick uterine lining sheds off, causing bleeding as it separates
from the uterus. This phase usually lasts from 3 to 7 days, with
menstrual flow being less on the first day, increasing during the
2nd and 3rd day and gradually tapering off on the 4th to 5th days.
Menstruation occurs due to the withdrawal of hormones (estrogen
and progesterone), causing the endometrium to shrink and die,
thus leading to its separation from the uterus.
The Proliferative Phase
After menstruation, proliferative changes occur during a period of
tissue regeneration. The endometrium repairs itself and it
becomes thicker.New blood vessels develop and the endometrial
glands become bigger in size. The stromal cells are arranged in a
compact manner. At the end of this stage, around the 14th day,
the proliferative endometrium is about 2-3 mm thick.
The Secretory Phase
The secretory phase begins soon after ovulation. Progesterone
production is increased and the glands increase in size as they
become secretory. Initially, secretions collect in the glandular
cells, but by the 19th - 22nd day, secretions are pushed out of
these cells and into the endometrial cavity. The secretion consists
of fructose, glucose and glycogen. It is meant to supply nutrition
to the fertilized ovum in the uterus.
If there is no fertilized ovum, endometrial growth stops. The lining
starts to shrink and die, resulting in bleeding and shedding. This
signals the beginning of another menstrual cycle.

Risk factors for Endometrial hyperplasia

-Obesity
-History of diabetes
-Family history of ovarian cancer

What is the treatment for disordered proliferative

endometrium?
The most common treatment for endometrial hyperplasia, which
occurs when there is proliferation of the endometrium, is
progestin therapy, according to the Women's Health and
Education Center. Although endometrial hyperplasia can increase
the risk of developing cancer, treating it with progestin or by
surgical means can help eliminate the risk.
Symptoms of endometrial hyperplasia include heavy bleeding
between periods and a shorter menstrual cycle. Doctors use tests
such as transvaginal ultrasounds, biopsies, and dilation and
curettage to diagnose endometrial hyperplasia. This disorder can
either be simple or complex, and it is atypical when there are
abnormal cell changes.