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What is Endometrial
Hyperplasia?
Endometrial Hyperplasia occurs when the uterine lining (endometrium) grows too
thick as a result of estrogen stimulation. Women with irregular menstrual cycles
who don't ovulate are more likely to have this condition. Hyperplasia generally
occurs when your body doesn't produce enough progesterone to rein in the effects
of estrogen, which spurs cells of the uterine lining (endometrium) to divide.
Hyperplasia is most common during adolescence and as a woman approaches
menopause. Women with polycystic ovary syndrome and those on estrogen therapy
(without progesterone) also have an elevated risk of endometrial hyperplasia.
Obesity and late menopause (after age 55) are other known risk factors.
Endometrial Hyperplasia is a non-cancerous condition, however hyperplasia with
atypia is considered precancerous. It is best treated surgically with
hysterectomy.
What are the symptoms of endometrial hyperplasia?
The most common symptoms are:
* vaginal discharge
* abdominal pain with heavy flow
* bleeding between menstrual periods
* heavy or prolonged menstrual periods
Who is at risk for developing Endometrial Hyperplasia?
* Experiencing menopause
* Skip menstrual periods or have no periods at all
* Overweight
* Have diabetes
* Have polycystic ovary syndrome
How is this diagnosed?
If your doctor thinks you have
endometrial hyperplasia, he will take a small sample of your endometrium and
analyze it. He will usually advise a hysteroscopy
with a D&C to visualize the cavity of the uterus to make
sure that nothing else has been missed while taking the biopsy.
Can Endometrial Hyperplasia be Treated?
Yes. In most cases, endometrial hyperplasia can be treated with medication. The
most common form of medication is a hormone progesterone. Following continuous
progestin treatment of 3-4 months duration, repeat sampling of the endometrial
lining is required to demonstrate resolution of the hyperplasia and exclude the
presence of atypia.
In the following conditions surgery such as a
hysterectomy may be advised
-
If you do not respond to
treatment and bleeding is persistent and heavy
-
If the hyperplasia is of an
advanced type that might progress to a malignancy
-
If the hyperplasia worsens
over a period of time. This is found out by a repeat biopsy after a few months
of treatment
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