It is an overgrowth of the cells that make up the lining of the uterus, while this condition is not cancerous, it could lead to cancer.
Description and Symptoms
Endometrial Hyperplasia is a condition in which over-proliferation of the cells that make up the womb lining (endometrial cells) occurs. The endometrium (womb lining) is abnormally thick.
Endometrial hyperplasia consists of excessive growth of the endometrium (mucosal layer lining the inside of the uterus) and usually causes abnormal bleeding.
Usually, it is due to hyperstimulation by estrogen (female sex hormone). Estrogens stimulate the growth of endometrial cells, and the action of progesterone can subsequently reverse the process
It is a pathological condition in which there is an increase in the thickness of the inner layer and changes in the structure. Is based on a violation of the hormonal background, which leads to an increase in the proliferative activity of endometrial cells.
The most common symptom is unusual vaginal bleeding. Bleeding between periods can occur, or bleeding after the menopause. An abnormal vaginal discharge may also occur in some cases.
These symptoms can have other causes, such as fibroids or a bacterial infection. Ultrasonic scanning can be used to determine whether the endometrium is unusually thick.
An endometrial biopsy is often taken to confirm the diagnosis of endometrial hyperplasia.
There are two main categories of endometrial hyperplasia. Sometimes the cells of the womb wall generate more tissue than usual but don’t undergo any atypical changes.
In other cases, the cells give an atypical appearance when examined under the microscope.
Having endometrial hyperplasia raises the chances of developing endometrial cancer. The risk of cancer is much higher among patients who have the atypical form of endometrial hyperplasia.
Causes
Endometrial Hyperplasia is a condition caused by a hormone imbalance, the body’s production of estrogen is too high compared to the progesterone’s output.
The underlying causes of the inequality can include obesity, some medications (tamoxifen or estrogen hormones unbalanced by progestin hormones), or some ovarian conditions (polycystic ovarian disease or estrogen-releasing tumors).
Taking the combined oral contraceptive pill reduces the chances of getting endometrial hyperplasia.
Symptoms of endometrial hyperplasia.
For a long time, endometrial hyperplasia is clinically not manifested. Over time, however, when interrupted the process of separation of the functional layer of the mucous membrane of the uterus, there is abundant menstruation.
They may last longer than usual. Slowly Move menstruation in uterine bleeding.
Another clinical sign of endometrial hyperplasia is the absence of periods. However, just to be sure the doctor must examine the clinical picture to confirm if such symptoms are associated with a pre-existing pathology.
In this regard, another potential symptom of this condition is vaginal discharge. But given such sign is not uniquely inherent to endometrial hyperplasia, the sufferer should take more tests to confirm this isn’t uterine fibroids.
In those cases, uterine fibroids can cause abdominal pain, frequent need to urinate, constipation and others. But people with this condition are less prone to develop cancer
Endometriosis is characterized by the appearance of painful menstruation and pain during sexual intercourse.In this context, a nervous breakdown has gradually developed.
Therefore, the clinical picture of endometrial hyperplasia cannot be a fundamental to establish a diagnosis Definitive.You can only take a doctor to think about this pathology.
Diagnosis.
To diagnose it is available:
- Ultrasound through the vagina: It allows to see the state of the uterine mucosa (endometrium), and according to its characteristics makes us suspect possible endometrial hyperplasia.
- Aspiration biopsy using flexible aspiration cannulas (aspiration curettage): allows taking a sample of the endometrium
- Hysteroscopy: allows visualizing the cavity and its mucosa, and directing the biopsy, which increases its performance.
Classification.
Given the histological structure of endometrial hyperplasia is divided into the following types:
- Glandular – there is only a thickening of the inner layer of the granulocytic uterus
- Thickening of the inner layer of the uterus combined with the presence of cystic formations (obstructed endometrial glands)
- Atypical or ADENOMATOSIS (signs of endometrial cells atypia).
In practical gynecology mainly distinguishes between two basic types of hyperplasia of the inner lining of the uterus:
- The atypical, which requires action on the part of the doctor, since it is a precancerous process
- Neatipicheskaya.
Treatments
The combined oral contraceptive pill can lessen the symptoms of endometrial hyperplasia, giving lighter periods.
Many would recommend the monophasic type (i.e., one in which the ratio of hormones doesn’t change, apart from when the person takes dummy pills).
The capsule supplies both estrogenic and progesterone-like hormones, helping to keep the hormones in balance.
Progesterone tablets can help lessen the symptoms of endometrial hyperplasia, giving lighter periods. Sometimes progesterone itself is used, but often synthetic analogs of progesterone, or progestins, are preferred.
Examples of the types of progestin used are medroxyprogesterone acetate and megestrol acetate.
These will counteract the effect of the hormone estrogen, bringing the body back into hormonal balance.
The Levonorgestrel Intrauterine System (LNG-IUS) is a contraceptive device that secretes the progestin hormone levonorgestrel.
It can rectify the hormone imbalance, and relieve the symptoms of endometrial hyperplasia. Periods tend to be lighter and may stop altogether. Mirena is a popular brand.
Danazol is a synthetic steroid compound, which acts in a similar manner to a male hormone. It has sometimes been used to treat endometrial hyperplasia.
This drug is dangerous during pregnancy, as it can “masculinize” a female fetus. The patient should take adequate contraceptive measures.
Side-effects include weight gain, unwanted hair growth, deepening of the voice, acne, and oily skin. Sometimes swelling of the hands, feet, or ankles occurs (such swelling can be severe, and the sufferer should report it).
Surgery: Endometrial hyperplasia is sometimes treated with a hysterectomy, particularly when the risk of developing cancer is relatively high, as with the atypical form of the condition.
A patient should carefully consider other options with their physician before going ahead with a hysterectomy, since it can lead to an increased risk of cardiovascular disease and brittle bones in later life.
Prevention.
Preventive measures against endometrial hyperplasia is a normalization of hypothalamic-pituitary-ovary relationships. To this end, women must comply with the following guidelines:
- Use contraceptive methods to prevent rejection abortions
- Of intrauterine devices
- Give preference to hormonal contraceptive methods
- Regular visits to the gynecologist (at least once a year)
- Normalization of body weight
In conclusion, people should note that endometrial hyperplasia is a background for the pathological process of developing endometrial cancer. Therefore, diagnosis and treatment of this disease are timely.
The diagnostic search is based on clinical examination and additional research methods.
