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Health

Treatment of endometrial hyperplasia

, medical expert
Last reviewed: 06.07.2025
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Treatment of endometrial hyperplasia is a set of measures aimed at eliminating pathological processes. Let's consider the main methods of treating endometrial hyperplasia and their effectiveness in relation to certain forms of the disease.

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Endometrial hyperplasia is a disease that represents pathological changes affecting the glandular and stromal elements of the endometrium. There are several forms of endometrial hyperplasia, which differ in their symptoms, course of the disease and treatment methods.

Treatment can be conservative, involving drug therapy, medicinal baths, drugs, solutions for intravenous administration, tampons, and traditional medicine methods. But treatment can also be radical, that is, complete removal of the uterine cavity. The type of treatment depends on the form of the disease. Thus, the most dangerous form of endometrial hyperplasia is atypical hyperplasia. This type of disease is a precancerous condition that can at any time develop into a malignant form, requiring radical methods of therapy.

Treatment methods for endometrial hyperplasia

Methods of endometrial hyperplasia depend entirely on the type of disease. Today, modern treatment methods allow treating hyperplasia without radical removal of the uterine cavity. If hyperplasia has not caused serious changes in the uterus, then medications are used for treatment. If the glands have formed cysts or polyps, then in addition to drug treatment, surgical intervention is used. When choosing treatment therapy, the doctor takes into account the patient's health, her age and the severity of the disease. Let's look at the main methods of treating endometrial hyperplasia.

Drug therapy

Several groups of drugs are used to treat endometrial hyperplasia. The doctor selects the necessary dosage and the appropriate drug. This helps prevent side effects that manifest as weight gain, excess hair growth, or acne on the skin.

  • Combined oral contraceptives

The drugs help restore the hormonal balance in the female body. The most popular of them are: Janine, Yarina, Regulon. As a rule, oral contraceptives are prescribed to young girls, nulliparous women who have glandular-cystic or glandular hyperplasia of the endometrium. The use of drug treatment is explained by the fact that curettage and other surgical methods are not desirable.

The drugs are taken for at least six months. The gynecologist individually creates a contraceptive regimen for taking the drug. This allows the menstrual cycle to be regular, and the periods themselves to be less painful and heavy. While a woman is taking contraceptives, her body begins to produce progesterone on its own.

  • Synthetic analogues of progesterone

Since endometrial hyperplasia occurs due to progesterone deficiency, the use of progesterone preparations allows to cure the disease. The artificial sex hormone acts similarly to that produced by the body. The use of synthetic analogues of progesterone restores the menstrual cycle, and the use of gestagens is effective in the treatment of endometrial hyperplasia in women of all ages.

The only downside of the drug is that there may be bloody discharge between periods. The duration of treatment is from three to six months. The most effective drugs are Norcolut and Duphaston.

  • Gonadotropin-releasing hormone antagonists (GnRH)

Modern drugs that reduce the production of estrogens (female sex hormones), which promote the growth of the endometrium. The drugs slow down the growth and division of cells, due to which the thickness of the mucous membrane decreases. This kind of process is called endometrial atrophy. But drugs help to avoid infertility and hysterectomy.

The drugs are easy to use and easy to dose. Typically, patients are given one injection once a month and prescribed a nasal spray. In the first weeks of using the drug, the woman feels a deterioration in her condition, but this passes as the estrogen level increases. The woman establishes a regular cycle, and her periods become painless. The duration of treatment with gonadotropin-releasing hormone agonists (GnRH) is from one to four months.

Treatment with surgical methods

Surgical treatment methods involve surgical intervention. This type of treatment can be radical, i.e. removal of the uterus, or more conservative – curettage, cauterization, cryodestruction, etc. The advantage of such treatment is that it minimizes the likelihood of recurrence of endometrial hyperplasia in the future.

  • Scraping (cleaning) of the uterine cavity

The main diagnostic and treatment method for endometrial hyperplasia. The procedure itself is performed under intravenous anesthesia and takes no more than 20-30 minutes. The gynecologist removes the superficial functional layer of the endometrium. In other words, 20 minutes of the doctor's work is similar to the body's work during 3-7 days of the menstrual cycle. The disadvantage of such treatment is that endometrial hyperplasia can recur.

  • Cryodestruction

This method involves freezing the affected areas of the mucous membrane using low temperatures. The cold causes necrosis of the affected layer of the endometrium. The treated area of the endometrium is rejected and comes out as bleeding with clots.

