Symptoms of endometrial hyperplasia and possible causes of the disorder

Endometrial hyperplasia is a fairly common gynecological diagnosis. It is usually given to women of childbearing age. The disease is often found in young teenage girls or in premenopausal women, that is, during those time periods when hormonal changes occur in the female body.

The article was checked by doctor Olga Zorina

Pregnancy and childbirth, Gynecologist, Gynecologist-endocrinologist

The main cause of the disease is an imbalance of sex hormones, namely increased estrogen and decreased progesterone.

Patients diagnosed with polycystic ovary syndrome, endometriosis, mastopathy and uterine fibroids are at risk. In addition, hormonal imbalance is usually associated with metabolic disorders, so women with diabetes and obesity are also at risk.

When girls hear that they have been diagnosed with endometrial hyperplasia, they often feel frightened. Let's look at how dangerous this really is in this article.

Endometrial hyperplasia is excessive proliferation (overgrowth) of the uterine mucosa. Typically, the endometrium grows during the menstrual cycle, preparing a bed for future fertilization of the egg.

If pregnancy does not occur, the mucous membrane peels off and comes out along with menstrual flow. Such cyclical changes occur every month.

On this basis, the disease is distinguished from endometriosis, when, with excessive growth of the mucous membrane, its cellular structure does not change.

Based on the results of histological analysis, the following forms of pathology are distinguished:

• atypical (adenomatosis);
• simple.

The atypical form is rare, but it is the most dangerous.

With atypical pathology in the overgrown mucous membrane, structural changes occur in the cells (atypical nuclei, multinucleolar cells, etc.), this is revealed by histological examination of the tissue.

Modern medicine considers this form of the disease a precancerous condition. However, this is not a death sentence, and not in all cases the violation develops into carcinoma. According to statistics, endometrial cancer develops in approximately one in ten women diagnosed with adenomatosis.

In the case of a simple form of the disease, there are no atypical cells. It, in turn, is divided into glandular and glandular-cystic.

• Glandular endometrial hyperplasia is an excessive proliferation of glandular endometrial tissue. Glandular cystic hyperplasia is a cystic form of glandular endometrial hyperplasia.
• The most common diagnosis is simple glandular hyperplasia.
• Based on localization, there are two types of disease:

With diffuse growth of the mucous membrane occurs evenly over the entire surface of the uterus. In focal cases, cells grow only in a limited area. In this case, so-called polyps are often formed. Both diffuse and focal types can be simple and atypical.

The main symptom is menstrual irregularities. If you are concerned about spotting that occurs between menstruation, especially if it comes with clots, then this is a mandatory reason to contact a gynecologist.

1. Excessively heavy periods may indicate the presence of the disease. 
2. There may also be a delay in menstruation followed by heavy and painful discharge.
3. Endometrial hyperplasia is a common cause of infertility, so the disease is often detected when a girl is unable to get pregnant.
4. Treatment is always selected individually, taking into account many factors: the patient’s age, other concomitant ailments (both gynecological and general), and the type of disease.
5. Endometrial hyperplasia is treated both with medication and with surgery.

Various hormonal drugs are commonly used. If the pathology is detected in a young nulliparous girl, combined oral contraceptives are often used. As a rule, therapy lasts at least six months.

Doctor's advice

If the nature of menstruation changes, the appearance of intermenstrual bleeding, heavy menstruation with clots, it is necessary to consult a gynecologist with an ultrasound scan of the pelvic organs.

Progestins (synthetic analogues of progesterone) are prescribed at any age. Treatment with gestagens is also quite long-term. When using them, bleeding between periods may occur.

Indications for hospitalization for established endometrial hyperplasia. Planned - ultrasound signs of endometrial hyperplasia and blood discharge from the genital tract (menorrhagia, metrorrhagia, postmenopausal bleeding).

Emergency – profuse bleeding from the genital tract.

Pregnancy and childbirth, Gynecologist, Gynecologist-endocrinologist

• If medications do not help, surgery is used. 
• To stop uterine bleeding - separate diagnostic curettage of the uterine mucosa under the control of hysteroscopy. In case of relapse of endometrial hyperplasia in patients of the late reproductive period who have achieved reproductive function, endometrial ablation is indicated - balloon, electrosurgical, laser
• All of them are aimed at removing pathological overgrown tissue inside the uterus.
• Curettage is also used for diagnostic purposes, so after it a histological analysis of the tissue is required.

In extreme cases, when there is a danger of the disease degenerating into cancer (atypical form), it is necessary to resort to surgical removal of the uterus. As a rule, removal is carried out in premenopausal women who have given birth, while the ovaries are preserved.

The main symptom of the disease is menstrual irregularity. It is important to correctly determine the form of the disease, for which a tissue biopsy is taken and histological analysis is performed. The method of treatment depends on many factors, so it is necessary that it be chosen by an experienced gynecologist.

For more information about the causes of the disorder and treatment methods, watch the video:

Source: https://sprosivracha.com/articles/health/62-giperplaziya-endometriya-chto-eto-takoe-simptomy-i-lechenie-zabolevaniya

Endometrial hyperplasia - treatment, symptoms, diagnosis of the disease

Endometrial hyperplasia remains a pressing problem of modern gynecology. What it is and how to treat it is the topic of this article.

The endometrium is the lining of the uterus. Endometrial hyperplasia (hyper - over; plasis - formation) is a pathological proliferation of the uterine glands and, to a lesser extent, the endometrial stroma.

