Changes in the endometrium caused by endogenous hormonal dysfunction

The endometrium responds precisely and predictably to every hormonal dysfunction that may result from absent, deficient or excessive hormone production caused by an arrest of follicular maturation at different stages. Anovulatory failures may be due to arrest of follicular development and may cause endometrial atrophy or deficient proliferation. Arrest of follicular regression may result in irregular proliferation or various degrees of hyperplasia. Ovulatory failures may be due to arrest of corpus luteum maturation and followed by deficient secretion with dissociated or coordinated delay in differentiation. Arrest of corpus luteum regression may cause secretory hypertrophy. Both, anovulatory and ovulatory functional disturbances, are followed by prolonged and irregular endometrial shedding with necrosis, since regular dissociation of endometrial stromal cells is impaired. Almost all such functional deviations may cause infertility.