Endometrial hyperplasia

Hyperplasia of the endometrium is a benign enlargement of the endometrium (inner layer of the uterus). Let's look at the species, the dangers of this pathology, the methods of treatment and prevention.

Hyperplasia of the endometrium leads to thickening and increase in the volume of the uterus. The entire pathological process is the reproduction of stromal and glandular elements of the endometrium. That is, it is an overgrowth of the shell of the walls and tissues. The cause of this pathology can be hormonal disorders, chronic inflammatory processes and other diseases. The danger of endometrial hyperplasia is that, without proper treatment, the disease takes the form of a cancerous tumor, that is, an oncological disease.

If a woman is diagnosed with endometrial hyperplasia, this is one of the reasons for the development of infertility. Launched stages of the disease lead to the inability to have children, hormonal disorders and cancer. There are several types of pathology that differ in the type of flow, symptomatology and treatment methods. The most common is glandular hyperplasia, which causes the proliferation of glandular tissue, cystic - accompanied by the appearance of cysts of different sizes. The most dangerous seeing is atypical. It is this species that is considered a precancerous condition. Timely diagnosis and treatment is the ideal way to prevent the onset of the disease.

Hyperplasia of the endometrium of the uterus is a disease characterized by a pathological proliferation of the endometrium, that is, the inner mucosa of the uterus. It is this part of the uterus that undergoes regular cyclic changes during the menstrual cycle. Because of hormonal changes, the endometrium grows only in the case of fertilization of the oocyte. But if conception itself did not occur, the endometrium returns to normal size and leaves the uterus with secretions during menstruation. At the site of the distant endometrium, a new one begins to grow, that is, a new cycle of endometrial changes begins.

There are several types of pathology: glandular, glandular-cystic, focal or polyps, as well as atypical. Very often the disease is asymptomatic. Therefore, it is possible to recognize hyperplasia only after a routine examination or ultrasound. In some cases, the disease manifests itself in anovulatory uterine bleeding, which occurs after a delay in menstruation or against an irregular cycle. Many women are diagnosed after the examination because of the inability to conceive a child. The disease becomes the cause of infertility.

The causes of the disease are varied. Hyperplasia of the endometrium of the uterus can appear against the background of hormonal disorders, pathologies of lipid, carbohydrate and other types of metabolism, because of gynecological diseases and surgical intervention. Very often the disease occurs in women with violations of fat metabolism, hypertension, high blood sugar, myoma of the uterus and liver diseases.

ICD-10 code

ICD 10 is an international classification of diseases of the tenth revision. That is, ICD 10 is a single normative document for the registration of morbidity, which simplifies the process of diagnosing.

According to the international classification of diseases, refers to diseases of the genitourinary system (N00-N99). Under N85.0 is glandular hyperplasia of the endometrium, and under N85.1 adenomatous hyperplasia of the endometrium. This section includes other pathologies and diseases of female genital organs, such as: uterus hypertrophy, uterine eversion, abnormal position and subinvolution of the uterus.

Causes of endometrial hyperplasia

The causes of endometrial hyperplasia are diverse. There are many factors that provoke the appearance of the disease. As a rule, pathology develops on the background of hormonal disorders and disruptions, with endocrine system diseases, arterial hypertension and obesity.

Hyperplasia can occur simultaneously with chronic inflammatory diseases of the organs of the reproductive system. It is only the gynecologist who can determine the cause and prescribe the treatment, after the examination and examination of the test results.

[1]

Symptoms of endometrial hyperplasia

Symptoms of endometrial hyperplasia do not always appear. So, in some women the disease is asymptomatic, and it can be identified only after the examination. The main clinical symptoms are manifested as anovulatory bleeding, spotting from the vagina between menstruation, violation of the cycle.

In women there are non-uniform bloody discharge and blood clots, that is, particles of the overgrown mucous membrane that has peeled off, the monthly ones become painful. And the most dangerous symptom of endometrial hyperplasia is infertility.

Excretions in endometrial hyperplasia

Allocations in endometrial hyperplasia are manifested as non-cyclic spotting bleeding. This is the main sign of pathology. The disease is accompanied by a delay in menstruation. Hyperplasia does not cause pain during sex, but after sexual intercourse appear spotting spotting.

As a rule, women rarely turn to a gynecologist because of the incomprehensible nature of secretions. But it is on the preventive examination that the doctor can determine the presence of the disease. In some cases, the discharge is accompanied by pain in the groin and in the ovaries. In any case, spotting in the middle of the menstrual cycle is considered a pathology. The task of a woman to pass all the necessary tests to diagnose the disease and undergo proper treatment.