Endometrial structure

• During the normal menstrual cycle, under the influence of female sex hormones, periodic changes occur in the functional layer of the endometrium.
• Estrogens (estrone, estradiol, estriol) cause proliferative growth of endometrial glands, but have little effect on the stroma.
• The main volume of estrogen is produced by the ovarian follicle in the 1st phase of the menstrual cycle.

Progesterone - suppresses the reproduction of glandular cells (proliferation) and rebuilds the uterine glands from a growing state to a secretory one. In this case, progesterone stimulates the growth of stromal cells.

Progesterone (corpus luteum hormone) is produced mainly in the 2nd phase of the menstrual cycle by the corpus luteum of the ovary, as well as by the adrenal cortex. It prepares the lining of the uterus for implantation of a fertilized egg.

If fertilization does not occur, the corpus luteum in the ovary regresses, and the production of sex hormones (both estrogen and progesterone) fades away.

The nutrition of the functional layer of the endometrium is disrupted, it is destroyed, dies and is removed with menstrual blood.

The basal layer of the endometrium is not subject to cyclic rejection. It ensures the restoration of the functional layer in the next menstrual cycle.

Ovarian-menstrual cycle, changes in the endometrium

Normally, the size and structure of the endometrium in each phase of the monthly cycle has a strictly defined pattern.

High “impact” doses or long-term, continuous exposure to a moderate amount of estrogens on the endometrium against the background of progesterone deficiency lead to pathological proliferation of the uterine glands - endometrial hyperplasia. In the process of hyperplasia, an increase in volume and disorganization of both the functional and basal layers of the mucosa occurs. The endometrium loses its functions.

Source: https://promatka.ru/giperplaziya-endometriya/giperplaziya-endometriya-simptomy-i-lechenie.html

Endometrial hyperplasia - treatment, symptoms, signs

The disease, which in medical terminology is called “endometrial hyperplasia,” is a danger to women’s health. The main reason for its negative impact is the lack of timely examination and prevention of the possibility of disease progression.

The consequence is high rates of advanced forms of endometrial hyperplasia in medical practice. Education is a necessary component of the prevention of this disease, since the possibility of starting timely treatment depends on the ability to independently diagnose symptoms.

Definition of disease

Before we begin to define the disease itself, it is necessary to divide it into two components. The term “hyperplasia” represents the excessive formation of cells, or rather, their uncontrolled growth, which leads to negative consequences.

The main danger of lack of control of cell division is the possibility of the disease transitioning into a precancerous state. The term “endometrium” must be understood as the inner lining of the uterine cavity.

Combining the two terms gives us the disease endometrial hyperplasia, which can be interpreted as excessive growth of endometrial cells in the uterine cavity.

Endometrial hyperplasia: risk group

The main risk group includes women during menopause. Since during this period some changes occur in the woman’s body, the establishment of excessive cell division in the inner lining of the uterus can lead to bleeding.

Normally, the period of menopause should be accompanied by a certain degree of thinning of the endometrium. A similar phenomenon occurs against the background of a decrease in the impact of hormonal levels. Normal indicators are endometrial thickness from 2 to 16 mm.

After menopause, the layer should normally be about 5 mm. This “drying” process occurs due to a significant decrease in estrogen in the body.

In the case of the opposite behavior of the body (the presence of hyperplasia), this may indicate certain hormonal imbalances in a woman.

It should be noted that during menopause, the presence of any uterine bleeding is unacceptable. A big mistake is the opinion that menstruation can return after menopause.

For every woman, it is necessary to create a clear understanding that any bleeding after the cessation of menstruation is a direct signal to contact a gynecologist.

Additionally, it should be noted that the following categories of patients constitute a special risk group:

• overweight women;
• women with cystic formations in the ovaries.

However, it would be incorrect to say that hyperplasia cannot occur in other age groups. In rare cases, the disease can be diagnosed both during puberty and during the childbearing period.

Types of endometrial hyperplasia

There is a certain division of hyperplasia based on the basis for cell formation, which can be discussed in the following points:

• proliferation of glandular tissue;
• glandular tissue with the addition of cystic tissue;
• precancerous (atypical);
• fibrous, glandular-fibrous and polyp-like growths of the endometrium.

It is the latter type of disease that occurs much more often than others. Fortunately, the occurrence of such uncontrolled cell growth quite rarely develops into a precancerous condition that is dangerous to a woman’s health.

Endometrial hyperplasia: causes

Now it is necessary to define the main reasons that become the basis for the occurrence of the disease under discussion. These include:

• the predominance of estrogens in a woman’s body;
• lack of progesterone;
• diseases that can cause hormonal imbalance (diabetes, blood pressure problems, excess cholesterol in the blood, thyroid problems and diseases from the field of mammology);
• long-term inflammatory processes of the genitourinary system;
• benign formations of the uterus.

Additionally, it is necessary to note a possible predisposition due to genetic inheritance.

Picture of symptoms when endometrial hyperplasia occurs

The main symptom when the disease occurs is uterine bleeding. They occur during the period of rejection of formations of the endometrial layer. Its detachment from the wall of the internal cavity of the uterus is accompanied by damage to the capillaries, which cause bleeding.

Depending on the frequency of occurrence, they can be of a varied nature. In some cases, bleeding is moderate, in others it is spotting. However, there is always the possibility of severe bleeding, which can result in anemia.

