Symptoms of endometrial hyperplasia

The mucous membrane lining the uterus from the inside is called the endometrium. Endometrial tissue is sensitive to female sex hormones: under the influence of estrogen, the growth and thickening of the mucosa occurs, and the development of progesterone restrains this process.

Significant growth of cells of the uterine mucosa with an increase in the thickness of its membrane in medical practice is defined by the term endometrial hyperplasia. Pathology can be local (focal), or cover the entire surface of the uterus.

The cause of the formation of areas of hyperplasia is the predominance of the hormone estrogen. In turn, the shifts in the hormonal balance are associated with:

• drug therapy, including estrogen;
• syndrome of polycystic ovaries;
• overweight;
• period of menopause.

The risk factors include urinary infections, abortions, endocrine pathologies, genetic predisposition, the presence of diabetes and hypertension in the history, puberty and poor environmental conditions.

Signs of hyperplasia are the pain of the lower abdomen and the violation of the cycle. Common Symptoms of Endometrial Hyperplasia:

• long periods with heavy bleeding;
• Spotting bleeding periods of menopause;
• the appearance of bleeding between menstruation;
• malfunctions of the menstrual cycle (irregularity, heterogeneity of secretions, etc.);
• severe pain during menstruation (especially if no previous syndrome has been observed);
• infertility.

However, the real danger lies in the asymptomatic course of the disease, which is quite often found in clinical practice and is found only at a gynecologist's appointment or directly on ultrasound. The result of untimely diagnosis is various complications, as well as infertility and cancer.

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Symptoms of endometrial hyperplasia in menopause

According to specialists, the formation of pathology of the uterine mucosa occurs long before entering menopause. And such factors as hereditary predisposition and the presence of benign genital diseases play a significant role here. In addition, with age, the defenses of the body weaken, the situation is complicated by the operations and chronic diseases that have been affected (especially liver damage).

The period of menopause is recognized as the most difficult in view of the increased risk of gynecological diseases. Appearing at this time, hyperplasia can develop into a malignant tumor of the uterus, which is why women are recommended to undergo scheduled examinations without waiting for anxiety symptoms. The risk group includes women over 50, suffering from diabetes and hypertension, metabolic disorders, and also being overweight.

Against the backdrop of fluctuations in the hormonal background and a decrease in ovarian function, the symptoms of endometrial hyperplasia include:

• severe and prolonged bleeding;
• smearing type bloody, scanty discharge;
• detection of polyps.

Unfortunately, the symptoms of endometrial hyperplasia do not always appear. The latent development of the pathological focus is fraught with late treatment, when the pathogenetic process has reached its peak, and treatment requires colossal efforts.

Diagnosis of pathology can be done by transvaginal ultrasound or aspiration biopsy. The latest research in the case of focal lesions often gives false data. The thickness of the endometrium is normal for the climatic period of up to 5 mm. The presence of the mucosa in the range of 6 to 7 mm is the reason for observation and repeated ultrasound. When the indicator reaches 8 mm, scraping of the mucosa is applied with the subsequent study of the biological material (before and after the procedure the uterine cavity is examined by means of a special probe).

Symptoms of endometrial hyperplasia in postmenopausal women

Postmenopause lasts for several years, during which the full extinction of ovarian function occurs. The new physiological stage in a woman's life is characterized by a decrease in the production of sex hormones - estrogen and progesterone, affecting not only the genitals, but also the digestive, nervous, musculoskeletal system, brain, skin and hair.

Huge changes in the work of the ovaries often occur with the development of cysts, which do not make themselves felt until the rupture or bending of the legs or vice versa are manifested by the strongest pain syndrome. Similar cysts and unordered division of endometrial cells often give a large percentage of malignant tumors.

As already mentioned, changes in the reproductive system of the postmenopausal period occur with a decrease in the production of estrogen, which explains the negative impact on the genital area in the presence of various climatic dysfunctions. An alarming sign is the appearance of bloody outflows of any type - abundant, meager, etc. Symptoms of endometrial hyperplasia in postmenopause include cramping abdominal pain that characterizes the development of large polyps. The period of postmenopause is characterized by single polyps against the background of mucosal atrophy.

Symptoms of glandular hyperplasia of the endometrium

The concept of "glandular hyperplasia" appeared as a result of the characteristic development and increase in the glands of the endometrium of the uterus. Glandular hyperplasia is referred to as precancerous pathology. The lack of proper treatment leads to an atypical form of hyperplasia with the formation of cells that resemble cancerous in structure.

A clear sign of glandular pathology is a violation of menstrual function, which manifests itself in various bleeding. Symptoms of glandular hyperplasia of the endometrium:

• bleeding cyclic type (menorrhagia) - abundant and longer than normal menstruation;
• bleeding acyclic nature (metrorrhagia).

