If for some reason the inner layer of the uterus grows, and the number of cells significantly exceeds the norm, endometrial hyperplasia is diagnosed. To formulate the diagnosis accurately, it is necessary to obtain samples of biological tissues and study them under a microscope in a laboratory. Such an analysis is called histological. Some believe that endometrial hyperplasia indicates a malignant neoplasm, but in fact this is a delusion. Several subspecies of the pathological condition are distinguished. Some of them are associated with the danger of malignancy in the future, while others are benign. However, this does not mean that there is no need to treat the problem: hyperplasia, even benign, can lead to serious consequences.
Check does not hurt!
It is possible to detect endometrial hyperplasia in a timely manner if you regularly visit a gynecologist. At the preventive examination, they will not be diagnosed, but they may notice signs on the basis of which they are sent for additional tests. Based on the results of the event, it will be possible to clarify according to which scenario the pathological condition develops, what therapeutic measures are necessary.
A histological examination, to which the tissues are directed when suspected endometrial hypoplasia, usually takes from a couple of days to two weeks. The exact timing depends on the equipment used in the laboratory. You can examine not only the samples taken from the patient during the biopsy, but also obtained by curettage of the uterus tissue.
Types and Features
Uterine endometrial hyperplasia is possible of two types: accompanied by non-standard cells or without it. Another classification option:
The second option is the formation of internal structures, adenomatosis. At the same time, in the endometrium, such elements appear that the uterine inner layer is completely unusual.
If the diagnosis is confirmed, and uterine endometrial hyperplasia is detected, the doctor will report that the case belongs to the groups according to both classification options.
If the pathology is simple, there are two options:
- glandular;
- cystic glandular.
The complex is usually called adenomatous, divided into the following types:
You should be aware: adenomatosis is not a malignant formation. The doctor will tell you more at the reception that this is endometrial hyperplasia. How to treat, the doctor will also introduce the course of the case, focusing on the results of the study, chronic diseases, individual characteristics.
If adenomatosis is established, all objects of research studied in the laboratory are sent for additional familiarization to the oncologist. Based on the information received, you can choose the optimal course of the fight against pathology.
Often, treatment of glandular endometrial hyperplasia, as well as glandular cystic, is defined as the treatment of background disease. At the same time, it is taken into account that the probability of degeneration of cells into malignant is close to zero, but still there. True, as medical practice shows, the term "background diseases" is rarely used by specialists, as it is considered insufficiently accurate.
Statistics and Risks
If endometrial hyperplasia is established, treatment can be started immediately, following the doctor's recommendations. Do not panic, considering that the condition is close to precancerous. On average, the current statistics of malignancy of cells is as follows:
- with simple hyperplasia, the transition of the form occurs in 1% of cases;
- with complex risk - 3%;
- with atypical downtime - 8%;
- complex atypical accompanied by a risk of degeneration close to 29%.
Where did the trouble come from?
Before you figure out how to treat endometrial hyperplasia, you should understand why the pathological condition has developed. The main condition for the growth of cellular structures is hormonal disruption. Estrogens (the base hormones of the reproductive female system) are compounds that can activate the growth and reproduction of endometrial cells.
If the hormonal background is normal, the second stage of the menstrual cycle is accompanied by the production of progesterone, which prevents the overgrowth of cellular structures. If the uterine layers are exposed to estrogen for a long time, and progesterone is insufficient, endometrial hyperplasia develops (glandular, complex, with or without atypical cells, cystic).
The risk of hyperplasia is high if the ovaries function poorly or do not perform their tasks at all. From statistics it is known that endometrial hyperplasia in menopause is relatively often detected, shortly before this period in a woman's life. This is due to a change in the hormonal background of the body. In addition, the risk of a pathological condition is higher in people suffering from excess weight, polycystic ovary and hormones producing this organ that produce hormonal compounds.
Hormones and pathology
In order for glandular endometrial hyperplasia to develop, a cystic, complex form, not only an excessive amount of estrogen is necessary, but also specific boundaries of their activity. Scientists have established that there are two types of estrogens:
The first group - formed by the structures of the body, the second - medications, synthetic hormonal compounds, selected unsuccessfully.
