I Have A Thick Endometrium Endometrial Hyperplasia

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 

1. The amount of vaginal bleeding 
2.  The type of hyperplasia. If the cells are abnormal or atypical.
3.  If you are planning a pregnancy.

Discuss the various choices with your doctor. 

1. Progesterone therapy - either orally or through an intrauterine device. This treats the hormonal in balance. 
2. 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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Reviewed By : Dr Deepak Rao 
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