A thick, healthy lining of the uterus, known as the endometrium is necessary for a healthy menstrual cycle and pregnancy. A fertilized egg needs the lining of the uterus to be a certain thickness to implant and begin growing. So what should you do if your endometrial lining is thin? Learn how to build and protect a thick, healthy uterine lining naturally. There are many natural therapies to help increase the thickness and health of the uterine lining. In this article, we’ll discuss the different causes of a thin uterine lining and what you can do about it; including fertility cleansing, herbs and supplementation, and physical therapies like self fertility massage and acupuncture.
The endometrium is the layer of the uterus that thickens in preparation for the implantation of the fertilized embryo. The endometrium is also the layer that is shed during menstruation. Estrogen is responsible for creating a thick, lush, and blood-rich endometrium. If estrogen levels are not adequate the uterine lining will remain thin. A healthy, adequate uterine lining is at least 8mm thick. Below that, doctors consider it inadequate.
What Causes a Thin Uterine Lining?
There are 5 main causes of a thin uterine lining…
1. Low Estrogen
For the endometrium to thicken it is reliant on adequate levels of estrogen. In fact, the entire menstrual cycle is dependent on adequate levels of estrogen. Women with absent periods known as amenorrhea often have a thin uterine lining due to low levels of hormones.
The most common cause of low estrogen is perimenopause and menopause. This is completely normal as hormone levels begin to decline as a woman ages. This can become a difficult and compromising situation if you are trying for a baby. This is not as common for women in their 20’s and 30’s, but more common in women over the age of 40.
If you struggling to get pregnant or keep a pregnancy, it may be a good idea to have your estradiol levels tested and uterine thickness measured.
If it is determined you have a thin uterine lining, most doctors will prime the uterus with estrogen medications to see if the endometrium responds well and thickens. If this does not work, it then indicates the blood flow is compromised or the endometrial tissues are damaged.
2. Inadequate Blood Flow
There are a variety of reasons blood flow to the uterus may be compromised. If the uterus is not receiving adequate blood flow, it may not be able to create a thick enough endometrium each month. Here are some reasons blood flow may be reduced causing a thin uterine lining:
- Sedentary lifestyle – I am literally talking about little-to-no movement each day. Women who have desk jobs or sit all day are more likely to have compromised blood flow to the uterus.
- Tilted uterus – Normally the uterus should tilt forward, but in about 20% of all women, the uterus tilts backward, or to one side. The malposition of the uterus may cause reduced circulation to the uterus.
- Uterine Fibroids – These noncancerous tumors of the uterus may alter the blood flow to the endometrium by pressing on vital circulatory avenues that supply the endometrium with blood flow. Older uterine fibroids may calcify and become hard over time, further compromising blood flow.
- Uterine Fibroid embolization – This is a surgical procedure to cut off blood supply to the fibroids with the goal of starving them from blood supply, essential reducing them in size or eliminating them. This may cut off vital blood supply to many areas of the uterus and damage the uterus, causing even greater reduction in circulation to the uterus.
- Uterine Arterial Constriction – The uterus relies on the uterine artery to bring in fresh blood. High stress levels can stimulate the sympathetic nervous system to cause arterial constriction, reducing blood flow to the uterus. Not only does chronic high stress alter blood flow, but it alters hormone levels in the body, contributing to hormonal imbalance. Uterine arterial constriction may also happen due to any of the above reasons previously discussed.
3. Poor Health of the Endometrial Tissue
Damage from infection, surgery or illness may cause damage to the tissues of the endometrium. This damage may also compromise blood flow the endometrium as well as how the endometrium functions.
Infection and Pelvic Inflammatory Disease
Chronic bacterial infections, sexually transmitted disease (STDs), or damage to the uterus may cause PID or pelvic inflammatory disease. The constant state of infection and inflammation can cause damage to the tissues and may result in scar tissue formation of the endometrium. When this happens, the endometrium may not be able to function as it should.