[2], [3]

Bleeding in endometrial hyperplasia

Bleeding in endometrial hyperplasia occurs quite often. As a rule, instead of bleeding appear masticious discharge. But the presence of bleeding may indicate not only the pathology, but also other, concomitant diseases. The nature of bleeding depends on the age of the woman and the proliferative process.

• Cyclic bleeding appears in the period of menstruation and has a continuous course, from 2-3 weeks. This type of bleeding with endometrial hyperplasia occurs in women of reproductive age.
• Acyclic bleeding - not associated with the menstrual cycle, begin in the period between menstruation, have varying duration and intensity (from 2-3 weeks to several months). Characteristic for women of reproductive age.
• In the menopause, bleeding caused by hyperplasia of the endometrium of the uterus is manifested as abundant and irregular menstruation. After such a period of time, bloody spotting appears.
• After menopause with endometrial hyperplasia, spotting becomes scarce, but has a long-lasting character.
• Strong bleeding with clots character for young girls in the period of the formation of ovulatory and menstrual cycles.

Note that spotting reveals a polyposis, and bloody - about glandular hyperplasia and adenomatosis.

[4], [5], [6], [7]

Monthly for endometrial hyperplasia

Monthly for endometrial hyperplasia can be either regular or irregular. It depends on the hyperplastic process of the endometrium and the periods of extinction-the formation of menstrual functions. As a rule, irregular monthly, there are in women over 40 years old and in young girls 15-16 years. If the disease occurs in women of reproductive age, then this may not disrupt the cycle of menstruation. It all depends on the type and degree of expression of endocrine-metabolic disorders (diabetes mellitus, hypertension, obesity).

If the pathology is combined with metabolic and endocrine disorders, the monthly ones become irregular. If there are no violations, then the menstrual cycle is regular. Monthly depends on the type of pathology. So, with some types of disease, menstruation disappears altogether or becomes irregular with smearing secretions. And with other types, the monthly ones become abundant with blood clots. That is, it is unequivocal to say whether the regularity of menstruation depends on the endometrial hyperplasia, since it is necessary to determine the type of disease and to consider other variants of pathological lesions.

Pain in endometrial hyperplasia

Pain in hyperplasia of the endometrium is the first signal for a woman to go to the gynecologist urgently. As a rule, pain occurs when a certain period of time the disease was asymptomatic. In this case, the appearance of pain indicates a progression of the disease.

To identify the cause of pain and diagnose endometrial hyperplasia, the gynecologist conducts a histological examination of endometriosis tissue. The procedure is painless and is carried out in an outpatient setting. If the study did not give a positive result, then the woman is sent for ultrasound. Based on the indications of histology and ultrasound, the gynecologist diagnoses the cause of the pain and gives an accurate assessment of the endometrium in the female body.

Endometrial hyperplasia and pregnancy

Endometrial hyperplasia and pregnancy are phenomena that are extremely rare at the same time. This is due to the fact that this pathology provokes female infertility, since the embryo can not attach to the altered walls of the uterus. That is, talking about pregnancy and at the same time endometrial hyperplasia does not happen often. Modern medicine considers hyperplasia as a precancerous condition. Infertility and increased thickness of the endometrium lead to the fact that a benign tumor degenerates into an oncology.

Pregnancy with endometrial hyperplasia occurs very rarely. If this happens, then, as a rule, a woman is diagnosed with a focal pathology form. This allows the egg to develop on a healthy portion of the mucosa. It is focal hyperplasia - this is the kind of disease that is an exception to the rules and allows a woman to become pregnant. But such cases are rare, and therefore require observation by a gynecologist and gentle treatment.

The most dangerous form of pathology for women is atypical. This type of disease refers to malignant tumors and is a precancerous condition. Atypical hyperplasia can be regenerated from the focal form of the disease. Any form is an indication of infertility. The task of a woman to regularly undergo preventive examinations at the gynecologist to prevent the disease.

[8], [9], [10]

Pregnancy after endometrial hyperplasia

Pregnancy after endometrial hyperplasia is a matter of interest to many women who have suffered the disease and want a child. Infertility and endometrial hyperplasia go in parallel, so a woman can not become pregnant at the time of illness. But after a successful treatment and a certain rehabilitation period, there is every chance to conceive and tolerate a healthy baby.

Pregnancy and endometrial hyperplasia have two variants of development. At the first variant, the woman who does not plan pregnancy in the near future, treats with the help of hormonal preparations (oral contraceptives). At the second variant, when the woman is ready to become pregnant, the doctor spends sparing treatment and preventive maintenance of barreness. This allows you to prevent the pathological complication of the disease - infertility, and after the rehabilitation period, endure a healthy baby.

