The endometrium is the lining of the uterus. In pre-menopausal women, the endometrial thickness has a wide range because of hormonal fluctuation. In post-menopausal women, the endometrial thickness is typically less than 5 mm. Some causes of thickened endometrium include obesity, hormone replacement therapy, tamoxifen use (medication to treat breast cancer or prevent it for those at high risk), certain conditions such as PCOS or Lynch syndrome and endometrial hyperplasia.