Endometrial thickening is also often associated with the absence of menstruation because it is mostly caused by abnormal ovulation. If a cycle does not ovulate or if ovulation is abnormal, it is possible that the endometrium will remain in a hyperplastic state and will not be able to show withdrawal bleeding. If the endometrium does not peel off, it may remain in a proliferative state, and over time, endometrial lesions or endometrial cancer may occur. This condition often occurs in young women after the first menstruation or in perimenopausal women who are approaching menopause, mostly due to the absence of normal ovulation or sporadic ovulation, so it is manifested by frequent delay or absence of menstruation or heavy bleeding after menstruation. If this happens frequently, it is recommended to treat with short-acting oral contraceptives or progesterone tablets. Women in fast menopause are recommended to have a diagnostic scraping procedure to exclude endometrial lesions.