Despite the fact that endometrial hyperplasia excludes the possibility of having children during the period of the disease. Complete recovery, which involves timely diagnosis and treatment - allows you to become pregnant after endometrial hyperplasia.

Endometrial hyperplasia after childbirth

Hyperplasia of the endometrium after childbirth, is not common, but in some cases, the disease begins to recur after the birth of the child. This happens with focal and atypical pathology.

The possibility of relapse after childbirth is possible, but not so dangerous. So, as a woman has already endured and gave birth to a healthy baby, so small ailments go to the background. Recurrent hyperplasia is recommended to be treated with surgical scraping and hormone therapy. In particularly difficult cases, a radical surgical intervention is possible, which involves the complete removal of the uterus.

[11], [12], [13], [14],

Classification of endometrial hyperplasia

Classification of endometrial hyperplasia is a system in which all kinds and forms are collected. With the help of classification, the gynecologist easily determines the form according to the results of the tests and the manifested symptoms. Thanks to this, it is possible to appoint an effective and timely treatment. Let's look at the main types of pathology.

• Simple - a feature of this type is that there is a significant increase in glands, but their architecture is preserved.
• Complicated - there are heterogeneous accumulations of glands in the endometrium.
• Simple and complex with atypia - in addition to enlarging the glands, signs of atypia of the nuclei appear in the endometrium.

The processes of atypia are the destruction of the structure of the cell nucleus. This division into types has clinical and prognostic significance. So, on simple it is necessary 1% of all cases of transition of disease in a cancer of a uterus, on difficult - 3%. In cases of simple hyperplasia with atypia, uterine cancer occurs in 8% of cases, with complicated with atypia - in 29%. According to the research conducted, in 42.6% of cases, the atypical form develops into uterine cancer.

There are several forms of endometrial hypertrophy, which are also included in the classification. Let's consider the main:

1. The glandular form is the lightest and benign form. The probability of developing cancerous tumors is 2-6%. With this form, cells actively divide, and the endometrium thickens. The glands are uneven, they can be pressed together, but there is no stroma between them. From the straight, the tubular glands turn into sinuous and expand substantially. But, despite such changes, the contents of the glands come out freely.
2. The glandular-cystic form - cells strongly expand and block the outflow of mucus. Because of this, the mouth of the gland takes the form of a cyst - a bubble with a liquid. As a rule, such changes are due to the action of estrogens.
3. The cystic form - glandular cells grow and increase in size, which makes them look like blisters. The internal part of the gland has a normal epithelium, so this form does not degenerate into a cancerous tumor.
4. Focal form - endometrial cells grow not uniformly, but separate foci. The foci are sensitive to the action of hormones. Elevations with altered glands-cysts appear on the endometrium. If the cells are divided into polyps, then it grows in size, from a few millimeters to 2-5 centimeters. There is a risk of developing a cancerous tumor in the hearth. If the changes are not uniform, then this form is called diffuse.
5. Atypical form or adenomatosis is the most dangerous form of endometrial hyperplasia, which leads to cancer. The only way to treat an atypical form is to remove the uterus.

The choice of treatment depends entirely on the form of the disease. So with simple glandular hyperplasia, for therapeutic purposes use hormonal drugs, and with atypical - removal of the uterus.

[15], [16], [17]

Glandular endometrial hyperplasia

Glandular endometrial hyperplasia - is a pathological process of deviation of the structure of endometrial tissue from the norm. The glandular cells grow, increase in volume and contribute to the thickening of the endometrial tissue. The basis of such a violation in intensive proliferation processes in the glandular uterine layer. The danger of this disorder is that there is a risk of degeneration of pathology into oncology. Timely diagnosis and treatment, allow to maintain the reproductive functions of the female reproductive system.

Cystic hyperplasia of the endometrium

Cystic endometrial hyperplasia is a form of lesion that represents changes in the endometrium at the cellular level. Cystic and glandular-cystic form - it's almost the same. Cystic hyperplasia is the process of cyst formation due to disturbances in the endometrium layer. In addition to cysts, large stromal nuclei begin to form in the endometrial layer. With a basal cystic form, the thickness of the basal layer of the endometrium is increased.

To diagnose the disease, in addition to the examination, the doctor takes the tissue for histological analysis. In some cases, a biopsy is used, which gives more accurate results. Another method of diagnosing the cystic form is ultrasound.