Dilation and Curettage (D&C Procedure)
D&C performed incorrectly may cause the basalis layer of the endometrium to be removed. Once this layer is gone, the endometrium cannot grow, the results of which is a variant of Ashermans Syndrome. Women who have had a D&C have a 25% risk of developing Ashermans 2-4 weeks post-procedure. D&C performed for missed miscarriage have a 30.9% chance of developing Ashermans, whereas women who have had a D&C due to an incomplete miscarriage only have a 6.4% chance of developing Ashermans. Women who have had more than 2 D&C’s have an increased chance of developing Ashermans by 32%. 90% of all Ashermans cases are due to D&C procedure.
A 2013 study in the Iranian Red Cresent Medical Journal aimed to investigate the impact of D&C on the endometrial lining, particularly thickness. 444 patients, non-smokers with BMIs less than 30 with regular menstrual cycles (no other uterine health issues) participated. Participants had either 0, 1, 2, 3, or 4 past D&C procedures. Endometrial thickness was measured one day before ovulation and 5-7 days after. Researchers found “Endometrial thicknesses were correlated to number of previous performed D&C… Patients with history of D&C had thinner endometrium in both measurements. The differences between endometrial thicknesses of two groups (with and without D&C history), were statistically meaningful in both measurements. Those, without D&C history had thicker endometrium, one day before and 5-7 days after ovulation…”
Scar Tissue and Adhesion Damage
Scar tissue damage to the endometrium, with adhesions within the uterine cavity is known as Ashermans syndrome. There are different grades of severity. This type of damage can be a direct result of one of or a combination of the following:
- Reproductive organ surgery; laparoscopy, cesarean section
- Genital Tuberculosis
- Induced medical abortion
4. Repeated Use of Clomid
Clomid is a medication used to stimulate ovulation. It is one of the first medications suggested by doctors for couples struggling to conceive. In some women, repeated use of Clomid has been shown to cause a thin uterine lining. Clomid tricks the body into acting as though estrogen levels are low, which stimulates production of GnRH, which signals the pituitary to increase FSH. The hopeful end result should be ovulation. Clomid sounds great for stimulating ovulation, but what about the fact that it is antiestrogenic?
Repeated use of Clomid, especially when used for 3 cycles in a row, can block the stimulation of estrogen to thicken the endometrium. Clomid contains two isomers. Isomers are compounds that contain the same molecular formula, but different structural formulas. Isomers usually have different actions. When a woman discontinues the use of Clomid, one of the isomers leaves the body in a week; the other one remains, acting as an antiestrogenic for up to six weeks. Repeated use of Clomid causes a buildup of this isomer resulting in a thin uterine lining. This action on estrogen levels can also prevent natural ovulation in future cycles, actually inhibiting conception. It is suggested to give the body a break from Clomid for at least 6 weeks to eliminate the remaining isomer from the body.
Remember that Clomid may help you get pregnant right away, but it does not solve the root of the fertility problem. It is a temporary boost, a band-aid, but Clomid cannot solve all infertility-related problems.
5. Long-term Birth Control Use Containing Progestin
Long-term use of oral contraceptives containing higher amounts of Progestin has been linked to thinning of the uterine lining and uterine atrophy. The longer a woman uses progestin, the increased chance for a weak and thin uterine lining.
Natural Therapies to Build & Protect the Uterine Lining
If you know you have a thin uterine lining it is essential you work to nourish and increase the endometrium once again. It may also be helpful to learn about using natural therapies to aid in healing damaged tissues. If damaged tissues are not healed, they may never function properly ever again. If you are going for IUI or IVF and the uterine lining is not thick enough, those procedures may be cancelled.
Get Moving: Exercise!
No matter the reason for thin uterine lining, be sure to move your body each and every day. If you have a desk job, this is very important. Sitting all day compresses the reproductive organs. Walking is simple and moves the hips, allowing greater blood flow to the uterus. Fertility Yoga is also an excellent way to enhance circulation to the reproductive organs. It helps to reduce stress, which helps to keep the uterine artery open. Be sure you are moving and stretching your legs, hips, abdomen and back to provide adequate circulation to the reproductive organs.