Internal estrogens are elevated with anovulation. They stimulate endometrial cells to grow more actively. Location of estrogen production - adipose tissue, ovaries. Perhaps the presence of increased concentrations of estrogen against the background of the tumor, affecting the hormonal background.
Estrogens that can be ingested with tablets, plasters, gels can provoke hyperplasia. Mostly the risk is associated with the use of these components without progesterone. If the remedy is balanced, contains both types of hormonal compounds, the likelihood of hyperplasia is minimal, and oncological processes are even lower.
How to notice?
The main sign of endometrial hyperplasia is prolonged menstrual flow. The frequency increases, and the volume of discharge becomes larger. The cycle loses regularity. Another symptom of endometrial hyperplasia is uterine bleeding.
Some women have a discharge containing blood before menstruation or shortly after. Possible allocation in the middle of the cycle. Sometimes pathology can be noticed by prolonged (several weeks), but small in volume, secretions containing blood.
As medical statistics show, most often women come to see a doctor when they find uterine bleeding. It is observed after a long period without menstruation, comes completely unpredictably, so a woman often starts to panic, not understanding what treatment is needed. The symptom of endometrial hyperplasia of this type causes the greatest fear during menopause.
Diagnostics
As follows from the reviews compiled by the treated patients, endometrial hyperplasia is not always confirmed. To clarify the diagnosis, as noted by women in whom hyperplasia was suspected, an ultrasound examination is necessary. The work uses a specific vaginal sensor. With the help of such a device, it is possible to study the condition of the uterus from the inside, identify the features of the layers of tissues that make up the organ, evaluate the presence of thickenings, changes, if any. Additionally, an ovarian ultrasound may be prescribed for cysts, tumors, and other diseases.
Based on the results of ultrasound, they decide what additional methods for assessing the condition are necessary in a particular case. As follows from the reviews, endometrial hyperplasia (suspected, confirmed) is often the reason for the appointment of hysteroscopy. This is such a procedure in which the uterine cavity is studied at high magnification using a hysteroscope. As a rule, at the same time a woman is recorded on the curettage procedure.
With certain signals, the doctor may decide that a biopsy must first be done. For this procedure, a curette reassigned for one use is used, visually similar to the shaft of a conventional pen. The procedure itself does not cause pain and is not associated with additional risks, does not require hospitalization. The duration of the analysis is only a few minutes, but the amount of information obtained in this way is large enough to reliably assess the condition of the patient. According to the results of the procedure, the doctor will say for sure whether there is hyperplasia, according to which scenario the pathology develops, and what measures should be taken to combat it.
What to do?
Perhaps the treatment of endometrial hyperplasia is a topic that causes maximum interest in women who are faced with such a diagnosis or suggesting it relative to themselves. The specificity of treatment is due to a key feature of the pathological condition, namely, its dependence on the hormonal background. In order to normalize the condition of the endometrium, a hormonal therapeutic program should be developed, but do it in such a way as not to cause even more harm. For this reason, self-treatment of hyperplasia is strictly prohibited.
If simple endometrial hyperplasia is established, the treatment is to prevent cell degeneration. Additionally, preventive measures for bleeding in the uterus are practiced. If atypical cell structures are revealed during tissue examination, the patient is referred to an oncologist to develop a course of treatment, since the risk of malignancy is assessed as unacceptably high.
Do not think that the pathological condition or its therapy puts an end to the future of the woman as a continuer: as follows from the reviews, curettage with endometrial hyperplasia, biopsy become a source of accurate data, so doctors choose a program that allows the reproductive organ to normal, and then pregnancy is possible. An exception is situations when atypical cells become an excuse for organ removal. The mere fact of the presence of such structures does not mean that surgery cannot be avoided: hormone preparations may be sufficient. The doctor responsible for the development of the course will tell you more about this at the reception.
Hormone treatment
The choice of therapy is determined by a number of factors. Several hormone treatment strategies are known, but there is no reliable information on the benefits of any of the methods relative to others. As a rule, glandular, cystic endometrial hyperplasia is treated with progestogens, progestins, that is, drugs that supply the body with compounds that are close in effect to progesterone.