  • Laser ablation or cauterization

Cauterization is similar in principle to the method described above. Only in this case, the gynecologist works with instruments heated to high temperatures. The affected areas of the endometrium are destroyed and independently exit the uterine cavity. After the procedure, the uterine mucosa is restored as after a past menstruation.

  • Removal of the uterus or hysterectomy

This type of treatment is used for atypical and complex forms of endometrial hyperplasia. Hysterectomy is most often used to treat hyperplasia in women who are in menopause or when there is a high risk of developing cancer. Before removal, the uterus and ovaries are examined. If the ovaries are normal, they are not removed. Complete removal of the uterus, ovaries and fallopian tubes is done for adenomatosis and when cancer cells are detected.

After such treatment, the woman is prescribed a course of hormonal drugs. This helps improve the general condition and prevent relapses of endometrial hyperplasia in the future.

Treatment of glandular hyperplasia of the endometrium

Treatment of glandular hyperplasia of the endometrium begins with a complete diagnosis of the disease and selection of an individual treatment method. It is worth knowing that glandular hyperplasia is an excessive growth of glandular tissue of the endometrium, which leads to its increase in both size and volume. The disease manifests itself in the form of heavy menstruation, infertility, anemia. To determine the pathology, the woman undergoes an ultrasound examination, endometrial biopsy and a number of hormonal studies.

Treatment of glandular hyperplasia of the endometrium involves curettage of the uterine cavity to remove the upper layer of the endometrium. In addition to curettage, the woman undergoes hormonal therapy, and if absolutely necessary, endometrial ablation or resection.

  • The first stage of treatment is diagnostic curettage of the uterine cavity. Based on the histology results, the doctor draws up a hormonal therapy regimen aimed at eliminating hormonal imbalance and suppressing endometrial proliferation. In case of glandular hyperplasia of the endometrium, drugs such as Yarina, Janine, Utrozhestan, Duphaston are usually prescribed. The duration of drug use is from three to six months. The gestagen-containing intrauterine system Mirena, which has a local therapeutic effect on the endometrial layer, is also distinguished by its therapeutic effectiveness. For women over 35 years of age and in the postmenopausal period, GnRH agonists (gonadotropin-releasing hormone agonists) are used for therapeutic purposes. The drugs contribute to the appearance of reversible amenorrhea and artificial menopause.
  • In addition to hormonal treatment, the woman is required to undergo vitamin therapy, physiotherapy, and anemia correction. Six months after treatment, a control ultrasound examination is performed. And at the end of the course of treatment, a repeat endometrial biopsy is performed. To stimulate the ovulatory cycle, Klimofen and other stimulants are used.
  • If glandular hyperplasia of the endometrium recurs even after hormone therapy, then ablation or resection methods using electrosurgical and laser techniques are used for treatment. This is especially relevant for women who are interested in having children.
  • For the treatment of glandular hyperplasia of the endometrium, which is complicated by uterine fibroids, endometriosis or occurs during menopause, a hysterectomy or panhysterectomy is performed.

As for the prevention of glandular hyperplasia of the endometrium, it is aimed at preventing uterine cancer and endometrial cancer. To do this, a woman should regularly undergo examinations by a gynecologist, select contraceptives and undergo professional training for conception and pregnancy. The main task of a woman is to promptly seek medical help and consultations, as well as follow all doctor's orders. Since the prognosis for the treatment of glandular hyperplasia of the endometrium depends on this.

Treatment of glandular cystic hyperplasia of the endometrium

Treatment of glandular cystic hyperplasia of the endometrium is most often carried out in women of reproductive age, since they are the most susceptible to this disease. The first stage of treatment is a diagnostic preliminary curettage of the mucous membrane of the uterine cavity, that is, the endometrium. The tissues are sent for histological analysis, based on the results of which the gynecologist draws up a treatment plan. Treatment is aimed at maintaining menstrual functions and correcting ovulation.

For the treatment of glandular cystic hyperplasia of the endometrium, several standard, effective treatment regimens are used, let's look at them:

  • Treatment begins on the first day of menstruation (presumed). The woman should take Ethinyl-Estradiol twice a day for 20 days. Two weeks after menstruation, the drug Regnim is prescribed, which is taken for 10 days. The duration of such treatment is from four to six months.
  • From the first day of menstruation, a woman takes Microfollin for two weeks in combination with the drug Regnim. The duration of treatment is from four to six months.