Cystic hyperplasia can have recurrent forms, that is, recurrent. As a rule, for the treatment use the use of hormonal drugs, which do not cure the disease to the end and give relapses. In such cases, resection is used for treatment, that is, excision of the endometrium, which is performed with a laser. The doctor removes the inner surface of the endometrium. Because of this, the wound heals, and the disease does not recur. Endometrial lesion can occur in women who have suffered from inflammation of the appendages in their youth.

[18], [19], [20],

Glandular cystic endometrial hyperplasia

The glandular cystic endometrial hyperplasia appears due to disorders and failures at the hormonal level. The lack of progesterone and excess estrogen, which occur during puberty, cause endometrial hyperplasia in young girls. Hormonal disruptions can also occur due to misuse of progestogen contraceptives. Sexual infections can also cause the growth of the endometrium, as well as untreated diseases of female genital organs. Treatment depends on the woman's age, weight, endocrine disorders, chronic diseases and the desire to have children in the future.

Endometrial focal hyperplasia

Focal hyperplasia of the endometrium is a disease that is caused by hormonal disorders. Pathology leads to changes in the uterine cavity and causes malfunctions of the menstrual cycle. The focal form arises from the fact that endometrial cells grow non-uniformly, causing an increase in polyps. Polyps grow into cysts, which without proper treatment can degenerate into malignant tumors. In this case, it is an atypical form, the treatment of which can be a complete removal of the uterus.

[21]

Simple endometrial hyperplasia

Simple endometrial hyperplasia is accompanied by a characteristic increase in the number of glands. Despite the pathological processes, the architecture of the structure of the endometrium is preserved. This form accounts for about 1% of the development of the disease in uterine cancer.

• A simple typical causes an increase in stromal and glandular structures. This leads to the fact that the endometrium increases in volume, cystic enlargement of the active glands occurs. In this case, the vessels in the stroma are located evenly, there is no atypia of the nuclei.
• A simple typical causes changes in the normal location of the glandular cell nuclei. Also, it helps to modify the shape of cells, forming round cells with nuclei, causing the expansion of vacuoles and anisicytosis. In 20 out of 100 cases, the disease takes a malignant form.

Atypical endometrial hyperplasia

Atypical hyperplasia of the endometrium is the most dangerous form of the disease. Atypicality indicates malignant processes in the endometrium. The cause of the disease can be regular hormonal failures, neglected diseases, disruption of the endocrine system, inflammatory diseases, infectious diseases of the genital organs, and others.

Treatment is long, and, as a rule, radical. Surgical removal of the uterus can prevent recurrence of the disease and does not allow for the possibility of metastasizing the malignant neoplasm.

[22], [23], [24]

Complex endometrial hyperplasia

Complex endometrial hyperplasia is a disease characterized by profound structural disorders and architectonics of the endometrium, which results in the proliferation of mucosal elements throughout its surface. Complex pathology can be with or without atypia.

• A complex form without atypia indicates that the woman in the endometrium does not have degenerated cells, which can be transformed into cancer cells and actively multiply.
• Complicated with atypia is a disease in which cells are transformed and transformed into cancerous cells. Atypical cells form malignant tumors in 40% of cases.

Complex endometrial hyperplasia involves several methods of treatment. If the disease without complication, then for the treatment use medicamentous hormonal treatment. If hyperplasia with atypia, then scraping, and in especially severe cases - surgical removal of the uterus.

[25]

Polypoid endometrial hyperplasia

Polypoid hyperplasia of the endometrium is a pathological process that is characterized by accelerated growth of the endometrium, which takes a pathological structure. Polyps are clots of endometriosis tissue with blisters of pale pink color. For diagnosis, ultrasound is used, in which the polypoid shape is an uneven surface with multiple cysts, grooves and pits. Polyps differ in size and shape. In this case, the deeper they are located to the bottom of the uterus, the larger they grow in size. Hysteroscopy can be used for detailed diagnosis of polyps.

Polypoid hyperplasia in the first stages can be asymptomatic. But with the appearance of painful symptoms, it is necessary to contact a gynecologist. For treatment, the doctor can prescribe hormonal therapy and conduct scraping. In rare cases, the disease recurs.

Adenomatous hyperplasia of the endometrium

Adenomatous hyperplasia of the endometrium is a disease whose second name is adenomatosis, that is, a synonym for atypical hyperplasia. The disease belongs to precancerous pathologies, since there is a high risk of oncology. According to the results of the conducted studies, this type of pathology in 30% of cases degenerates into cancer.

