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Mapping the endometrium, cell by cell

The endometrium undergoes dynamic structural and functional changes through the reproductive cycle and is indispensable for pregnancy. It is also a key nexus of disease: endometrial dysfunction can lead to endometriosis and endometrial cancer, amongst various other conditions. Despite this, surprisingly little is known about its physiology or what goes wrong during disease.

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Articles of Interest

Endometrial thickness

Endometrial thickness is a commonly measured parameter on routine gynecological ultrasound and MRI. The appearance, as well as the thickness of the endometrium, will depend on whether the patient is of reproductive age or postmenopausal and, if of reproductive age, at what point in the menstrual cycle they are examined.

Endometrium: The Last Frontier in Fertility

Estrogen secreted from the ovary in the first half of the menstrual cycle, helps the uterine lining build-up, or “proliferate” and thicken. Progesterone secreted from the ovary, in the second half of the menstrual cycle, after ovulation, will “mature” the lining such that the glands branch and become enlarged with glycogen secretions.

Physiology of the Endometrium and Regulation of Menstruation

The physiological functions of the uterine endometrium (uterine lining) are preparation for implantation, maintenance of pregnancy if implantation occurs, and menstruation in the absence of pregnancy. The endometrium thus plays a pivotal role in reproduction and continuation of our species. Menstruation is a steroid-regulated event, and there are alternatives for a progesterone-primed endometrium, i.e., pregnancy or menstruation. Progesterone withdrawal is the trigger for menstruation. The menstruating endometrium is a physiological example of an injured or "wounded" surface that is required to rapidly repair each month.

The Menstrual Endometrium: From Physiology to Future Treatments

The endometrium is a complex and dynamic multicellular tissue that responds to the ovarian hormones. Oestradiol is most abundant in the first half of the menstrual cycle, coincident with high rates of endometrial cell proliferation. Following ovulation, the endometrial secretory phase commences, where high levels of progesterone produced by the corpus luteum lead to altered endometrial morphology to prepare for implantation. If implantation does not occur, the corpus luteum regresses. Subsequent withdrawal of progesterone and oestradiol triggers a series of molecular and cellular events that resemble a classical inflammatory episode (pain, heat, redness and swelling) and culminates with menstruation.

The uterus and the endometrium Common and unusual pathologies

Fibroid diagnosis is not enough, it is also about location location location.

What Most Women Don't Understand About Their Uterine Lining

Most people think of the uterus as a super-flexible sac designed expressly to house and protect a developing fetus. But your uterus is a lot more complex than that, and a lot of its function relies on the endometrium, the layer of tissue that lines the inner surface of the organ.

Why is my endometrium important? What more do I need to know?

The endometrium is made up of layers, the first layer acts as a stabilizing anchor within the uterus and remains unchanged while the second is a dynamic layer that fluctuates based on what stage of the menstrual cycle a female is in. This functional layer of the endometrium is where a fertilized egg or a blastocyst will implant if conception takes place. Every month the endometrium undergoes changes in preparation the arrival of an embryo.

Resources

Radiopedia

The endometrium refers to the inner lining of the uterine lumen, composed of endometrial glands surrounded by loose highly cellular connective tissue.

The Endometrium

Examination of the physical relation­ ships, biochemical interactions and hormonal influences in this tissue could further advance the understanding of this pivotal tissue in the reproductive process.