Self-diagnosis of hyperplasia

In most cases, the course of the disease is accompanied exclusively by bleeding. There are no additional symptoms that could allow a woman to independently identify the disease.

However, it is possible to independently diagnose the discharge. Since dead endometrium also comes out along with the blood, the clots will have a fairly dense structure.

In some cases, there is a certain prolongation of the discharge process, associated with the impossibility of quickly removing an insufficiently liquid texture.

Medical diagnosis of the disease

Primary diagnosis occurs through ultrasound. Thanks to the possibility of a detailed examination of the picture, the doctor receives information regarding the current state of endometrial thickness. Based on the data obtained, a clinical picture is created and a diagnosis is made.

Next, further research is carried out aimed at making an accurate diagnosis based on the type of current disease.

Endometrial hyperplasia as a precancerous condition

The possibility of a precancerous condition is the main danger posed by the disease.
Before starting further discussion, it is necessary to clarify the presence of two possible variations of hyperplasia:

• with atypical cells (precancerous condition);
• without atypical cells.

At risk of a precancerous condition are women who have been diagnosed with hyperplasia with atypical cells.
The presence of atypical cells is determined using a biopsy.

To do this, a small section of mucous tissue is surgically cut off, which is subject to histological examination. If the presence of precancerous cells is detected, the woman is at risk of developing cancer over the next few years.

If the presence of endometrial hyperplasia is not accompanied by atypical cells, the risk of cancer remains minimal.

Treatment Options for Hyperplasia

All treatment options are based on the need to neutralize the effects of estrogen. A medicinal treatment option is suitable for this. It is carried out by taking another female hormone “progesterone”, due to which it is possible to create the necessary correction of cell growth.

However, it should be noted that self-administration of the drug without a doctor’s prescription is not correct.

Dosage and adjustment of the period of administration are the basis for the effectiveness of treatment, which should be prescribed by a specialist after the patient has passed all the necessary authorities, which allowed him to create a complete picture of the course of the disease.

Another treatment method is the installation of a medicated spiral. The basis for the effectiveness of its action, as in the case of tablets, is progesterone. Thanks to the installation of the spiral, it is possible to achieve a preventive and corrective effect, against the background of which bleeding stops and the endometrial layer receives the necessary impact.

In advanced cases of the disease, removal of the uterus is allowed. This measure is extremely rare and is allowed only in case of danger to the woman’s health caused by an abundance of endometrial hyperplasia.

Endometrial hyperplasia and alternative treatments

There are additional treatment methods that are used somewhat less frequently, but the likelihood of their use obliges us to highlight this side of the issue.

• Curettage
  should be understood as the removal of the hyperplastic layer of the endometrium. This method is used to eliminate an excessive number of formations that interfere with the functioning of the organ, as well as in cases where it is necessary to urgently stop bleeding.
• Cryodestruction
  Thanks to this method, a targeted effect is created on the affected areas of the endometrium. As a result, it is possible to eliminate excess tissue, as well as remove the main lesions.

Folk remedies are also used as alternative treatment methods

Attention! The use of folk remedies is not recommended as primary treatment or as complementary therapy without the permission of your attending physician.

The main known methods include:

• Creating a course from celandine and juices.
  According to this method, the patient needs to consume carrot and beet juice daily for 4 weeks. In addition to juices, it is suggested to douche weekly with a solution of celandine.
• Nettle tincture course.
  Daily consumption of 4 tablespoons of nettle alcohol tincture is required. According to traditional healers, by increasing the strength of the immune system, this method can eliminate the disease endometrial hyperplasia.
• Herbal treatment.
  Several herbs are selected for treatment: serpentine, calamus, nettle and cinquefoil roots. Their mixture is infused in boiling water for an hour, and then taken 100 ml 2 times a day

.
There is no scientific confirmation of the possibility of curing endometrial hyperplasia using folk remedies.

Endometrial hyperplasia: possible consequences

In addition to the possibility of developing into cancer, in the presence of atypical cells, the disease poses a particular threat to women of childbearing age. It lies in the possibility of infertility.

In this case, there is no possibility of ovulation occurring, which results in the inability to get pregnant.

Women who are sexually active and do not become pregnant within a year may be suspected.

The basis of the problem should be considered from the point of view of the onset of ovulation in a healthy woman. During the cycle, endometrial cells naturally grow in preparation for the possibility of implantation of an egg. At the end of the cycle, with the arrival of menstruation, the cells die. Accordingly, the endometrium becomes smaller (thinner).

Then the next cycle begins, which repeats the previous one. If the disease is present, there is no phase of endometrial reduction. As a result, the ovulation period turns out to be excluded from the chain.

It is worth noting that if we are talking about a woman of childbearing age with regular menstruation, she may experience the following symptoms:

• the appearance of bleeding between menstruation;
• increase in the menstrual cycle;
• change in the composition of discharge upon the onset of menstruation.

In any case, some correction phase of the normal cycle of menstruation begins.

Pregnancy during and after endometrial hyperplasia

It should be noted that endometrial hyperplasia and diagnosis of pregnancy are a set of data for making a decision on abortion according to indications.

Although the likelihood of pregnancy occurring is small, cases of its registration nevertheless arise. Dangers that lead to the need for abortion include:

• lack of a favorable environment for the fastening of the fetus;
• the impossibility of creating a favorable atmosphere for fetal nutrition;
• increased risk of diseases of various origins;
• increased likelihood of miscarriage;
• the possibility of killing the fetus due to an insufficient amount of substances necessary for its life support and growth;
• the risk of bleeding that is dangerous to a woman’s health.