The main clinical symptom is dysfunctional uterine bleeding. In addition to bleeding, women are noted violations of menstrual, genital and sexual functions. Diagnosis of the disease by histological examination. For this, the gynecologist makes a selection of endometrial tissue from different parts of the uterus and examines them under a microscope. The characteristic features of histological examination are:

• Incorrect position of the endometrial glands and their large number.
• Between the glands there are no epithelial cells, the glands are located close to each other.
• The glands of the endometrium instead of the tubular become branchy in appearance.
• Appear structures of iron in the gland, protrusion, within the glands can form bridges from the cells of the epithelium.

All of the above features may have varying degrees of severity and are evidence of atypical adenomatous hyperplasia of the endometrium. Hyperplasia can be considered adenomatous and because of the large number of glands that are located close to each other. Atypia of cells is that they are rejuvenated, that is, they are prone to anaplasia. This leads to the fact that such cells actively multiply and grow into cancerous cells.

[26], [27], [28], [29], [30]

Basal endometrial hyperplasia

Basal hyperplasia of the endometrium is very rare. A characteristic feature of this disease is the thickening of the basal layer of the endometrium due to the proliferation of the glands of the compact layer, the appearance of polymorphic nuclei of stroma cells of rather large size. The pathology of the basal layer is an extremely rare pathology variant, which is most often found in women after 35 years of age and has a focal character.

The thickened hyperplastic layer, as a rule, has a thick stroma with tangles of blood vessels that have thickened walls. For this pathology are characterized by long, painful and profuse menstruation. This is because the hyperplastic parts of the basal layer are torn very slowly. For treatment use a combined method, make a scraping and conduct hormonal therapy.

[31], [32], [33]

Diffuse endometrial hyperplasia

Diffusive endometrial hyperplasia is a pathology that implies proliferative processes. Diffusity covers the entire surface of the endometrial tissue. That is, it indicates a pathological process throughout the mucous membrane of the uterus. Diffuseness can take the form of an attic, i.e. Adenomatous or glandular-cystic hyperplasia. It depends on the type of pathological growth.

• Diffuse glandular-cystic form of hyperplasia manifests itself as growth and appearance of cysts and glands that spread and grow in the entire surface of the mucous membrane of the uterus.
• The adenomatous diffuse form is a pathological proliferation of glandular cells and epithelial cells in the entire surface of the uterine mucosa. This form can sprout in the muscular layer of the uterus. Atypical diffuse hyperplasia is a precancerous condition.

As a rule, the diffuse appearance of the pathology appears due to chronic inflammatory processes in the uterine cavity. A disease-provoking factor can be numerous abortions, elevated levels of estrogens in the blood, inflammatory diseases of the genital organs, endocrine disorders. In 70% of cases, the disease accompanies obesity, diabetes, liver disease or hypertension.

[34], [35], [36]

Local endometrial hyperplasia

Local endometrial hyperplasia is a limited form of the disease, called a polyp. According to histological studies, there are several forms that depend on the cells that predominate in their structure: fibrous polyps, glandular, glandular fibrous.

Polyposis is characterized by rapid growth of endometrial cells in the uterine cavity. Polyps may have a foot or be attached directly to the endometrium. Local hyperplasia can consist of one or more polyps that are related to benign neoplasms. This species often recurs, especially with the age of the woman.

Symptomatics manifests itself in the form of cramping pains, which increase at the moment of growth of the next polyp. Women begin to have malfunctions in the menstrual cycle, excessive bleeding and severe bleeding. Timely diagnosis, this is the key to successful treatment and a favorable outcome of the disease.

Endometrial hyperplasia in menopause

Hyperplasia of the endometrium in menopause is one of those problems that lies in wait for a woman. It is due to hormonal changes in the body. It is during the menopause that a woman should pay special attention to her health condition. Since during the menopause, there is a danger of developing a variety of diseases, both benign and malignant.

Hyperplasia of the endometrium in menopause, develops due to excessive proliferation of the mucous membrane of the uterus. During this period, a woman can experience profuse uterine bleeding. Appearance pathology contributes to overweight, endocrine system diseases, hypertension. The danger of the disease is that during the menopause it can degenerate into malignant tumors and lead to uterine cancer.

Regular examinations at the gynecologist can prevent the development of the disease. Normally, the endometrium should not exceed a thickness of 5 mm. Any increase is a prerequisite for conducting an ultrasound study. If the thickness of the endometrium reaches 8 mm, then this pathology and a woman perform diagnostic curettage. If during the menopause, the endometrium reached a size of 10-15 mm, then the gynecologist conducts separate scraping and histology of the material obtained. As for the treatment for menopause, then there are several methods, let's consider them:

• Hormone therapy - drugs contribute to a positive outcome of the disease and are an excellent prevention of oncology.
• Surgical intervention - the gynecologist conducts scraping of the mucous membrane of the uterus, removes foci of pathology, stops bleeding and conducts diagnostics of the tissues obtained. Cauterization with laser (ablation) is used for surgical treatment. With atypical hyperplasia of the endometrium during menopause, a woman is removed for the uterus.
• Combined treatment - this type of treatment implies a combination of hormonal therapy and surgical intervention. In some cases, this prevents relapse of the disease.