Unfortunately, at present, there are no such standard tools that could become a universal answer. Suitable for one person causes unpredictable reactions of the body in another. Endometrial hyperplasia in postmenopausal women requires completely different approaches than in the reproductive period, and the presence of chronic pathologies, individual intolerance or even weight problems are factors that make it necessary to select funds strictly individually, by trial and error.
There is no universal scheme, generally accepted dosages of hormonal drugs. When developing a program, the doctor focuses on age, weight, height, body type of the patient, financial capabilities (some medications are very expensive). Prescribe funds, curettage for endometrial hyperplasia, decide on surgery, focusing on the type of pathology, plans for pregnancy in the future, side effects provoked by various means.
Glandular hyperplasia: a risk group
As statistics show, more often a pathological condition is diagnosed in women who have had:
- polycystic ovary;
- scraping;
- abortion;
- gynecological surgery;
- uterine fibroids.
With certain risks associated with the rejection of hormonal contraceptives, the late onset of menopause. More often, hyperplasia is detected in nulliparous women than in those with children.
The risk group includes people suffering from:
- diabetes mellitus;
- overweight;
- high blood pressure;
- liver pathologies;
- impaired thyroid function;
- mastopathy.
The nuances of therapy
The main purpose of curettage is the prevention of repeated heavy bleeding. It is the measures to stop such volumetric discharge - the primary task of the doctor.
Curettage of the uterine walls is an intervention that has nothing to do with abortion, curettage of the embryo. During the abortion, the hormonal system is disrupted, but curettage with hyperplasia can prevent bleeding, since during the procedure the doctor removes the tissue that is its source.
Among the currently popular medications, special attention deserves:
- "Yarina."
- "Utrozhestan".
- "Janine."
Sometimes doctors recommend stopping on the drugs "Regulon" or "Dufaston". Duration of admission is from three months to six months, after which changes in condition are checked.
An alternative is to install a special Mirena spiral.
If the patient's age is 30 years or older, then medications are used, due to which the body is temporarily introduced into a condition similar to menopause.
To increase the effectiveness of such treatment, it is necessary to maintain the strength of the body with vitamin complexes, undergo physiotherapy procedures prescribed by the doctor, and take measures to correct anemia, if any, accompanied by hyperplasia.
A control ultrasound examination is usually carried out a quarter of a year after the completion of the course, and a second examination - six months after the elimination of hyperplasia. Also, as the therapeutic program is completed, the patient is referred for a second biopsy. It is taken into account that a pathological condition can recur. If the problem recurs, prescribe a surgical intervention: ablation or resection.
Causes and consequences
The absence of ovulation for a certain period of time can cause a pathological condition or illness. When treating hyperplasia, it is important to keep the patient under control in order to notice signs of new health problems in time. Anovulation can provoke:
- polycystic ovary;
- rheumatism;
- overly excited, nervous state;
- metabolic syndrome;
- neoplasms in the pituitary gland.
Symptom Features
The possible manifestations of hyperplasia were indicated above. Medical statistics show that not every woman is concerned about such phenomena. In a large percentage of cases, the pathology proceeds secretly, without manifesting itself with any phenomena. The only way to determine hyperplasia in this case is regular preventive gynecological examination. Often, hyperplasia is detected as part of an ultrasound examination if the patient signs up for a doctor for a reason not related to the work of the reproductive system (an examination is prescribed to compile a complete picture of the condition).
Doctors pay attention: do not neglect preventive medical examinations, since hyperplasia can cause fertility, malignant neoplasms.
Sometimes hyperplasia is detected when determining the reasons for the impossibility of conception. Infertility and severe soreness during cyclic discharge are signs that make it possible to suspect a pathological condition.
Changes in the walls of the uterus begin long before the menopause. It is known that the risk of cell proliferation is higher if among close relatives there were people with benign, malignant neoplasms. Age also plays a role: as the body ages, the body weakens, hardly resists aggressive factors, and there is a higher risk of getting sick or surviving an operation.