It is now necessary to consider the possibility of pregnancy after completing the full course of treatment. Firstly, the outcome of treatment is largely influenced by the promptness of its initiation.

Treatment in the early stages allows not only to preserve a woman’s reproductive function, but also to eliminate possible consequences, minimizing the risk of recurrence of the pathology.

In rare cases, endometrial hyperplasia occurs after the birth of a child. The explanation is predisposition, as well as the shock to hormonal levels caused by the birth of a child. In this case, diagnosing the disease is easier, since for a certain period of time after giving birth, the woman must be observed by a gynecologist.

Endometrial hyperplasia: prevention

As a preventative measure, it is necessary to visit a gynecologist at least once a year. During the visit, an ultrasound should be performed, on the basis of which your attending physician will be able to determine the thickness of the endometrium and compare it with the norm, relative to your current condition.

Thus, endometrial hyperplasia can be stopped with timely seeking medical help. Your main enemy with this disease is time. Do not forget about prevention and soberly assess the symptoms.

Source: https://womanvip.ru/giperplazija-jendometrija-lechenie-simptomy-priznaki/

Endometrial hyperplasia

Pathogenesis

An abnormal increase in the number of endometrial cells occurs as a result of continuous stimulation of the uterus by estrogen and a decrease in progesterone concentration. This may be an endogenous or external source of estrogen.

An endogenous increase in hormone concentration occurs during chronic anovulation associated with cystic ovary syndrome. Obesity also increases estrogen concentrations as estradiol levels increase in the body.

In rare cases, abnormal thickening of the glandular tissues of the uterus occurs due to estradiol-secreting ovarian tumors.

An external source of the hormone can be estrogen therapy. However, the use of combination replacement therapy, including progesterone, does not lead to thickening of the endometrium. The exact mechanism of transformation of the uterine mucosa under the influence of the hormone is unknown.

It is believed that benign tissue thickening is caused by genetic mutations and the already listed external factors. Thus, a mutation of the gene that suppresses tumor growth of tissues was found in 55% of women with endometrial hyperplasia. In women suffering from uterine carcinoma, this mutation is found in 80%.

Based on these data, scientists came to the conclusion that external influences increase the risk of abnormal division of endometrial cells only if there is a genetic predisposition to such a disease.

Symptoms

For many women, changes in the glandular epithelium of the uterus do not lead to any symptoms. At the same time, significant tissue proliferation is often accompanied by menstrual disorder.

Patients complain of increased uterine bleeding, pain in the lower abdomen and disruption of the duration of certain periods of the cycle.

A change in the nature of uterine bleeding can be manifested by a general increase in the volume of bleeding or episodic increased bleeding.

Additional symptoms and signs:

• delayed menstruation;
• frequent release of blood clots;
• weakness;
• spread of pain to the perineal area;
• pale skin;
• dizziness;
• decreased performance;
• inability to conceive a child within 8-12 months of active sexual activity.

If you experience constant pain and uterine bleeding that is not associated with menstruation, you should seek medical help. These signs may indicate the development of uterine carcinoma.

Uterine cancer and hyperplasia

Endometrial cancer is a malignant neoplasm that forms from the glandular cells of the inner lining of the uterus. Due to the influence of negative factors and disruption of internal regulation, epithelial cells begin to divide uncontrollably and form a pathological focus.

Gradually, the tumor grows into deeper tissues, including the muscular and serous membranes. Also, cancer cells can penetrate the bloodstream and spread in the body, provoking the growth of secondary tumors (metastases) in other organs.

This extremely dangerous disease is considered the most common type of cancer among women.

In addition, the focus of cell proliferation does not spread to other parts of the uterus and does not metastasize. At the same time, such a condition may be a direct precursor to carcinoma.

The increased influence of hormonal imbalance, bad habits, inflammatory processes and other unfavorable factors on the thickened endometrium can ultimately lead to the growth of the tumor.

Diagnostics

To undergo all necessary examinations, you should make an appointment with a gynecologist. The doctor will ask the woman about her complaints and review her medical history to identify risk factors for the disease.

The next stage of diagnosis is a general examination of the genital organs.

Since such a study may not be enough to explain suspicious symptoms, the gynecologist prescribes additional diagnostic procedures.

Conducted instrumental and laboratory studies:

1. Endoscopic examination of the uterine cavity (hysteroscopy). Before the examination, the doctor asks the woman to sit in a gynecological chair. After this, the doctor carefully expands the cervical canal and inserts a hysteroscope equipped with a light source and optics into the uterine cavity. This procedure allows a specialist to study in detail the condition of the internal lining of the organ and carry out additional manipulations.
2. Biopsy is the collection of tissue from the area of ​​the changed endometrium. The gynecologist inserts a special syringe into the uterine cavity. A piston is used to remove cells from a suspicious area of ​​the mucous membrane. The doctor can obtain cells from several parts of the organ at the same time. Carrying out the procedure under ultrasound control improves the accuracy of cell collection. In the laboratory, specialists study the resulting material using staining, microscopy and other methods. Thus, a biopsy is the most reliable diagnostic method, making it possible to assess the morphology of tissues and exclude the presence of malignant cells in the organ. If necessary, cells are scraped out.
3. Ultrasound diagnosis of the uterus. To obtain more accurate visual data, the doctor inserts a sensor through the vaginal opening. Using reflected ultrasound waves, an image of the uterus is created on a monitor. This painless study allows the doctor to assess the condition of the organ and exclude the presence of a tumor process.
4. Computed tomography or magnetic resonance imaging are auxiliary methods of visual diagnosis. Before the examination, the woman is asked to remove all metal objects from herself. Tomography results, presented in the form of three-dimensional images of organs, are necessary to search for even minor structural changes in tissues. If a tumor process is suspected, CT helps to assess the extent of the pathology.
5. Blood analysis. In the treatment room, a nurse draws venous blood. The study of the material allows you to assess the level of sex hormones. The blood test is repeated during treatment of the disease.

