Endometrial Hyperplasia: Symptoms, Treatment & Complications
Have you ever heard of endometrial hyperplasia? If you are a concerned woman who is eager to have a baby, you probably have.
Table of Contents
What Is Endometrium?
The inner surface of the uterus that is covered with a mucous membrane is known as endometrium in medical terms. The endometrial tissue grows quite rapidly and thickness under the influence of female hormones – estrogen. Thus, in the first half of the menstrual cycle (the first 2 weeks from the beginning of menstruation), the endometrial thickness reaches a few millimeters due to the increased level of estrogen.
At health women, the stimulatory effect of estrogen on the uterine lining is inhibited by another hormone – progesterone, which starts to actively produce in the second half of the menstrual cycle (around 2 weeks before the next menstruation).
What Is Endometrial Hyperplasia?
Endometrial hyperplasia represents the excessive proliferation and thickening of the uterine lining, also often known as glandular hyperplasia because it`s characterized by an excessive growth of the uterine lining glands.
Endometrial hyperplasia can capture the entire surface of the uterine lining or just some parts of it (focal hyperplasia).
Presently, the main reason for the development of hyperplasia is considered the increased level of estrogen. This increase is possible in the following situations:
- Drug treatment which contains estrogen, but not progesterone.
- During menopause.
- Women who suffer of polycystic ovary syndrome (PCOS).
- Obese women.
As recent studies show, combined oral contraceptives (which contain both estrogen and progesterone) doesn`t increase the risk of developing hyperplasia and uterine cancer, they even reduce it.
Symptoms & Signs
The main symptoms may be:
- Vaginal bloody discharges, excessive and abundant during menstruation.
- Vaginal bleeding for women at menopause.
- Mild vaginal bleeding which aren`t related to menstruation.
For women at menopause, any bleeding or vaginal discharge, no matter how light or abundant, short or long, frequent or rare, should be considered a sign of great concern and a possible sign of cancer or endometrial hyperplasia.
If you are 40 – 50 years old and experience a bleeding after 4 – 6 months but you didn`t experienced one until then – contact a doctor immediately.
Can Endometrial Hyperplasia Cause Uterine Cancer?
This is considered a precancerous condition, meaning it can degenerate in uterine cancer in the absence of proper treatment.
In around 1% of cases, hyperplasia transforms directly in uterine cancer. In 8% of cases, it transforms in hyperplasia with atypia (hyperplasia with cells that have a similar structure with the cancerous ones). Also, hyperplasia with atypia transforms in uterine cancer in around 30% of cases.
Consequences & Complications of Hyperplasia
As already mentioned, endometrial hyperplasia increases significantly the risk of uterine cancer.
In addition, menstruation is very heavy and abundant, and there may also be severe bleeding if you experience this condition. Heavy, long menstruation and irregular bleeding at women with endometrial hyperplasia may lead to anemia most of the times.
This medical condition may cause infertility in young women.
Analyzes & Examinations
Main investigations that help in diagnosing this condition are:
- Common gynecological examination.
- Diagnostic curettage.
- Vaginal ultrasound.
Hysteroscopy – allows the examination of the uterus with a special optical system. During the procedure, the doctor may take a small piece of endometrial tissue for a supplementary investigation under the microscope (biopsy) in order to ensure that hyperplasia isn`t cancer.
Diagnostic curettage and histological examination of the obtained tissue is the main procedure of diagnosing the endometrial hyperplasia. In addition, curettage allows the distinction between hyperplasia and uterine cancer.
Vaginal ultrasound – helps the doctor estimate the size and structure of the uterus, fallopian tubes and ovaries, and determine hyperplasia and uterine cancer.
The tactic of the treatment depends on the woman`s age and general health, her desire of having children again, cause of the condition as well as the results of the histological examination of the obtained tissue after curettage.
As already mentioned, progesterone (female sexual hormone, which produces in the second half of the menstrual cycle) has a regulatory influence on the growth of the endometrium. For this reason, progesterone preparations are the main method of treatment for this medical condition.
Progesterone preparations (medroxyprogesterone acetate, levonorgestrel, megestrol acetate) are effective and lead to the disappearance of hyperplasia for the vast majority of women in a period of 3 – 6 months of treatment.
In case that the histological examination of the obtained tissue from curettage shows a risk of uterine cancer (), it`s recommended a surgical intervention of removing the uterus. Only a procedure of this type can protect the woman from developing uterine cancer in the future.
Currently, there isn`t a known method of treating hyperplasia. Therefore, using any popular remedies in treating this condition is allowed only simultaneously with or after basic treatment and only with the doctor`s agreement.
Most popular remedies of treating this medical condition include vaginal washes or internal tampons soaked in medicinal infusions. It should be mentioned that such remedies can only aggravate the woman`s health and lead to severe complications.
Don`t use any popular remedies in treating endometrial hyperplasia and don`t refuse the doctor`s help or advice. If you do, you`ll lose precise time and if the condition worsen, your chances for recovery will diminish considerably.