Hello Dear. Endometrial biopsy may be required in your case to rule out various conditions. Some of the reasons for endometrial thickening in a non-pregnant women are as follows 1. endometrial carcinoma: variable appearance 2. endometrial hyperplasia: usually uniformly hyperechoic and tends to be diffuse. Can be a differential diagnosis of many conditions i.e. PCOS 3. endometrial polyp: usually hyperechoic, often focal, look for vascular stalk 4. Tamoxifen-related endometrial changes: variable appearances 5. hormone replacement therapy (HRT): in postmenopausal female 6. endometritis: prominent hyperechoic endometrium with or without fluid and debris 7. adhesions: irregular echogenic areas with focal thickening 8. obstructed outlet 9. ovarian tumours associated with endometrial thickening -endometrioid carcinoma of the ovary -granulosa cell ovarian cancer Kindly discuss with your gynecologist and get all tests done. Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you. All the best With warm regards Dr Sanjay Kini