A gynecologist can get by with just a few diagnostic procedures. If necessary, a consultation with an oncologist or endocrinologist is scheduled.

Source: https://www.nrmed.ru/rus/dlya-vzroslykh/ginekologiya/giperplaziya-endometriya/

Treatment of endometrial hyperplasia - causes and signs of pathology

There are three balls in the wall of the uterus - mucous, muscular and peritoneum. Pathological growth of the inner layer is called endometrial hyperplasia.

The disease can occur at any age, but is most common in menopausal women. This is associated with sudden hormonal changes in the body during this period.

Hyperplasia is characterized by a long course with frequent relapses. In addition, diagnosis is somewhat difficult, since the disease does not have clear symptoms.

To stabilize the condition of the mucous ball, doctors resort to surgical and conservative treatment methods.

What is endometrial hyperplasia

Hyperplasia of the endometrium of the uterus is a malfunction in the functioning of the mucous ball of the organ, which occurs as a result of hormonal imbalance in the body and is characterized by pathological growth of the inner lining - hypertrophy.

Normally, a woman's endometrial thickness changes throughout the menstrual cycle. At first, its layer is thin, but gradually, under the influence of sex hormones, it begins to thicken, preparing for the implantation of a fertilized egg.

If it is not fertilized or does not reach the uterine cavity, the mucous ball sloughs off and leaves the body during menstruation. It is important to know that there are two types of endometrium - basal and functional.

If hormonal surges occur in the female body, the uterine mucosa is the first to react to changes in the concentration of sex hormones. Moderate hyperplasia of endometrial tissue develops, which gradually increases in size and volume.

Not all areas of the inner membrane are equally sensitive to the effects of hormones, so only a part of the cells can succumb to pathological growth - local damage.

When the endometrium grows diffusely, the entire surface succumbs to hyperplasia more or less evenly.
In the photo you can see how thick the endometrium is during hypertrophy in comparison with the physiological state of the uterine mucosa.

The uterine cavity is small, only 3-4 cm in length and 2-3 cm in width, so the mucous ball cannot hypertrophy for too long.

As a result, detachment of the pathologically hyperplastic endometrium occurs, which leads to severe uterine bleeding. After separation of the endometrium, a large area of ​​the uterus looks like a continuous bleeding wound.

To stop this process, you will need the help of a specialist who will prescribe medications or perform curettage.

It is important that the disease will recur cyclically until the cause of endometrial hyperplasia is eliminated. This means that the functional ball will be layered over and over again, and then released with great blood loss.

How to treat hyperplasia

The choice of tactics for treating endometrial hyperplasia depends on many factors - the woman’s age (reproductive or menopausal), the severity of the disease, the presence of cysts or polyps, and the patient’s wishes.

Previously, the disease was treated radically by removing the problem organ, that is, the uterus.

Modern techniques make it possible to treat hyperplasia without loss of reproductive function, and in mild forms, even without surgical intervention, by prescribing medications.

The procedure is both therapeutic and diagnostic in nature, since the resulting tissue is sent for examination to a histological laboratory. Next, having received the examination results, the doctor chooses a tactic and prescribes the necessary treatment.

Medicines

To stop the pathological growth of the endometrial ball of the uterus, attending physicians use three main groups of drugs related to hormonal drugs:

• COOK. Combined contraceptives containing female sex hormones in different concentrations and ratios. Prescribed to girls who have no history of pregnancy. COCs help best with glandular and glandular cystic hyperplasia. The drug stabilizes the patient’s hormonal levels, teaches her body how, in what order and how much estrogen and progesterone should be produced. The course of therapy is long; at best, treatment takes six months, but it happens that girls have to take pills for several years. The most famous representatives are Yarina and Janine.

• Synthetic progesterone. Typically, hyperplastic changes in the inner ball of the uterus occur due to insufficient production of progesterone by the female body. Therefore, the prescription of a piece hormone helps stabilize the menstrual cycle and recovery. Progesterone is effective for all types of hyperplasia; in addition, there are no special instructions regarding the patient’s age. The downside of the drug is that in some cases it can provoke the appearance of intermenstrual bleeding. The course of treatment lasts from 3 to 6 months; representatives such as Duphaston or Norkolut are most often used.
• Antagonists of releasing hormone, which affects the secretion of gonadotropin. Taking drugs slows down the secretion of estrogens in the female body, and since they stimulate the growth of the uterine mucosa, the endometrium stops hyperplasia. Its cells stop dividing and reverse development occurs - atrophy. The advantage of medications is ease of use - one injection once a month is enough. During the first 10-14 days, the body tries to compensate for the effect of the antagonist by increasing the production of estrogen, which is why women complain of a deterioration in their condition. After two weeks, the opposite effect occurs, and the patient’s well-being improves - pain disappears, the menstrual cycle stabilizes.