[37]

Endometrial hyperplasia in postmenopausal women

Hyperplasia of the endometrium in postmenopause is a common occurrence. It is during this period in the female body, and especially in the reproductive system, involuntary changes begin. The secretion of the hormone estrogen is sharply reduced, which leads to pathogenetic disorders.

The main symptom is spotting. This is the first alarm that should make a woman turn to a gynecologist. Untimely diagnosis and treatment can lead to a precancerous condition, which under favorable conditions will quickly take the form of cancer.

For treatment use hormonal therapy, surgical treatment or combined method.

• Hormone therapy - because pathology is a hormone-dependent disease, the use of hormonal drugs is not only one of the effective methods of treatment, but also the prevention of oncology.
• Operative treatment - most often, patients undergo scraping, that is, removing foci of endometrial overgrowth. After scraping, the tissues are sent to a cytological study. Laser cauterization is popular and effective. This method involves the destruction of foci of pathologies and is characterized by complete bloodlessness, since blood vessels are cauterized. Radical surgical treatment is considered the removal of the uterus. Removal is carried out in the case when all the above-mentioned methods did not give a positive effect.
• Combined treatment is an integrated approach that allows to significantly reduce the volume of the enlarged endometrium before surgery and conduct preventive treatment of the disease.

[38], [39]

What is dangerous for endometrial hyperplasia?

What is dangerous is endometrial hyperplasia - the first issue of women who have been diagnosed with this disease. The most important and very deplorable consequence of the disease is infertility, that is, the inability to have children. Due to pathology, the fetus can not attach to the walls of the altered mucous membrane of the uterus. But hyperplasia is dangerous not only for those who want to feel the charm of motherhood. Without proper treatment, the disease takes the form of a malignant neoplasm whose treatment negatively affects the work of the whole organism.

As a rule, it is possible to diagnose with ultrasound (transvaginal or abdominal). In some cases, the gynecologist gives direction to a biopsy of the uterus or echogasterosalpingography. The most accurate method, which allows to accurately determine hyperplasia, is hysteroscopy. This method is a biopsy under the control of optical systems.

Relapse of endometrial hyperplasia

Recurrence of endometrial hyperplasia is one of the clinical problems that needs to be addressed in the period of choosing the type of treatment for the disease. As a rule, surgical tactics are used to prevent relapses. But even this kind of treatment does not guarantee that the endometrial hyperplasia does not recur.

The course of the disease depends on the type of pathology and age of the patient. Thus, in the treatment of simple endometrial hyperplasia, that is, polyps, conservative methods of treatment are used, which in 40% of cases give relapses of the disease. If pathology takes an atypical form, then hormone therapy and surgical intervention are used to treat it. But this is also not a guarantee that the disease will no longer recur.

• With recurrence of atypical hyperplasia of the endometrium, a woman is sent for ultrasound examination to determine the extent of the lesion. The patient is scraped and hormonal therapy is prescribed. But if after such a treatment process, the hyperplasia recurs, then the woman is shown to remove the uterus.
• With relapses of simple, glandular, cystic or glandular-cystic form, hormone therapy is used. If a woman plans to give birth in the near future, then for treatment and normal conception, use ablation, i.e., endometrial resection (procedure of complete destruction). Electrosurgical and laser methods are used for these purposes. Treatment is carried out under anesthesia and under the control of a hysteroscope.

That is, relapses of complex forms of endometrial hyperplasia are a direct indication for the removal of the uterus. When other forms of the disease recur, a woman undergoes hormone therapy and regular scraping.