Any gynecological diseases are more likely to occur in women during menopause than in younger people. In addition, the probability of malignant cells in older women is higher. From 50 years of age and older, it is recommended that you regularly visit a gynecologist for examination, even if there are no symptoms that make you suspect something is wrong in the body.
Home conditions: how to help yourself?
Folk remedies for endometrial hyperplasia are known, but their use should be agreed with the doctor. A reasonable approach is a combination of traditional methods and generations tested by generations, but do not abandon the first in favor of the second - this can lead to fatal consequences. Mostly folk remedies are aimed at maintaining the strength of the body, stimulating regenerative processes. , .
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Pine uterus and burdock against hyperplasia
On the boron uterus with endometrial hyperplasia, a therapeutic tincture is prepared. 50 g of dry grass will require half a liter of vodka. I mix the products and let them brew in a dark, cool room for at least a month, then decant the liquid. You need to take such a drug in a teaspoon every day for at least three consecutive months. A feature of the uterine uterus is the ability to control hormonal levels. The plant has a mild effect, so there will be no harm from it (when taking the medicine in reasonable amounts). The grass of the red brush has a similar effect. To enhance the effect of treatment, you can use decoctions and infusions to prevent inflammatory processes. These are cooked on mint, lemon balm and other medicinal herbs.
To prepare a burdock medicine, rhizomes of plants dug in the beginning of autumn are taken. The natural product is crushed, squeezed juice, used for food twice daily: morning and evening. A single dosage is a tablespoon. To increase the effectiveness of the drug, you can mix the juice of a golden mustache. The use of such a composition twice daily allows you to notice improvement in the condition one month after the start of the program. To obtain a lasting result, you will need six months of treatment or even longer.
Nettle is considered useful. On the plant, you can make tincture with alcohol: for 200 g of grass - half a liter of liquid. The mixture is insisted for at least three weeks in a darkened cool room, then used in food twice daily, in the morning and shortly before going to bed. Such a tool not only positively affects the uterine endometrium, but also strengthens the immune system.
Hyperplasia: is it possible to do without curettage?
This procedure causes fear in many and even gives rise to a sense of panic. However, not everything is so scary: sometimes you can do without it. How necessary is the event, the doctor will tell you at the reception. The doctor will explain the risks associated with rejecting it.
Taking measures to stabilize the condition, hormonal contraceptives, which contain different types of substances, are first prescribed. The activity of the ovaries is suppressed, which means that cell proliferation slows down. The doctor will explain in what dosage to use the drugs. Often at first you need to eat a couple, or even a triple of tablets every day, gradually reducing these volumes. Typically, the growth rate of the endometrium returns to normal by the end of the first month of treatment. Significant success will be signaled by the absence of bleeding.
To improve the condition, the doctor may additionally prescribe calcium gluconate or Dicinon, Vikasol, Traneksam.
To prevent the growth of uterine tissue in excess of normal thickness, it is important to provide the patient with antagonists of the compounds responsible for proliferation. To do this, take:
- Norkolut.
- "Absolute-Nor."
- Norluten.
The best option will be chosen by the doctor. He will explain exactly what days of the cycle you need to use tablets: 10-28 or 16-25. At the same time, the first menstrual phase is reduced, which means that the endometrium has only a small time period for growth, but the luteal stage lengthens - at this time the mucous membrane of the reproductive organ is stable. Progesterone may be given as an injection to increase effectiveness.
To replenish blood reserves, improve well-being, it is generally recommended that vitamin complexes be administered intramuscularly and take special medications to maintain immunity.
initial stage
If hyperplasia can be detected when the problem is still developing, local treatment will be effective and sufficient. A good option is Mirena. This is an intrauterine device that supplies levonorgestrel to the female body, a hormonal compound obtained by the transformation of progesterone. Every day, the mucous membranes of the body are influenced by active components, supplied in equal volumes at a stable time. This leads to a gradual decrease in tissue thickness, prevents abnormal proliferation, and therefore, there are disturbing bleeding. After three months of continuous use of the spiral, amenorrhea is possible.
Doctors pay attention: you can use this tool for no more than five years in a row. The risk of relapse after removal of the helix is assessed as extremely low.