This treatment regimen for glandular cystic endometrial hyperplasia is designed for women in the premenopausal period. It is necessary to take estrogen-gestanens for six months. This will normalize the hormonal background and prevent the pathological development of the disease.

Glandular cystic hyperplasia of the endometrium is subject to mandatory treatment, regardless of the degree of manifestation of the pathology and the age of the patient. The treatment method is selected individually for each woman. And it depends on the age of the patient, the complexity of the disease, individual characteristics of the body. The duration of treatment is from three months to six months. The effectiveness of the treatment is checked by repeated biopsy. If after the treatment the disease has taken a severe form or relapsed, then this is an indication for surgical intervention, which in especially difficult cases involves the removal of the uterine cavity.

Treatment of simple endometrial hyperplasia

Treatment of simple endometrial hyperplasia involves prevention of uterine and endometrial cancer. Treatment tactics depend on the clinical manifestations of the disease, the histological variant of hyperplasia, the woman's health and other features of her body. Treatment begins with stopping bleeding, anti-inflammatory therapy and regulation of the menstrual cycle. During the treatment, the woman may be hospitalized, both on a planned and emergency basis.

Simple endometrial hyperplasia is polyps that appear on the uterine mucosa and require removal. Polyps often recur, so curettage does not help to completely cure hyperplasia. This is because the polyp has a fibrous stalk. The most effective treatment is hysteroscopy, that is, surgical removal along with the basal layer. After such treatment, the woman undergoes a control hysteroscopy to confirm the effectiveness of the treatment. In complex cases of simple endometrial hyperplasia, the patient is prescribed resectoscopy.

In addition to surgical intervention, hormonal treatment is mandatory to restore the normal functioning of the female body and normalize the cycle. Oral combined contraceptives (Novinet, Regulon) are used for these purposes. In some cases, a woman is given a hormone-containing IUD, which is an alternative to pills. But the only drawback of the IUD is a decrease in menstrual flow and even amenorrhea. In any case, the woman is under dispensary observation for one to two years. This allows the gynecologist to monitor the patient's condition and prescribe or adjust treatment in a timely manner.

Treatment of simple glandular hyperplasia of the endometrium

Treatment of simple glandular hyperplasia of the endometrium consists of several stages. At the first stage, the woman is given medical care to stop the bleeding and curettage of the uterine walls is performed for therapeutic and diagnostic purposes. The main task of the first stage of treatment is to stop the bleeding by eliminating its source. The endometrial tissues obtained as a result of curettage are sent for histological analysis. The analysis confirms the presence of simple glandular hyperplasia of the endometrium. If the analysis does not contain cancer cells, then the treatment is conservative, usually without surgical manipulations.

The next step in the treatment of simple glandular hyperplasia of the endometrium is to restore the body and normal menstrual cycle. To do this, eliminate the causes that prevent ovulation: hormonal imbalance, anatomical obstacles to the release of the egg, taking estrogen-containing drugs without progesterone, and others. For these purposes, hormonal therapy is used, which replenishes the hormone deficiency. If the planned menstruation does not occur after hormonal treatment, this indicates that the hyperplastic processes have not been stopped, that is, the disease is progressing.

The final stage of treatment of simple glandular hyperplasia of the endometrium is the elimination of conditions and diseases that contribute to anovulation. This may occur due to prolonged psychological overexcitement, metabolic syndrome, rheumatism or polycystic ovary disease. Elimination of all negative factors is a guarantee that the disease will not recur in the future.

Treatment of focal endometrial hyperplasia

Treatment of focal endometrial hyperplasia is a long process that involves the use of gestagens. The woman undergoes diagnostic curettage to study the endometrial tissues for histology. For treatment, the drug 17-OPK (17-hydroxyprogesterone caproate solution) and the drug Duphaston are prescribed. The duration of use of drugs is up to nine months.

A mandatory step in the treatment of focal endometrial hyperplasia is hysteroscopy. This allows for a detailed examination of the pathological area of the mucosa and the choice of further treatment tactics. Treatment should not be limited to taking hormonal drugs. If the patient has metabolic disorders, for example, excess weight, the doctor prescribes a diet. In this case, it is weight loss that will determine and contribute to the effectiveness of the main therapy.

Treatment of atypical endometrial hyperplasia

Treatment of atypical endometrial hyperplasia is most often performed in women during pre- and postmenopause. Atypical endometrial hyperplasia is a pathological precancerous condition, which is an indication for removal of the uterine cavity. Radical surgical intervention, i.e. extirpation of the uterus, is an effective treatment method in this case, which prevents relapses of the disease. But the question of removing the uterus arises after hormonal treatment. As a rule, in addition to the uterus, the woman also has her ovaries removed. Removal of the ovaries depends on their condition and the severity of extragenital pathology.