Diagnosis of endometrial hyperplasia

Diagnosis of endometrial hyperplasia is a complex of methods that allow to identify the disease, determine its type, causes and carry out all the diagnostic measures necessary for successful treatment. Diagnosis consists of:

• Gynecological examination - allows to identify the presence of inflammatory processes and other diseases that accompany pathology or caused the disease.
• Ultrasound examination of pelvic organs with the help of a vaginal sensor - determines the thickening of the endometrium, the presence of polyps and other neoplasms in the uterine cavity. With this method, you can visually see the changes that occur in the uterine cavity.
• Hysteroscopy is a method of examining the uterine cavity using a special optical sensor. In addition to the examination, with hysteroscopy, separate curettage of the uterine cavity is performed for diagnostic purposes. The resulting scraping is sent to the study to determine the type of pathology. This diagnostic method is carried out on the eve of the proposed menstruation, in order to obtain reliable data.
• Hormonal research and aspiration biopsy - a piece of endometrial tissue recovers for histological examination. To study the hormonal background, the work of the adrenal glands, the thyroid gland, as well as the level of progesterone and estrogen, is checked.
• Biopsy - with the help of an endoscope, a tissue sample is taken from the uterine cavity, which is examined under a microscope. This method is used to study changes in cells and determine the risk of developing cancer. A biopsy is performed in the second half of the cycle.
• Echosalpingography - sterile isotonic solution or contrast substances are injected into the uterine cavity. The doctor uses a special scanner and watches what happens in the uterus and fallopian tubes. This method allows you to determine the patency of the fallopian tubes and the state of the mucosa. In the process of research, it is possible to identify foci of hyperplasia, cysts, nodes, polyps.
• Radioisotope study of the uterus using radioactive phosphorus - the substance is injected into a vein, and it accumulates in the expanded endometrial tissue. In a healthy tissue substance almost does not penetrate. This allows you to identify the foci of hyperplasia. Thus, areas with high concentrations of phosphorus, correspond to the foci of growth of endometrial cells.

[40], [41], [42]

Endometrial hyperplasia on ultrasound

Hyperplasia of the endometrium on ultrasound - allows you to visually track changes in the uterine cavity, determine their extent and severity. Ultrasound examination allows to determine the thickening of the endometrium, the presence of polyps, cysts, knots and other tumors that have appeared. The advantage of this diagnostic method is that by results of ultrasound it is possible to make premature conclusions about the treatment procedure and make a forecast for the course of the disease.

Ultrasound examination reveals characteristic echopriznaki, which correspond to one or another kind. That is, ultrasound not only determines the presence of the disease, but also the form of hyperplasia. Ultrasound examination makes it possible to assess the condition of neighboring organs, which can be the cause of pathology.

[43], [44], [45], [46]

Treatment of endometrial hyperplasia

Treatment of endometrial hyperplasia depends on the form of the disease and the stage. There are basic methods of treatment, they include:

• Separate diagnostic curettage and hysteroscopy.
• Hormonal therapy (compiled according to the results of histological examination).
• Surgical removal of the uterus (performed with ineffectiveness of the above treatment methods or recurrent form of the disease).

Timely diagnosis and identification of the causes of the disease, allow the most effective treatment course with minimal complications and side effects.

Tampons with endometrial hyperplasia

Tampons with endometrial hyperplasia are one of the methods of treating the disease. To date, there are tampons on the pharmaceutical market that treat a number of female diseases. Tampons are appointed by the attending physician, which indicates the duration of use of tampons and the frequency of their use.

The most popular medical tampons are considered to be tidbits Beautiful Life, which are officially recognized as traditional medicine and are an effective medication. The composition of tampons include natural plant extracts, which have a therapeutic effect. Particles of the endometrium, go out painlessly, tampons absorb harmful bacteria and prevent inflammatory diseases against the background of endometrial hyperplasia. The composition of tampons includes soothing agents that relieve spasms and other painful manifestations of the disease. Medical tampons allow to slow down the development of the disease in the early stages and serve as an excellent prophylaxis for relapses.

Diet with endometrial hyperplasia

The diet for endometrial hyperplasia is aimed at restoring reproductive functions and maintaining a disease-weakened organism and immune system. Patients are recommended to follow a low-calorie diet. Such a diet is one of the methods of treating not only hyperplasia, but also polyps in the uterus.

Low-calorie diet is explained by the fact that more often than not, endometrial hyperplasia affects women with excess weight who lead an unhealthy lifestyle and move little. Because of violations of fat metabolism, there is a high probability of developing diabetes and hypertension. As a result, this leads to hormonal disorders, against which there is hyperplasia of the endometrium or polyps. Low calorie diet is a pledge of a healthy body and beautiful figure.

[47], [48], [49], [50]

Nutrition for endometrial hyperplasia

Nutrition with endometrial hyperplasia should be healthy and low-calorie. At the heart of the diet should be vegetables, lean meat, milk, fruits. Dishes should be prepared with a minimum of fat and oil. Useful will be green salads, vegetable soups and dishes from seasonal products, low-fat broth.

Nutrition is aimed at restoring the normal functioning of the body. Compliance with diet leads to a norm of deviations in the work of the endocrine and cardiovascular system, which can provoke the development of pathology. From the diet it is necessary to cross out alcohol and harmful foods that are saturated with trans fats and genetically modified organisms.