Prepare with a Fertility Cleanse
An official journal of the United States and Canadian Academy of Pathology, Inc., Modern pathology, identifies how repeated use of synthetic hormones and medications for fertility can cause a thin uterine lining. If you have used Clomid or hormonal birth control in the past, especially long-term, give your body at least a 3-6-month break from those medications to restore the lining of the uterus, and prepare for pregnancy. Consider the benefits of performing a Fertility Cleanse in that time. Specific herbs in the Fertility Cleanse aid in restoring hormonal balance and improving uterine health. To aid the body in cleansing, choose to eat whole organic foods, use all-natural home care and body products and learn what xenohormones are so you can avoid them.
Herbs and Supplements to Nourish and Build a Thin Uterine Lining
When selecting herbs and supplements to build, nourish, and protect the uterine lining, we need to consider the different actions they have. Think of herbs and supplements that promote circulation, support adequate estrogen levels (phytoestrogens), are high in iron for healthy blood, and those that have a direct action on the uterus. Selecting herbs and supplements that have actions that best fit the reasons for your thin uterine lining may be best.
Herbs and Supplements to Support Healthy Estrogen Levels
- Red Clover aerial parts (Trifolium pratense): Red clover aids in improved circulatory function to the reproductive organs and entire body. High in vitamins and minerals to build the blood and support proper function of the uterus, red clover is high in isoflavones, a type of phytoestrogen, which aids in protecting the body from xenohormones. Red clover supports both liver and kidney function for improved hormonal balance and regular detoxification of pollutants.
- Shatavari (Asparagus racemosus): Shatavari’s main constituents are steroidal-saponins, which have been shown to help regulate estrogen levels. Shatavari is an adaptogen herb that also supports appropriate immune and stress response. This plant is a phytoestrogen. Phytoestrogens have been shown to help protect the body from xenohormones which cause hormonal imbalance.
- Royal Jelly: A Japanese study in the journal Evidence-based Complementary and Alternative Medicine published online in 2007 shows that Royal Jelly has the propensity to mimic human estrogen, which may help those who suffer from low estrogen levels. This study also showed potential for increased size of uterine cells in the rats studied. While there may need to be more studies done to show full potential of Royal Jelly consumption on uterine health, this is an exciting potential for women with weak uterine muscles or a thin uterine lining.
- Ground Flax seed (Linum usitatissimum): Flax seeds contain lignans, which are the second strongest group of phytoestrogens. Flax is also high in fiber. Studies have shown that flax has the combination of the lignans and fiber to help remove excess estrogen from the body, while also protecting it from xenoestrogens.
- Maca root (Lepidium meyenii): Maca aids the body in controlling estrogen in the body. Proper estrogen levels are essential to building up the endometrium in preparation for ovulation and conception.
- Wild Yam root (Dioscorea villosa): Wild yam may have the ability to aid the body in balanced estrogen production. Wild yam helps to support proper function of the uterus.
Blood Building Herbs and Supplements
Be sure you are eating foods rich in iron first and foremost. Good choices are beets, spinach, beans, organic red animal meats, pumpkin seeds, molasses, and asparagus. Make sure to also include foods that help the absorption of iron like oranges, strawberries, broccoli, tomatoes, and green pepper. If you know you have low iron levels, we suggest you supplement with a whole food iron supplement like Blood Builder or include some of the herbs below…
Iron Rich Herbs:
- Dong Quai root (Angelica sinensis): Dong Quai is referred to as a blood tonic aiding in iron deficiency and anemia.
- Nettles leaf (Urtica dioica): Nourishing for the blood, high in iron and vitamin C.
- Raspberry leaf (Rubus idaeus): Raspberry leaves are high in carotenoids, citric acid, tannins,vitamin A, B complex, C, and E. They also have an easily-assimilated form of iron, calcium, phosphorus, potassium and silica. Raspberry leaf is a uterine tonic, supporting overall health of the uterus.