Today, atypical endometrial hyperplasia can occur even in young women who have not yet given birth. In this case, doctors conduct organ-preserving treatment. For these purposes, highly effective synthetic hormonal drugs are used, which treat not only hyperplasia with atypia, but also endometrial cancer in the early stages.

The results of hormonal therapy depend on the pathogenetic variant of the disease and the nature of the atypical process. The treatment process should be accompanied by dynamic observation. Every two months, the woman undergoes curettage, that is, diagnostic scraping. The main criterion for recovery is endometrial atrophy. After this, the patient undergoes a course of rehabilitation treatment, which is aimed at restoring the functions of the endometrium, that is, a course of hormonal therapy.

The results of treatment are assessed every three months. For this purpose, separate diagnostic curettage and dispensary observation are carried out. In case of relapses of the disease, conservative hormonal treatment is replaced by surgical intervention, i.e. extirpation of the uterus.

Treatment of adenomatous hyperplasia of the endometrium

Treatment of adenomatous endometrial hyperplasia can be done in two ways. The method of treatment depends on the patient's age, individual characteristics of her body and the course of the disease. Thus, for older women who are in the postmenopausal period, radical surgical treatment is carried out. But for women of reproductive age, conservative therapy is possible.

Conservative therapy involves using GnRH and a number of other hormone-containing drugs. The effectiveness of such treatment is monitored by diagnostic and therapeutic curettage, which is performed every two to three months. In addition, a woman should undergo an ultrasound examination every month to determine the thickness of the endometrium. But even after long-term conservative treatment, adenomatous hyperplasia of the endometrium can recur. Due to the inability to control the disease, the woman undergoes removal of the uterus with appendages.

Treatment of endometrial hyperplasia in premenopause

Treatment of endometrial hyperplasia in premenopause is a process that is the elimination of the disease in a woman's transitional period. Premenopause is a condition that occurs before menopause, usually in women aged 45-47. Sometimes premenopause symptoms are observed in women aged 30-35, this is possible due to hormonal imbalances. This period can last from several months to several years. A woman experiences a weakening of ovarian function, but still retains the ability to conceive a child. The main sign of menopause is the absence of menstruation during the last 12 months.

Premenopause is accompanied by the appearance of many diseases that are caused by hormonal imbalance. It is against this background that endometrial hyperplasia develops. Treatment of endometrial hyperplasia in premenopause begins with diagnostics of the woman's condition. Diagnostics allows to exclude, and if necessary, to recognize other pathological processes.

  • A woman must undergo an ultrasound examination of the pelvic organs to visualize the uterus and appendages. This will allow pathology to be identified at an early stage of development.
  • Hormonal profile analysis is mandatory. The analysis is necessary to determine the level of hormones in different periods of the cycle. The data obtained helps in the preparation of hormone replacement therapy.
  • Diagnostic curettage makes it possible to determine the form of hyperplasia and identify cancer cells. Endometrial tissue obtained as a result of curettage is sent for cytological examination.

Based on the results of the tests and diagnostics, a treatment plan is made. As a rule, hormonal therapy is used, which helps to correct the onset of menopause and prevents further pathologies of the endometrium and the appearance of tumors of the genitals. In addition to treatment with hormonal drugs, vitamin therapy is carried out. Such treatment stimulates the functions of the ovaries, using vitamins A, E, calcium. The patient may be prescribed sedatives and antidepressants, which will help cope with sleep problems and unstable mood. In especially severe cases of the disease and with recurrent endometrial hyperplasia, the woman undergoes removal of the uterus and subsequent hormonal treatment.

Treatment of endometrial hyperplasia in menopause

Treatment of endometrial hyperplasia in menopause can be carried out in several ways. The type of treatment depends on the form of the disease, individual characteristics of the woman's body, her age and concomitant diseases. Let's look at the main types of treatment for endometrial hyperplasia in menopause.

  • Hormonal therapy

The woman is sent for diagnostic endometrial curettage and ultrasound examination. Based on the test results, the dosage of administered hormones is selected, which is regularly adjusted after periodic endometrial examinations. Hormonal therapy contributes to a positive outcome of the disease and is an excellent preventive measure against the development of cancerous processes in the uterine cavity.

