- Endometrial hyperplasia - hormones
- Endometrial hyperplasia - diagnosis
- Endometrial hyperplasia - treatment
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Endometrial hyperplasia is one of the most common gynecological problems in women. It can affect many women, but most often it affects postmenopausal women. Neglecting endometrial hyperplasia, i.e. abandoning treatment, can cause many he alth problems, including neoplastic diseases of the reproductive organs.
Endometrial hyperplasiais a fairly common problem among women of all ages. The endometrium is the mucosa that lines the inside of the uterus. Its thickness depends on the age of the woman and the phase of the menstrual cycle.
The thickness of the endometrium is assessed during an ultrasound examination. In young girls who are not yet menstruating, the endometrium should be 0.3 to 0.5 mm. In mature women, the thickness of the mucosa in the first phase of the cycle is 7-9 mm, and in the second phase - up to 15 mm.
On the other hand, in menopausal women who use hormone replacement therapy, the endometrium may be up to 8 mm, and in the remaining women, up to 5 mm. If the endometrium is more than 12 mm thick during the menopause, the diagnosis should be extended to rule out endometrial cancer (uterine cancer).
Endometrial hyperplasia - hormones
The thickness of the endometrium also changes during the menstrual cycle and depends on the concentration of female sex hormones, i.e. estrogens and gestagens. The endometrium consists of two layers - basal and functional.
They are clearly visible in the luteal phase (this is the period from ovulation to menstruation). Then the functional layer peels off and menstrual bleeding occurs.
In the follicular phase, which lasts from menstruation to ovulation, the functional layer is rebuilt from the basal part. During this time, the thickness of the endometrium increases several times, as the mucosa of the uterine cavity is prepared for possible implantation of the embryo.
If fertilization does not take place in a given cycle, the functional layer peels off and the woman starts menstruation again.
Under abnormal conditions, endometrial hyperplasia may occur. Most often, endometrial hyperplasia is caused by endocrine disruptions. This ailment occurs primarily in women over 55.
Endometrial hyperplasia - diagnosis
The endometrium is examined by performing a transvaginal ultrasound. The examination is safe and painless. The doctor inserts a thin ultrasound head into the uterus and, observing the image on the monitor, can measure the thickness of the uterine mucosa.
If he decides that the endometrium is growing, he may order a biopsy and a histopathological examination of the sample taken. The histopathological evaluation is extremely important because it allows to determine whether the neoplastic process is taking place in the endometrial tissues or not. The study also allows you to develop a strategy for further proceedings.
Endometrial hyperplasia - treatment
Treatment of endometrial hyperplasia depends on the severity of the disease. If the hypertrophy is minor, the doctor suggests hormone therapy and systematic observation of the endometrium.
When the lesions are larger, it is necessary to cure the uterine cavity. It is a procedure performed under anesthesia. Uterine curettage is the removal of excess tissue. Bleeding may occur for 3-4 days after the procedure.
If the bleeding is prolonged, the woman should see her doctor as soon as possible so that he can find out why.
Tissue removed during curettage is sent for histopathological examination. The aim of the test is to detect a precancerous condition or a neoplasm.
If the test confirms the presence of neoplastic cells, a hysterectomy is performed, i.e. the complete removal of the uterus and ovaries, in order to prevent the development of neoplasms.
Endometrial examination should be regularly performed by all women over 55, who are particularly prone to developing cancers of the reproductive organ.