How Do You Treat Endometrial Hyperplasia?

Have you ever heard of endometrial hyperplasia? If you are a concerned woman who is eager to have a baby, you need to know more about this condition.

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.

What Does Thickening of the Womb Lining Mean?

The thickening of the womb lining represents a common parameter measured during a MRI scan or gynecological ultrasound.

The way the endometrium looks, the uterine lining that covers the internal face of the uterus as well as its size, largely depends on the patient`s reproductive age and the menstrual cycle period.

In post-menopause, vaginal bleeding and the thickened endometrium might be the signs of uterine cancer. Endometrial hyperplasia represents the medical name of the endometrium`s unjustified thickening over 5 mm.

What Can Cause Hyperplasia?

The main cause of endometrial hyperplasia is considered the increase of the estrogen level in the blood, which can be triggered by the following factors of risk:

• Treatment that involves estrogen, without the opposition of progesterone.
• The installation of menopause.
• Polycystic ovary syndrome.
• Diabetes.
• Obesity.
• Interventions on the uterus or abortion.
• Age of 40+ years.
• Thyroid or gall bladder disorders
• Family history of colon, uterine or ovarian cancer.

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.

Evolution

In most cases, endometrial hyperplasia regresses in a spontaneous manner. The most part of the non-regressive lesions will persist under this particular form with no malignant transformation. Still, the condition`s evolution very much depends on personal factors of risk as well as the cell type of the condition. Therefore, the risks for this affection to evolve to endometrial carcinoma are:

• Simple Hyperplasia – 1%.
• Simple hyperplasia with atypia – 8%.
• Complex hyperplasia – 3%.
• Complex hyperplasia with atypia – 29%.

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

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.
• Hysteroscopy.
• 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.

How Do You Treat Endometrial Hyperplasia?

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.

Medications

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.

Surgical Intervention

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.

Popular Remedies

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.

Can Endometrial Hyperplasia Go Away on Its Own?

Mild hyperplasia could go away on its own, or unlike cancer, it can be treated with hormonal treatment. Simple hyperplasia has a rather small risk of turning into cancer. Still, both simple and complex atypical hyperplasia might become cancerous if left untreated, in around 8% and, respectively, up to 29% of cases. You should try and get proper treatment for pre-cancerous endometrial conditions, such as hyperplasia, as fast as you can.

Conclusions

• Endometrial hyperplasia represents a premalignant uterine lesion.
• This happens because of the prolonged periods of low progesterone and high estrogen levels in the organism.
• Increased risk factors of endometrial hyperplasia involve: menopause, POS, obesity, tamoxifen therapy, smoking as well as other specific cancers.
• Combined contraceptives don`t really pose a risk of development of hyperplasia; there are even studies which find them protective.
• Most cases of this condition regress in a spontaneous manner; if not, the treatment most often involves drugs (medications based on progesterone).
• Surgery is advisable in very rare cases with a high risk of malignancy (hysterectomy).