  • Surgical treatment

The patient undergoes scraping of the mucous surface of the uterine cavity to remove pathological foci and conduct diagnostics. In some cases, the endometrial tissue is cauterized with a laser to destroy the foci of pathology. As for hysterectomy, that is, removal of the uterus, this procedure is performed in case of relapses of endometrial hyperplasia.

  • Combination treatment

This treatment method involves a combination of surgical and hormonal treatment. Hormonal therapy reduces the volume of surgical intervention due to the reduction of the overgrown endometrium. But most often, during menopause, surgical removal of the uterus is performed followed by hormonal therapy.

Treatment of endometrial hyperplasia in postmenopause

Treatment of endometrial hyperplasia in postmenopause begins with diagnostic curettage. The procedure is performed under full hysteroscopy control. If the disease appeared in a woman for the first time, during the postmenopausal period, then after the curettage procedure, the doctor prescribes hormonal therapy. The patient is given drugs that contain prolonged-action gestagens. The duration of such treatment is from eight months to a year.

In addition to hormonal treatment, for endometrial hyperplasia in postmenopause, women are prescribed GnRH analogues (Buserelin, Dipherelin, Goserelin). The duration of use of these drugs is up to one year. Hormonal treatment is carried out with regular ultrasound examinations to diagnose the recovery process. If endometrial hyperplasia recurs during postmenopause, then surgical treatment is performed. This method involves removal of the uterine cavity or extirpation of the uterus, ovaries and fallopian tubes.

If a woman is diagnosed with atypical endometrial hyperplasia after diagnostic curettage, this is an indication for surgical treatment. This is necessary to prevent relapses of the disease and to avoid malignancy of the pathology. Most often, a complete amputation of the uterus is performed. If surgery cannot be performed due to severe somatic diseases or contraindications, the woman is given hormone therapy in the maximum permissible dosages.

Curettage for endometrial hyperplasia

Curettage for endometrial hyperplasia has two functions - diagnostic and therapeutic. Separate diagnostic curettage is performed on absolutely all women with any form of endometrial hyperplasia. The procedure is performed under general anesthesia, under hysteroscopy control. If curettage is performed without hysteroscopy, then local anesthesia is used.

Curettage for endometrial hyperplasia is performed the day before the expected menstruation. During the procedure, the woman's entire uterine mucosa, that is, the endometrial layer, is removed, carefully treating the bottom and corners, where polyps or adenomatosis may be located. Hysteroscopy is used to control the removal procedure, that is, how cleanly the mucous membrane is removed. Without hysteroscopy, even experienced doctors can leave small areas of the endometrium, which lead to relapses of the underlying disease.

After the curettage procedure, a woman may have minor bloody discharge for 3-10 days. But this is considered normal, so it should not cause panic. In addition to bleeding, after the curettage procedure, particles of resected tissue may come out, but this is also a normal postoperative phenomenon. After the first curettage procedure, the second curettage is performed after 4-6 months, for diagnostic purposes. This allows you to evaluate the results of treatment, and if necessary, prescribe a number of drugs or remove the uterus.

Treatment of endometrial hyperplasia without curettage

Treatment of endometrial hyperplasia without curettage is an ineffective therapy, which, as a rule, does not give the expected therapeutic effect. That is, the absence of curettage is blind treatment. Since without curettage it is impossible to assess the effectiveness of the therapy used. A woman must completely rely on her well-being.

If, after a course of hormonal therapy, endometrial hyperplasia recurs, this indicates the ineffectiveness of the main treatment. The gynecologist draws up a new treatment plan. If endometrial hyperplasia remains untreated, the foci of the disease are subject to malignancy, the only treatment method for which is complete removal of the uterus.

All this suggests that the treatment of endometrial hyperplasia is much more effective if therapeutic and diagnostic curettage is performed. The procedure is performed under anesthesia, so the woman does not feel pain. The tissues obtained as a result of curettage are sent for cytological analysis. Thanks to this, the doctor draws up a treatment plan that will be effective for a particular form of endometrial hyperplasia.

Treatment of endometrial hyperplasia is a long-term therapy aimed at treating pathologies in the uterine cavity. Today, there are many effective drugs that are used to treat hyperplasia. Medicines are selected individually for each patient, based on her age, the nature and form of the disease, and other characteristics of the body. Modern drugs can cure even atypical and complex forms of the disease. Timely diagnosis and examination by a gynecologist is a guarantee of effective and successful treatment of endometrial hyperplasia.

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