By Zaira Salvador BSc, MSc (embryologist).
Last Update: 04/12/2018

The endometrium, uterine lining or endometrial lining is the inner layer of the womb, where embryo implantation takes place and the gestational sac develops, marking the beginning of a new pregnancy.

For this to be possible, it is necessary for the endometrium to be receptive. In other words, it should be in optimal quality conditions to favor the implantation of the embryo.

If not achieved naturally, increasing endometrial thickness is possible using hormonal drugs, as in the case of IVF patients. In any case, all women should take the following tips in order to improve endometrial thickness and quality before getting pregnant.

Understanding the endometrium

By endometrium or uterine lining we refer to a mucus membrane that lines the the inside of the womb in females. Endometrial thickness keeps on increasing throughout the menstrual cycle. If no embryo implantation occurs, it sheds in the form of menstrual flow.

So, in short, endometrial thickness varies depending on each different phase of the menstrual cycle.

When sperm meets egg and fertilization occurs in the Fallopian tube, the resulting embryo will start its journey toward the uterus and attach to the uterine lining.

For embryo implantation to be possible, endometrial thickness should be about 7 to 10 mm. Broadly speaking, this occurs naturally around days 19-21 of the cycle, considered the receptive phase of the endometrium or implantation window.

Related story: Sperm’s Journey to the Egg – How Sperm Meets Egg with Pictures.

What is a thick endometrium?

As explained above, the endometrium is considered to be receptive when it reaches the optimal thickness during the secretory phase of the menstrual cycle. Moreover, if observed through ultrasound scan, we would be able to see a triple line appearance.

The female sex hormones released from the ovary are responsible for increasing endometrial thickness and causing it to acquire a triple line appearance. All these characteristics are necessary for embryo implantation.

Furthermore, embryo-endometrial developmental synchrony is another factor contributing to increasing the chances of success. This synchrony occurs thanks to the effects of cytokines and other growth factors that favor embryo implantation.

To learn more, click here: What’s the Role of the Endometrium? – Function & Thickness.

Tips to improve endometrial thickness

Both naturally and in cases of women undergoing fertility treatment, endometrial thickness is a crucial factor for embryo implantation to be possible.

In the case of Assisted Reproductive Technology (ART), fertility specialists can be involved in the process of fertilization if the technique used is ICSI. However, whatever the technique used, embryo implantation is something that has to occur naturally.

Administering hormones like progesterone can help improve endometrial quality for implantation, both in the case of IVF patients and those who are trying to get pregnant.

If you need to undergo IVF to become a mother, we recommend that you generate your Fertility Report now. In 3 simple steps, it will show you a list of clinics that fit your preferences and meet our strict quality criteria. Moreover, you will receive a report via email with useful tips to visit a fertility clinic for the first time.

Women who face issues trying to conceive, or those with too think uterine linings, can improve endometrial thickness naturally by following these useful tips:

Foods to eat

A balanced diet can help women increase endometrial receptivity thanks to the action of estrogen, balanced hormones, and blood flow.

The following are some recommendations and foods that can help prepare your uterine lining:

  • Spread your meals evenly throughout the day to balance your insulin and cortisol levels, which have a direct effect on reproductive hormones.
  • Follow a fiber-rich diet, with a low glycemic index.
  • Coenzyme Q10, or CoQ10, is a highly recommendable compound. This antioxidant can help reduce oxidative stress in the tissues, which has great benefits for the endometrium.
  • Other foods that are rich in antioxidants and vitamins C and E are tomatoes, spinach, dried fruit…
  • Foods containing B-group vitamins contribute to improve the blood flow, including eggs, carrots, spinach, dates, fish, Goji berries…
  • Avoid sour foods during your period, including yogurts, grapefruits, and green apples.
  • Reduce or give up coffee and other caffeine drinks.

If necessary, your doctor may prescribe certain medications or food supplements that contain these vitamins in order to improve endometrial thickness.


Sleeping has a direct effect on reproductive hormones and causes them to be properly balanced. Getting enough sleep can improve endometrial thickness.

You need at least 7 hours of sleep a day to allow your body to recover and promote the optimal growth of tissue.

To keep healthy sleep habits, you should go to bed and wake up at the same time daily, even on weekends.

Doing exercise

Exercise is recommended to improve endometrial thickness because it improves blood circulation and increases the blood supply to the womb.

At least 30 minutes per day, adjusting your exercise sessions in order not to feel exhausted after a session, are enough. Moderate physical activity like yoga, pilates, walking, swimming, or cycling are good examples.

Moreover, physical activity can help relax your body and diminish the stress levels, which can have a negative effect on endometrial quality.

