Endometrial hyperplasia is an abnormal proliferation of the inner (mucous) membrane of the uterus, when it becomes much thicker than in a normal state. In general, the concept of "hyperplasia" means an increase in the number of tissue cells or an organ, as a result of which the volume of this organ increases. According to medical statistics, up to 20% of women suffer from endometrial hyperplasia, and in 5-10% of them, the disease transforms into cancer.
There are several types of hyperplasia, these are:
- glandular hyperplasia;
- cystic hyperplasia;
- adenomatosis, i.e. atypical endometrial hyperplasia;
- focal endometrial hyperplasia.
Possible causes of the development of the disease are hormonal disorders, gynecological diseases, polycystic ovary syndrome (PCOS), abortion, uterine fibroids, diagnostic curettage, adenomyosis, concomitant extragenital diseases (diseases of the adrenal gland, thyroid gland, diabetes, obesity, high blood pressure).
Symptoms of endometrial hyperplasia can be menstrual irregularities (its lengthening or contraction, profuse blood loss); sudden uterine bleeding during menstruation or in the middle of the cycle, lasting up to several weeks; infertility.
Atypical endometrial hyperplasia is the most serious disease of all the above species. The threat of its transformation into cancer, in the absence of treatment, reaches from 20% to 80% and is most often observed during the termination (by age) of menstrual function. With atypical hyperplasia, the thickness of the endometrium reaches 3 cm.
Limited (focal) endometrial hyperplasia - these are polyps that germinate in separate foci. By structure, polyps are fibrous, glandular, and adenomatous. Depending on the size of the polyp, the thickness of the endometrium can reach 6 cm.
The underdeveloped inner layer of the uterus - the hypoplastic endometrium - is not a disease. Such an endometrium is observed with a weak influence of ovarian hormones and does not require treatment - it is simply observed.
In cases when atypical endometrial hyperplasia relapses and there is a big risk of its transition to oncological form, surgical intervention is applied - the overgrown layer of the uterine mucosa is removed. The procedure is highly accurate, fast and completely safe, thanks to modern technology.
Other methods of treating a complicated disease are removal of polyps - polypectomy, and removal of the uterus along with appendages - hysterectomy. Hysterectomy, as a rule, is used for severe, complicated by the development of atypia, forms, internal polyps, myomas.
In many respects, the effectiveness of surgical intervention depends on how effective preoperative hormonal therapy can significantly reduce the volume of the focus of hyperplastic endometrium. Combination treatment that combines several methods is often used, for example, surgical treatment with hormone therapy.
Atypical endometrial hyperplasia diagnosed:
- transvaginal ultrasound;
- echo hysterosalpingography (Echo-GHA);
- hysteroscopy (GHA);
- endometrial biopsy;
For the prevention of the disease, it is necessary:
- passing a routine gynecological examination once or twice a year (even if there are no complaints);
- treatment of various concomitant extragenital diseases (diabetes, obesity, arterial hypertension, etc.);
- diagnosis and subsequent treatment of diseases of the genital area (uterine fibroids, adenomyosis, etc.);
- weight loss.
Periodic examinations by specialists will allow you to identify a terrible disease on time and at times increase the chances of a complete and quick recovery.