Herbs Rich in Vitamin C to aid in iron absorption:
- Hibiscus flower (Hibiscus sabdariffa): High in vitamin C, which aids iron absorption, best combined with herbs high in iron like Nettles. Normalizing for blood pressure and proper blood formation. This is essential for a nourishing uterine lining.
- Rose Hips (Rosa muceta, R. woodsii, R. mosqueta, R. rubiginosa, R. canina): High in vitamin C, plus vitamin A, B’s, and linoleic acid. Supports absorption of iron. Protective of the nervous and endocrine system. Supports proper cell wall formation and cell metabolism for proper cellular function.
Herbs and Supplements to Increase Circulation to the Uterus
- Vitamin E & L-Arginine – A study published by Fertility and Sterility in April, 2010, showed that both vitamin E supplementation and/or L-Arginine may aid in increasing the thickness of the endometrium in women with thin uterine lining <8mm. Researchers wanted to see if these supplements could increase uterine radial artery (uRA) blood flow. Results showed vitamin E given at 600mg a day increased uRA in 72% of patients and endometrial thickness (EM) in 52% of patients. 6g of L-Arginine given per day resulted in an 89% increase in uRA, with an increase of EM in 67% of patients. The effect of vitamin E was examined in the endometrium. Results showed that vitamin E increased glandular epithelial growth, development of blood vessels, and vascular endothelial growth factor protein* expression within the endometrium.
- Dong Quai root (Angelica sinensis): Increases circulation to the uterus, iron-rich for proper blood formation.
- Fertility Enzyme Therapy: Specific enzymes can improve blood flow to the entire body. Proteolytic enzymes improve blood flow by increasing the flexibility of red blood cells, inhibiting the aggregation of platelets, and helps to prevent abnormal blood clotting. Systemic enzymes also help to support the cleansing of the tissues and promotes better circulation as well as stimulating formation of new, healthy tissue. The blood cleansing actions of systemic enzymes help to bring proper circulation to the reproductive system and get the “stagnant blood” cleared out, helping to remove toxins and also bringing fresh oxygenated blood to your uterus, ovaries and eggs.
Herbs to Strengthen the Uterus
A thin uterine lining is a signal the uterus is not functioning properly. Over time, this weakens the uterus. There are herbs that have a direct action on the uterine muscles, gently stimulating the uterus, which over time helps to strengthen it.
- Raspberry leaf (Rubus idaeus): Raspberry leaf works to tone the uterine muscles. One of the best herbs for uterine health.
- Dong Quai root (Angelica sinensis): Tones and strengthens the uterus by regulating hormonal control and improving the timing of the menstrual cycle.
- Evening Primrose Oil (Oenothera biennis): High levels of LA and GLAs in Evening Primrose Oil have a direct effect on uterine cells. These essential fatty acids contract and relax smooth muscle tissue. This action on the uterus is toning for the uterine muscles.
- Motherwort aerial parts (Leonurus cardiaca): Motherwort has been found to mildly stimulate the uterus, while also aiding the uterus to work efficiently. Red
- Clover aerial parts, blossom (Trifolium pratense): Nourishing food herb, high in vitamins and minerals. It is one of the best blood purifying herbs. High in both calcium and magnesium, essential for proper smooth muscle function of uterine muscles. Supports proper uterine tissue formation.
- Self Fertility Massage: A uterus with a thin endometrium is already, or may over time, become weak. External stimulation through massage can help to “awaken” the uterus once again. Massage enhances circulation to the reproductive organs, strengthens the muscles of the uterus, promotes proper function of the hormonal feedback loop, and supports detoxification of the reproductive organs. Self Fertility Massage can also aid in breakdown and healing of scar tissue damage to the reproductive organs.
- Castor Oil Packs: Castor oil packs stimulate 3 important parts of the body: lymphatic and circulatory systems and the liver. The stimulation of these body systems aids the body in healing the organs and tissues beneath where the castor oil pack is applied. The castor oil pack supports hormonal balance, detoxification of the reproductive organs, and breakdown and removal of scar tissue, while promoting essential blood flow directly to the uterus.