Excesses with glandular hyperplasia usually occur after a short delay or during a break between menstruation. In the adolescent period, active release of blood with clots is possible.

Against the background of profuse and prolonged bleeding, the symptoms of endometrial hyperplasia of the glandular form include weakness, malaise, anemia and dizziness, down to loss of consciousness.

Signs of endometrial hyperplasia by ultrasound

Examination of the uterus by ultrasound is assigned to assess changes occurring in the genital organ, detecting the thickness of the mucosa with the presence of areas of hyperplasia and polyps. The procedure is carried out by a special sensor inserted into the vagina. Ultrasound is an inexpensive, non-invasive, painless and informative enough diagnostic method. Due to ultrasound examination, a qualitative and quantitative evaluation is performed according to the echographic parameters corresponding to a certain menstrual phase.

Mucous endometrium is characterized by clear outlines and significant acoustic density in comparison with myometrium (muscle layer), located in the middle of the outer contour of the uterus. The thickness of the mucosa is affected by the monthly cycle: in the first phase, the wall does not exceed 3-4 mm, in the second phase it reaches 12-15 mm. A uniform thickening with pronounced flat contours and uniform echogenicity is evidence of endometrial hyperplasia by ultrasound. Polyps are represented by neoplasms with clear boundaries, thin echogenic rim and high acoustic density. Malignant changes are characterized by heterogeneous echogenicity and rugged contours.

Symptoms of glandular hyperplasia of the endometrium

The glandular form of hyperplasia is characterized by a thickening of the endometrium with active division of glandular cells, the arrangement of which is not uniform (often a group cluster is observed). A pathological condition can occur in the absence of pronounced symptoms. That's why not always patients describe the symptoms of endometrial hyperplasia, and complaints extend to exchange-endocrine disorders:

• headache;
• problems with sleep;
• excessive and unreasonable weight gain;
• reduced working capacity;
• strong thirst;
• irritability.

The main signs of glandular hyperplasia of the endometrium are the uterine bleeding that occurs as a result of dysfunction of the monthly cycle. Allocations can be weak / strong, long / short. The development of hyperplasia is also indicated by the smearing type of discharge, not associated with menstruation. Not the onset of pregnancy and pain syndrome with localization in the lower abdomen are often precursors of the pathology of the uterine mucosa.

If you celebrate any of these negative conditions, do not delay the visit to the gynecologist. Timely diagnosis of hyperplasia allows for high-quality therapy and avoiding undesirable complications.

Signs of focal endometrial hyperplasia

Focal hyperplasia is characterized by the growth of the endometrium in areas most sensitive to the action of hormones. Local lesions cover an area of several millimeters or centimeters. Outwardly this is manifested by several polyps.

To exit the mature egg from the follicle requires a sufficient level of progesterone and luteinizing hormone. Excess estrogen inhibits the egg, lengthens the first phase of the cycle, pushes ovulation and provokes proliferation of the mucous membrane of the uterus. The first signs of focal hyperplasia of the endometrium appear in the form of profuse and prolonged bleeding. To suspect the pathological process can be acyclic, bloody, uninvolved secretions of a short-lived nature.

It should be noted that the lack of the hormone estrogen does not ensure the maturation of the egg and its subsequent release from the follicle. In this case, the mucous membrane is discarded in part and the formation of polyps is observed. Symptoms of endometrial hyperplasia persist - varying in intensity menstruation lasts up to 10-14 days.

Echographic signs of endometrial hyperplasia

In order to differentiate hyperplasia and control the effectiveness of treatment, it is advisable to perform an ultrasound examination on the 5th-7th day of the cycle. At the same time, the accuracy of the study of revealed hyperplastic transformations is 90%, and the detected polyps of the endometrium are 60-80%. The information content of the screening method varies depending on the patient's age, the experience of the diagnostician and the performance of the device itself.

Echographic signs of endometrial hyperplasia:

• the thickness of the mid-uterine structure varies between 14.6-15.4 mm;
• polyps correspond to a value of 16.1-17.5 mm;
• suspected adenocarcinoma can be at the rates of 19.7-20.5 mm.

For the postmenopausal period, the sign of hyperplasia of the mucosa is the achievement of an M-echo value of 5 and above millimeters.

The main echographic symptoms of endometrial hyperplasia are:

• increased acoustic conductivity;
• flatness / unevenness of the M-echo contour;
• the nature of the heterogeneity of the endometrium;
• the inclusion of echo-negative or echopositive different structures;
• change in the relief of the mucous membrane of the uterus.

The detection of the above signs in the ultrasound process indicates the presence of hyperplasia.

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