Endomeetriumile

Endomeetriumile refers to the endometrium, the inner mucous membrane of the uterus that undergoes cyclic changes throughout a woman's reproductive life. It is a multi‑layered structure composed of the functional layer, which is shed during menstruation, and the basal layer, which regenerates the functional layer each cycle. The functional layer itself includes the stratum functionalis, which thickens in response to estrogen during the follicular phase, and the stratum basalis, which remains relatively unchanged and serves as a reserve for regrowth.

During the menstrual cycle, rising estrogen levels stimulate proliferation of the endometrial glands and stroma, leading to a thick, vascularized tissue by the mid‑cycle. If fertilization does not occur, progesterone withdrawal induces apoptosis of the endometrial cells, resulting in menstruation. In the presence of implantation, progesterone maintains the endometrium in a secretory state conducive to embryo attachment and growth.

Endometrium thickness, vascularity, and histology are important diagnostic indicators. Endometrial hyperplasia, often related to unopposed estrogen, can progress to endometrial carcinoma if left untreated. Common symptoms of endometrial disorders include abnormal uterine bleeding, pelvic pain, and infertility. Diagnosis typically involves transvaginal ultrasound to assess thickness and hysteroscopy with biopsy to evaluate histopathological changes.

Therapeutic approaches range from hormonal management—such as progestins or combined oral contraceptives—to surgical interventions like dilation and curettage, hysteroscopic polypectomy, or hysterectomy, depending on underlying pathology and patient reproductive goals. Recent advances in minimally invasive hysteroscopic procedures have improved outcomes and reduced recovery time for many endometrial conditions.