- Acupuncture and Moxibustion: Acupuncture has been shown to increase the release of beta-endorphins, which interrupts negative activity by the nervous system due to stress. As we learned earlier, stress can cause constriction of the uterine arteries. The release of beta-endorphins allows for more blood flow to the uterus. Moxibustion is the practice of burning Mugwort (Artemisia vulgaris) on top of acupuncture needles or in a small flat burner. The purpose is to bring heat to the area being treated. Mugwort is known to stimulate blood flow to the pelvic area, especially the uterus. This enhances the healing benefits of acupuncture.
What About Scar Tissue Damage?
If your doctor determines you have scar tissue and adhesion damage which is causing a thin uterine lining, it is important to learn more about Fertility Enzyme Therapy. Fertility Enzyme Therapy is the method of using systemic enzymes to help support reproductive health and fertility. Systemic enzyme blends have been shown to promote healthy circulation, breakdown and dissolve scar tissue and adhesion formation, reduce pain, reduce inflammation, and support proper immune system response.
The extent of scar tissue on and within the uterus will determine how effective both natural and medical treatment options will be. It would be best to take at least 6 months to work to heal the uterus from scar tissue damage prior to trying to conceive. Fertility Enzyme Therapy is most effective when combined with Fertility Massage and Castor Oil Packs.
*part of the system that restores the oxygen supply to tissues when blood circulation is inadequate.
1. Determine the cause of a thin uterine lining.
2. Fertility Cleansing to aid body in removal excess toxins and xenohormones for hormonal balance and increased uterine health.
3. Support healthy estrogen levels with herbs and supplements. Consider therapies for scar tissue and adhesion issues such as Fertility Enzyme Therapy.
4. Be sure to nourish the body with iron and vitamin C for proper blood formation.
5. Increase circulation, detoxification and strength of the uterus with herbs, supplements, exercise, Self Fertility Massage, castor oil packs, acupuncture and moxibustion.
Too learn more about related subjects covered in this article, please visit the following links:
- Malpani, D. (n.d.). Treating a thin endometrial lining. Retrieved from https://www.drmalpani.com/articles/thin-endometrial-lining
- Davar, R., Dehghani Firouzabadi, R., & Chaman Ara, K. (2013). Dilatation and Curettage Effect on the Endometrial Thickness. Iranian Red Crescent Medical Journal, 15(4), 350–355. http://doi.org/10.5812/ircmj.9863. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3785913/
- Thin Lining. (n.d.). Retrieved from http://www.acubalance.ca/thin-lining
- Shimmel, A., MD. (n.d.). Chiropractic And Acupuncture For Infertility. Retrieved from: http://www.holistichealthpractice.net/
- Isomer. (n.d.). Retrieved from: https://www.merriam-webster.com/dictionary/isomer
- Kazu Michi Suzuki, et. al. (2008). Estrogenic Activities of Fatty Acids and a Sterol Isolated from Royal Jelly. eCAM. 5(3)295–302 doi:10.1093/ecam/nem036. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2529378/
- Takasaki A, Tamura H, Miwa I, Taketani T, Shimamura K, Sugino N (April 2010). “Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium”. Fertil. Steril. 93 (6): 1851–8. doi:10.1016/j.fertnstert.2008.12.062. PMID 19200982. Retrieved from: https://www.fertstert.org/article/S0015-0282(08)04783-3/fulltext
- “Endometrium” Female Reproductive Endocrinology – Gynecology and Obstetrics. (n.d.). Retrieved from: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/female-reproductive-endocrinology/female-reproductive-endocrinology#v1061632
- Deligdisch L. (1993 Jan). Effects of hormone therapy on the endometrium. Mod Pathol. 1993 Jan;6(1):94-106. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8426860
- Romm, Aviva, Botanical Medicine for Women’s Health, Churchill Livingstone, 2010