It is recommended to eat fractional, every 2-3 hours. This will help maintain metabolic processes in the body at a high level, accelerate metabolism and give a feeling of saturation. In addition to nutrition, it is necessary to lead an active lifestyle, move more and spend time in the fresh air.

Prophylaxis of endometrial hyperplasia

Prophylaxis of endometrial hyperplasia implies timely treatment of any diseases of the female reproductive system. Particular attention is paid to anovulation, that is, infertility. Launched forms can once and for all deprive a chance, experience the joy of motherhood. Do not forget about the very radical treatment of the disease - removal of the uterus.

Preventive measures to prevent pathology include the use of hormonal contraception, which slows down the proliferation of the endometrium in the uterine cavity. Obligatory are preventive examinations at the gynecologist. Any violations of the menstrual cycle, pain during sex, abundant discharge and much more - require treatment and determine the cause of their appearance.

A mandatory preventive measure is proper nutrition and maintaining a normal weight. Receipt of birth control pills must be coordinated with a gynecologist. With the use of hormonal drugs, once a month you need to undergo examination of the uterus.

Methods of prevention are as follows:

• Preventive examinations at the gynecologist every six months.
• Abortion and use of hormonal contraceptives.
• Timely treatment of inflammatory diseases of the genital area and any other gynecological diseases.
• Treatment of extragenital diseases and lesions of the endocrine system.
• Regular exercise and exercise.

Prognosis of endometrial hyperplasia

The prognosis of endometrial hyperplasia depends on the form of the disease and the stage of its development. That is, the forecast can be either favorable or unfavorable. A favorable prognosis indicates that the diagnosed form of endometrial hyperplasia is treatable, and the risks of recurrence and degeneration into cancer are minimal. As a rule, after a course of treatment with a favorable prognosis, women fully recover reproductive, menstrual and sexual functions. A favorable prognosis is possible with simple, glandular, glandular-cystic, cystic forms, as well as with the appearance of polyps.

But the prognosis of the disease worsens as the patient's age increases. That is, the younger the woman, the more favorable the forecast. If a simple type of pathology is accompanied by violations of the endocrine and metabolic nature (obesity, diabetes, hypertension), the prognosis worsens. If the disease recurs, then the prognosis for the state of health is unfavorable, as the woman undergoes surgical treatment, which involves the removal of the uterus and the violation of a number of functions that can not be restored.

• If endometrial hyperplasia is diagnosed after menopause, then, as a rule, the prognosis for the state of health is unfavorable, and for life it is positive. This is due to the fact that at a later age, hyperplasia is very often malignant and is considered a precancerous condition.
• With complex or atypical hyperplasia of the endometrium, the prognosis is unfavorable, both in health and in life. This is due to the fact that both forms of the disease are considered a precancerous condition, in which the disease is quickly transformed into a malignant tumor.
• If the disease is resistant to conservative therapy, then surgical methods are used for treatment - scraping, removal of the uterus. In this case, the forecast is unfavorable for women's health, since part of the functions of the genital organs will never recover.
• The prognosis is also affected by concomitant diseases and pathologies. So, for example, with hypertensive disease, the prognosis of endometrial hyperplasia worsens, as the risk of recurrence of the disease increases significantly. This also applies to any endocrine-metabolic disorders (reduced glucose tolerance, increased cholesterol concentration, diabetes mellitus).

Hyperplasia of the endometrium is a disease that has several species that differ from one another in their course, nature, methods of treatment and prognosis for recovery. Regular examinations at the gynecologist, timely treatment of sexual diseases and a healthy lifestyle are a guarantee of women's health.

Sex with endometrial hyperplasia

Sex with endometrial hyperplasia is not prohibited. Many gynecologists recommend that patients do not give up sexual intimacy. Unpleasant feelings that arise at the time of sexual intercourse can be eliminated with the help of a long foreplay, the accuracy of the partner and the selection of the most acceptable posture. With severe pain and heavy bleeding, sex becomes impossible.

Dyspareunia or pain during sex is one of the symptoms of pathology. According to statistics, unpleasant and even painful sensations during sexual intercourse, is experienced by about 50% of women who have been diagnosed with the disease. In addition to pain, after sex there may appear minor bloody discharge, which is accompanied by aching paroxysmal pain in the ovaries.

Many women ignore this symptomatology, letting the disease run its course. But it is pain during sex and pathological discharge that is a sign of the disease and requires immediate medical attention. Do not forget that the absence of pain during sex, indicates the health of the woman and her reproductive system.