Femoral massage

It involves applying pressure with the fingers over the femoral artery for a few seconds. It is recommended from the end of menstruation until ovulation.

Repeat it 2 or 3 times on each leg. It can be performed 1 or 2 times a day. Femoral massages allow you to increase the blood supply to the organs located in the pelvis, particularly the uterus and ovaries.

This technique, however, should not be done after an IVF embryo transfer or in case you haver high blood pressure.


Several studies have claimed the many benefits of acupuncture on female fertility, as it increases the blood flow to the reproductive organs.

Chinese medicinal herbs are also useful to increase the blood supply to the uterus and ovaries.

Castor oil packs

This type of vegetable oil is rich in ricinoleic acid, which improves blood flow and promotes the elimination and healing of tissues and organs underneath the skin, in this case the ovaries and womb.

It can be applied by soaking a small piece of flannel or cotton in castor oil and placing it on the skin, above the pubic hair line. It should be done during the follicular phase of the menstrual cycle, that is, between 3 and 12 days after your last menstrual period.

One should note that these natural remedies can help increase endometrial thickness and quality in some cases. Unfortunately, in the most serious cases of infertility, or when there exist severe uterine disorders, the most appropriate is to follow a medical treatment that allows you to achieve the required endometrial thickness for implantation.

FAQs from users

Can you use vaginal viagra as a treatment to increase uterine lining?

By Zaira Salvador BSc, MSc (embryologist).

Viagra works by dilating the blood vessels to increase the blood supply to the penis. Some studies have suggested that viagra can also be used as a vasodilator to increase blood flow to the uterus and improve endometrial thickness.

Even though it is rather uncommon, some specialists prescribe vaginal pessaries with viagra as an active ingredient with the purpose of increasing endometrial thickness.

How can you thicken an endometrial lining that is too thin?

By Zaira Salvador BSc, MSc (embryologist).

If the lining of the uterus is too thin (<6 mm), achieving a pregnancy will be considerably difficult for you, and homeopathy won't be enough to improve this situation. In these cases, your OB/GYN will prescribe hormonal drugs containing estrogen and progesterone to increase endometrial thickness, like Progynova.

What causes the lining of your uterus to thicken?

By Zaira Salvador BSc, MSc (embryologist).

Estrogen is the hormone that causes the lining of the uterus to thicken and prepare the uterus for pregnancy. If pregnancy does not occur, estrogen and progesterone levels decrease, causing the endometrial lining to shed in the form of menstrual flow.

What does it mean when the lining of the uterus is too thick?

By Zaira Salvador BSc, MSc (embryologist).

Endometrial hyperplasia is a condition in which the uterine lining becomes too thick. Having too much of the hormone estrogen without the hormone progesterone is one of the main causes of endometrial hyperplasia.

Some of the most common symptoms of a too thick endometrial lining include: irregular or frequent periods, bleeding between cycles, heavy bleeding (dysmenorrhea), pain during intercourse (dyspaurenia), cramping, bloating in the pelvic region, etc. Visit your OB/GYN if you think you may have this condition.

Can aspirin thicken uterine lining?

By Zaira Salvador BSc, MSc (embryologist).

In some cases, a low dose of aspiring has been proven to help achieve higher pregnancy rates in women with mild fertility issues who are receiving fertility treatment. However, aspirin therapy cannot significantly increase the thickness of the endometrium.

Suggested for you

Having a healthy lining of the uterus is crucial for embryo implantation in the womb. If you found this interesting, why don’t check out the following post? What Is Embryo Implantation? – Process & Stages.

In the case of women undergoing IVF treatment, endometrial thickness plays a major role to achieve success after embryo transfer. Want to learn more? Read this next: IVF Embryo Transfer Procedure – Definition, Process & Tips.

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Authors and contributors

 Zaira Salvador
BSc, MSc
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia (UPV). Embryologist specializing in Assisted Procreation, with a Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI). More information
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  1. Featured

    Hello dr, my question is if you could have a missed period due to thin endometrial lining… thx

    • Sandra FernándezBA, MA

      Hello roxana,

      Menstruation is a monthly event that marks the beginning of a new menstrual cycle, even if the endometrium is too thin. In any case, it can cause the blood flow to be less heavy or the the duration may be shorter.

      A missed period can be either due to pregnancy or other types of menstrual alterations. Consult your doctor for further help.

      I hope this helps,

      Best wishes

  1. otherlady23

    Hello ladies
    Just to let you know, i did two medicated cycles of IVF to do a FET and both got cancelled due to too thin uterine lining 🙁
    I tried with a natural cycle and it worked! My lining was had the ideal measurements and am currently 8 weeks pregnant. Can u believe it?
    This proves that lining can vary monthly… so don’t give up!!!!!