Surgical intervention

Surgery involves the complete removal of the uterus, sometimes along with the fallopian tubes and ovaries. This method is a radical way to treat endometrial hyperplasia.

It is used to get rid of pathology in women during menopause, as well as at any age, if atypical cells are discovered after fractional curettage, since such structures indicate a cancerous transformation of the mucous ball.

If there is no heavy bleeding and the patient does not require emergency assistance, then the intervention is carried out as planned. Before it, the woman is carefully examined for the presence of concomitant pathologies, acute diseases are cured, and chronic ones are brought to stable remission.

Based on the research results, the scope of the operation is determined - removal of only the uterus or its appendages as well. If there are no pathological changes in the ovaries and fallopian tubes, then they are left in place.

Scraping

The main method of therapy and diagnosis. It consists of removing the functional endometrium from the uterus using special instruments.

The procedure is performed under general anesthesia and does not require incisions or stitches. Instruments are inserted into the organ cavity through the vagina and cervix, the entrance to which is widened with a special device - Hegar dilators.

It is important to know that curettage is a temporary method. If the cause of hyperplasia is not removed, the disease will constantly recur.

Cryodestruction

Treatment method for focal hyperplasia. Under the control of a camera (hysteroscope), a cryodestructor is inserted into the uterus - a device through which liquid nitrogen is supplied, which specifically freezes pathological areas.

  Can atypical endometrial hyperplasia turn into cancer?

Under the influence of cold, the tissues die, and over time they are torn away and removed outside. Cryodestruction, like curettage, is a temporary way to stop the disease.

Traditional methods

• Treatment of endometrial hyperplasia with traditional methods has no scientific basis.
• Some remedies can improve general well-being, increase hemoglobin levels after blood loss, or stabilize the tone of the myometrium (muscle ball of the uterus), but they do not affect the disease itself.
• That is, alternative medicine can only be used as symptomatic therapy, which is an addition to the main treatment.

• Nettle leaf tincture – brings hemoglobin levels back to normal after bleeding and helps prevent subsequent blood loss.
• Decoctions and alcohol tinctures based on fireweed and yarutki stabilize hormonal levels and inhibit the production of estrogen.
• Borovaya uterus - affects the tone of the myometrium, bringing it to a physiological state.

You can resort to folk recipes only along with traditional treatment.

The use of herbal medicine alone leads to aggravation of the disease and the development of complications.

Symptoms

Treatment of endometrial hyperplasia after the appearance of clear symptoms (bleeding) consists of curettage, and in case of significant blood loss and ineffectiveness of therapy, removal of the uterus.

Often, signs of endometrial hyperplasia are difficult to determine because there are no characteristic symptoms, but some manifestations may indicate pathological thickening of the inner layer of the uterus:

• Disruptions in the menstrual cycle are the most common manifestation of pathology. Menstruation occurs at different intervals and is often delayed. The structure of the discharge is heterogeneous; blood clots and exfoliated particles of the endometrium are present in large quantities.
• Amenorrhea is the absence of menstruation for several cycles. For a long time, the mucous ball grows in the uterine cavity, when its thickness reaches 2-3 cm, it is rejected and comes out. This process is usually accompanied by large blood loss, which can threaten the patient's life.

• Pathological vaginal discharge - appears a few days before or after menstruation, looks like ichor. The symptom is characteristic of hyperplasia with the appearance of polyps in the uterus.
• Pain during menstruation - thickening of the endometrium leads to painful detachment from the walls of the uterus. It is important that such a sign indicates hyperplasia only in the case when menstruation was previously asymptomatic, and then pain appeared. If a girl always experienced discomfort during this period, then this is considered a variant of the physiological norm.
• A stable cycle in the presence of heavy discharge for a long time - more than a week.
• Impossibility of pregnancy because ovulation does not occur in every cycle. Even if the egg is fertilized, it will have nowhere to attach due to changes in the endometrium.

Symptoms of endometrial hyperplasia can easily be confused with signs of other pathologies, so you should not self-medicate. With the first manifestations, you need to consult a doctor and undergo an examination.

Diagnostics

The diagnosis of endometrial hyperplasia is made on the basis of anamnestic data, as well as the results of additional examinations.

Often the disease is detected accidentally during ultrasound diagnostics of the pelvic organs.

Vaginal ultrasound allows you to better examine changes in the mucous membrane and clearly determine its thickness. It is prescribed for early diagnosis, as well as to monitor the effectiveness of treatment.

  Endometrial hyperplasia in menopause - reviews of curettage

The greatest diagnostic value is hysteroscopy and curettage. With their help, the degree of development and type of pathology are determined.

Classification of the disease

Based on the nature of the lesion and the type of cells that predominate in pathological tissues, several types of endometrial hyperplasia are distinguished:

• Atypical is a dangerous form of the disease characterized by the presence of abnormal cells. They can succumb to cancerous transformation at any time. Atypical hyperplasia is usually treated by removal of the uterus and adnexa.
• Focal - not the entire mucous ball is susceptible to pathological growth, but only its individual sections, so small lesions appear.
• Glandular-cystic - endometrial glands increase in size, cysts form over its entire surface.
• Glandular - the glandular tissue of the inner ball of the uterus grows, significantly increasing the thickness of the entire endometrium.
• Complex is the second name for an atypical type of pathology, or adenomatosis. The structure of endometrial cells is disrupted, and the proliferation of glandular epithelium predominates.
• Simple endometrial hyperplasia is characterized by a uniform increase in all cells of the mucous membrane and the absence of structural changes.

