What is endometrial hyperplasia?
Endometrial hyperplasia occurs when the uterine lining (endometrium) grows too thick as a result of estrogen stimulation (or not enough progesterone).
Endometrial hyperplasia is a non-cancerous condition, however, hyperplasia with atypia (abnormal cells) is considered precancerous. It is best treated surgically with a hysterectomy.
WHO IS AT RISK
- Older women experiencing menopause
- Overweight
- Women with polycystic ovarian disease
- Never having been pregnant
- Early menarche
- Obesity / diabetes mellitus
WHAT ARE THE SYMPTOMS OF ENDOMETRIAL HYPERPLASIA
Abnormal uterine bleeding
Contact your doctors if you have
- Heavy periods
- Shorter cycles
- Prolonged periods
- Spotting between periods
HOW IS THIS DIAGNOSED
1. USG - Ultrasound - your doctor will ask you to get an ultrasound done to measure the thickness of the endometrium.
If the endometrium is very thick the possibility of a uterine polyp has to be considered.
2. Hysteroscopy with a Dilatation and Curettage - A hysteroscopy will allow the surgeon to actually see the lining of the uterus and thereby determine how healthy it is.
D & C - following the hysteroscopy he/she may do a curettage and the material will be sent for histopathological evaluation.
HOW IS ENDOMETRIAL HYPERPLASIA TREATED
The various treatment options depend on
- The amount of vaginal bleeding
- The type of hyperplasia. If the cells are abnormal or atypical.
- If you are planning a pregnancy.
Discuss the various choices with your doctor.
- Progesterone therapy - either orally or through an intrauterine device. This treats the hormonal in balance.
- Hysterectomy may be advised if
- You are post-menopausal.
- If you do not respond to treatment and the bleeding is persistent and heavy.
- If the hyperplasia is of an advanced type that may progress to malignancy.
- If the hyperplasia worsens over a period of time. This can be found out by a repeat biopsy (hysteroscopy) often a few months of treatment.
In the above conditions, you may be advised for a laparoscopic hysterectomy.
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