Endometrial Stripe Size 2025: Average Thickness by Age & What It Means

Understanding the Endometrial Stripe

The endometrial stripe refers to the lining of your uterus, known medically as the endometrium. During ultrasound or MRI scans, this lining appears as a distinct dark line, which is why it’s called the endometrial stripe. It’s important to note this term describes a normal uterine tissue, not a disease or condition.

While endometrial cells can sometimes be found outside the uterus in conditions like endometriosis, the endometrial stripe specifically relates to the uterine lining itself.

This tissue naturally changes thickness throughout your life and reproductive phases. Below, we explore these changes, signs of potential issues, and guidance on when to seek medical advice.

Typical Appearance of the Endometrial Stripe

For women of reproductive age, the thickness and appearance of the endometrial stripe fluctuate depending on the menstrual cycle phase.

Menstrual & Early Proliferative Phase

During menstruation and the early proliferative phase, the endometrial stripe is very thin, often appearing as a fine, straight line on imaging.

Late Proliferative Phase

As ovulation approaches, the endometrium thickens, and the stripe may look layered with a darker central line. This phase ends once ovulation occurs.

Secretory Phase

After ovulation, the secretory phase sees the endometrium reach its thickest point, with fluid accumulation making the stripe appear uniformly dense on ultrasound.

Normal Thickness Ranges by Life Stage

The thickness of the endometrial stripe varies widely depending on age and reproductive status.

Before Puberty

In pediatric patients, the endometrial stripe remains thin throughout the month and may sometimes be undetectable via ultrasound.

Reproductive Age

During reproductive years, the stripe thickness changes with the cycle, ranging from under 1 mm to over 16 mm.

• Menstruation: 2–4 mm
• Early proliferative phase: 5–7 mm
• Late proliferative phase: Up to 11 mm
• Secretory phase: Up to 16 mm

Pregnancy

In early pregnancy, the endometrial stripe is typically 2 mm or thicker to support implantation. As pregnancy progresses, the stripe becomes obscured by the gestational sac and placenta.

Postpartum

After childbirth, the stripe is thicker due to residual blood clots and tissue, especially common following cesarean sections. It usually normalizes once menstrual cycles resume.

Postmenopause

Postmenopausal women generally have a stable, thinner endometrial stripe. Thickness greater than 4–5 mm without bleeding may indicate a risk for endometrial cancer and warrants medical evaluation.

Causes of Abnormally Thick Endometrial Tissue

A thickened endometrial stripe isn’t always alarming but can signal certain conditions, including:

Endometrial Polyps

Benign growths that can thicken the lining and sometimes carry a risk of malignancy.

Uterine Fibroids

Common benign tumors that may increase apparent thickness by attaching to the endometrium.

Tamoxifen Therapy

This breast cancer medication can alter endometrial thickness and cause early menopause symptoms.

Endometrial Hyperplasia

An excessive growth of endometrial glands, often in postmenopausal women, which can be precancerous.

Endometrial Cancer

Thickened endometrium combined with symptoms like irregular bleeding or pelvic pain may indicate cancer, requiring immediate medical attention.

Causes of Abnormally Thin Endometrial Tissue

Thin endometrium typically isn’t concerning unless accompanied by symptoms. Possible causes include:

Menopause

Natural thinning occurs as ovarian estrogen production declines.

Endometrial Atrophy

Low estrogen states from menopause, hormonal imbalances, or other health issues can prevent the lining from thickening adequately.

Symptoms Linked to Endometrial Abnormalities

Signs to watch for include:

• Bleeding between periods
• Severe menstrual pain
• Irregular cycle lengths
• Heavy or prolonged bleeding
• Pelvic pain or painful intercourse
• Difficulty conceiving

If you experience these symptoms, consult your healthcare provider promptly for evaluation and diagnosis.

Consult Your Healthcare Provider

Open communication with your doctor about your reproductive health is crucial. Regular check-ups and timely discussions about symptoms can ensure early detection and treatment of any uterine issues.

Do not delay seeking care if you notice abnormal symptoms—early intervention can improve outcomes.

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