Causes of pathology

The most common cause of endometrial hyperplasia is a failure in the production of hormones, as a result of which the level of progesterone decreases and the concentration of estrogen in a woman’s blood increases.

The disease can also occur due to immune dysfunction when antibodies attack endometrial cells, which leads to accelerated growth.

Damage to the basal layer of the endometrium, for example, after carelessly performed abortions, leads to the disease. Receptors that respond to the saturation of the body with progesterone are damaged, and even with normal hormone levels, the growth of the mucous ball does not stop.

It is important to know! If the causes of endometrial hyperplasia are not eliminated, the treatment will not bring results and the disease will soon appear again.

Why is endometrial hyperplasia dangerous?

If you ignore the symptoms of the disease, the growth of the endometrium in the uterus can lead to a number of complications:

• development of the oncological process;
• large blood loss during endometrial rejection;
• inability to carry a pregnancy to term;
• chronic anemia.

To avoid unpleasant consequences, it is important to start correct treatment on time.

Prevention

Twice a year, a girl of reproductive age should visit a doctor and undergo a gynecological examination. This will help identify changes at an early stage of development and prevent hyperplasia.

It is also important to treat inflammatory diseases of the pelvic organs in a timely manner and prevent them from becoming chronic.

It has been proven that taking hormonal contraception reduces the risk of pathology, since the drugs stabilize the condition of the patient’s reproductive system.

Traumatization of the walls of the uterus leads to hyperplasia, so it is necessary to avoid interventions in the organ cavity - abortion, caesarean section if physiological childbirth is possible, curettage for no apparent reason.

Is it possible to cure endometrial hyperplasia?

Treatment of the pathology is lengthy and requires strict adherence to the doctor’s instructions, but it is possible to get rid of hyperplasia. After hormonal levels are brought back to normal, tissue proliferation stops.

In cases where conservative therapy is powerless, they resort to radical methods - removal of the uterus.

Can endometrial hyperplasia go away on its own?

Without proper treatment, the disease will only get worse, so you cannot ignore the symptoms and prescriptions of a specialist.

If the hyperplasia goes away on its own, it means that the diagnosis was initially made incorrectly, since such a serious disease requires special therapy.

Source: https://endometriy.com/obolochka/giperplaziya/endometriya

Causes and consequences of endometrial hyperplasia

Endometrial hyperplasia is a thickening of the lining of the uterus caused by an overgrowth of the cells lining the uterus.

With the development of hyperplasia, increased growth of the endometrium occurs, and in some cases, its structural changes. The volume of the reproductive organ increases.

The uterine layer normally reaches its maximum size during certain phases of the menstrual cycle and is rejected.

Causes of endometrial hyperplasia

The etiology of endometrial hyperplasia is often associated with a lack of balance between two female hormones (estrogen and progesterone), a phenomenon where hyperplasia develops.

The causes of endometrial hyperplasia of the uterus are formed in cases where the body is exposed to estrogen without progesterone in the body, which serves to balance the first hormone.

These hormones, secreted by the ovaries, control the health and growth of the uterine lining. Estrogen causes the lining of the uterus to grow, and progesterone balances this growth.

Endometrial hyperplasia can also be provoked by:

1. Obesity.
2. Polycystic ovary syndrome.
3. Estrogen therapy without progesterone.
4. Tumors of the estrogen-secreting ovaries.

Hyperplasia can develop after drug therapy and hormone replacement therapy (hormones similar to estrogen). The latter type of therapy is generally recommended only for women who have had their uterus removed.

The patient may also be prescribed medications for breast cancer, which can have the same effect on the uterus as estrogen, so endometrial hyperplasia may have causes associated with such cancer treatment.

It is possible to more accurately understand why endometrial hyperplasia occurs only after a detailed examination.

Causes of endometrial hyperplasia in menopause

The main cause of endometrial hyperplasia in postmenopause and menopause is a very high level of the hormone estrogen. This in turn may be caused by the following conditions:

1. Anovulation, characteristic of menopause. During menopause, follicle growth stops and ovulation does not occur. Therefore, a full-fledged corpus luteum is not formed and progesterone is not produced. An imbalance occurs between estrogen and progesterone. An increased amount of estrogen promotes pathological growth of the endometrium.
2. Hyperplastic processes of the ovaries. During menopause, ovarian tissue is replaced by simple connective tissue, which synthesizes atypical estrogens that promote endometrial growth.
3. Tumors of the ovaries. Various cysts also synthesize large amounts of hormones.
4. Overweight. During menopause, the adrenal glands produce a lot of androgen. An overweight woman has a large amount of visceral fat, which this androgen converts into estrogen.

The types of endometrial hyperplasia vary depending on the characteristics of the cells found in the biopsy sample. Most often, a biopsy is performed using hysteroscopy. A thin camera is then placed into the uterus to obtain a tissue sample.

Special injections are used to reduce discomfort during this test. The advantage of this procedure is that the entire cavity is visualized using a camera, and the likelihood of insufficient material obtained (extracted) is less than with a blind biopsy.

Endometrial hyperplasia can be of two types:

1. No atypical changes.
2. With atypical changes.

Can endometrial hyperplasia turn into cancer?

Endometrial hyperplasia is not cancer, but in some women it can develop into uterine cancer.

Endometrial hyperplasia with atypical changes is when the cells change and become abnormal, and this leads to a higher risk of developing uterine cancer. In 30% of cases, endometrial hyperplasia causes uterine cancer.

Consequences of uterine endometrial hyperplasia

The main symptom of endometrial hyperplasia is abnormal vaginal bleeding. It may cause periods that are longer, heavier, or heavier, or bleeding may occur between menstrual periods. It is important to always report any abnormal bleeding to your doctor.

Endometrial hyperplasia can be diagnosed through vaginal ultrasound (US), hysteroscopy, or curettage surgery.

Why is endometrial hyperplasia of the uterus dangerous? In women, atypical endometrial hyperplasia can develop into cancer. At the same time, women with atypical changes are at increased risk of developing uterine cancer. This risk is higher in women with atypical endometrial hyperplasia who are postmenopausal.

For patients diagnosed with endometrial hyperplasia, doctors will try to prevent the consequences of the disease by taking into account when planning treatment:

1. The nature of the causes of the disease.
2. The presence of atypical cell changes.
3. Age (have you already gone through menopause).
4. The presence or absence of the patient’s desire to have children.

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Treatment of endometrial hyperplasia

If endometrial hyperplasia does not cause atypical changes in cells in a young woman, then treatment with progesterone will be simply necessary to balance the effect of estrogen on the body.

Side effects of high dose progesterone include increased appetite and weight gain. Once endometrial hyperplasia is cured, doctors will recommend that the patient become pregnant immediately (as soon as possible).

If the birth of the baby is delayed, it is recommended to continue therapy with progesterone and perform regular biopsies every six to twelve months.

If endometrial hyperplasia occurs in a woman who has already overcome menopause, or she exhibits atypical cell changes, then the doctor will most likely recommend surgery. As a result of surgery, the uterus and ovaries will be removed.

Twenty-five percent of premenopausal uterine cancers have cancer cells in the ovaries. In some cases, it is advisable to remove the uterus and wait for definitive detection and confirmation of pathology to determine whether the uterus contains cancer. If cancer is found, a second operation will be necessary to remove the ovaries.

In most cases, experts recommend non-open surgery, since open surgery is more painful, has a relatively high risk of complications, and leads to a long recovery period.

Also, with this diagnosis, you should not resort to robotic surgery. Surgeries in which robotics perform the procedure are extremely expensive and carry a high risk of complications.

Source: https://giperplaziya-endometria.ru/prichinyi-i-posledstviya-giperplazii-endometriya.html

Endometrial hyperplasia

Endometrial hyperplasia is a benign growth of the endometrium (the inner layer of the uterus). Let's look at the types, dangers of this pathology, methods of treatment and prevention.

Endometrial hyperplasia leads to thickening and enlargement of the uterus. The entire pathological process is a proliferation of stromal and glandular elements of the endometrium. That is, it is an excessive growth of the membrane of the walls and tissues.

The cause of this pathology can be hormonal disorders, chronic inflammatory processes and other diseases.

The danger of endometrial hyperplasia is that without proper treatment, the disease takes the form of a cancerous tumor, that is, an oncological disease.

If a woman has been diagnosed with endometrial hyperplasia, then this is one of the reasons for the development of infertility. Advanced stages of the disease lead to the inability to have children, hormonal disorders and cancer. There are several types of pathology that differ in the type of course, symptoms and treatment methods.

The most common is glandular hyperplasia, which causes the proliferation of glandular tissue, while cystic hyperplasia is accompanied by the appearance of cysts of different sizes. The most dangerous seeing is atypical. This type is considered a precancerous condition.

Timely diagnosis and treatment is the ideal option for preventing the onset of the disease.

Due to hormonal changes, the endometrium grows only when the egg is fertilized. But if conception itself does not occur, then the endometrium returns to normal size and leaves the uterus with discharge during menstruation.

In place of the removed endometrium, a new one begins to grow, that is, a new cycle of endometrial changes begins.

There are several types of pathology: glandular, glandular-cystic, focal or polyps, as well as atypical. Very often the disease is asymptomatic. Therefore, hyperplasia can only be recognized after a routine examination or ultrasound examination.

In some cases, the disease manifests itself as anovulatory uterine bleeding, which occurs after a delay in menstruation or against the background of an irregular cycle. Many women receive a diagnosis after testing due to their inability to conceive.

The disease causes infertility.

The causes of the disease are varied. Hyperplasia of the endometrium of the uterus can appear against the background of hormonal disorders, pathologies of lipid, carbohydrate and other types of metabolism, due to gynecological diseases and surgical intervention. Very often, the disease appears in women with lipid metabolism disorders, hypertension, high blood sugar, uterine fibroids and liver diseases.

ICD-10 code

ICD 10 is the international classification of diseases, tenth revision. That is, ICD 10 is a unified normative document for recording morbidity, which simplifies the process of making a diagnosis.

According to the international classification of diseases, it belongs to diseases of the genitourinary system (N00-N99). Under N85.0 there is glandular endometrial hyperplasia, and under N85.1 there is adenomatous endometrial hyperplasia. This section also includes other pathologies and diseases of the female genital organs, such as: uterine hypertrophy, uterine inversion, abnormal position and subinvolution of the uterus.

Source: https://ilive.com.ua/health/giperplaziya-endometriya_108014i15953.html