Ovarian hyperplasia

Ovarian hyperplasia is a gynecological disease characterized by the proliferation of stroma and endometrium, which leads to an increase in the ovary. Consider the causes of this pathology, diagnostic methods, types of treatment and prevention.

Ovarian hyperplasia is a proliferation of stroma of glands simultaneously with processes of luteinization, proliferation or hyperproduction of androgens. The disease can appear as a result of congenital pathology or a transferred disease, which has caused hormone failure. Without proper treatment, pathology leads to tissue tekomatosis, which indicates a precancerous process. It indicates an increase in the number of cells, which is accompanied by a violation of the secretion of hormones and the appearance of a corresponding clinical picture.

Hyperplasia can appear in one of the glands, as well as in different glands. Very often the disease occurs against the background of other tumor processes of the ovaries or uterus. Mzhet appear at any age, causing pronounced endocrine disorders and hyperplastic endometrial processes. Most often the disease appears in the pre and postmenopausal period.

[1], [2], [3]

Causes of Ovarian Hyperplasia

The causes of ovarian hyperplasia are not fully understood, but they are divided into congenital and acquired.

• Congenital hyperplasia of the ovary can appear as a result of hereditary gynecological diseases. These include tumoral formations of genital organs or mammary glands. Failure during puberty and any hormonal disorders.
• Acquired ovarian hyperplasia arises from such provoking factors as: inflammatory and non-inflammatory genital organs diseases, gynecological surgical interventions, the presence of hormone-dependent diseases of the genital organs (endometriosis, myoma, mastopathy).

Ovarian hyperplasia can occur as a complication due to diseases of the endocrine organs, the liver and even the cardiovascular system. Particular importance on the course of the disease has such signs as: obesity, high blood sugar, hyperglycemia or hypertension. The cause of the disease - increased formation of the sex hormone estrogen, which is responsible for the normal development and functioning of female genital organs.

In addition to the above reasons, there are a number of alleged provoking factors that can lead to the appearance of the disease, consider them in more detail:

• Retrograde menstruation - blood particles erupt during menstruation and enter the abdominal cavity, where they are fixed and function like real uterine tissues. As a result, the blood does not pour out, which leads to the appearance of foci of inflammation, local blood loss and ovarian hyperplasia.
• Metaplastic cause - in the process of menstruation, tissue particles are not fixed inside, but lead to a change in the structure of the endometrium. This can happen because of changes in the immune system and in the pathology of the fallopian tubes.

[4], [5], [6], [7], [8], [9], [10]

Symptoms of ovarian hyperplasia

Symptoms of ovarian hyperplasia depend on the cause that led to the disease. The clinical picture of lesions of the glands is characterized by early or late menarche (the first menstruation), menstrual irregularities, especially in the climacteric period, infertility. The presence of cystic follicles can also be a sign of ovarian hyperplasia.

The main symptoms: irregular menstruation, the appearance of bloody discharge, which is not associated with menstruation. Hormonal disorders and hormonal imbalance, excess body hair growth, overweight, may also indicate a pathology in the glands.

Hyperplasia of the ovarian endometrium

Hyperplasia of the ovarian endometrium is a disease of hormonal origin. With endometrial hyperplasia, a tissue that is rejected during menstruation due to violations of peristalsis of the fallopian tubes, enters the peritoneum and glands. This process occurs in healthy women, but because of hormonal disorders and a number of other factors, ovarian hyperplasia develops. On the surface of the glands endometrioid foci and cysts are formed, which leads to an increase in the ovaries.

Hyperplasia of the ovarian endometrium has several types, each of which is characterized by symptoms, treatment methods and prognosis.

• Very often there is glandular-cystic hyperplasia of the ovarian endometrium. The disease is characterized by the presence on the walls of the glands of numerous glands that resemble the endometrium. Such ovarian formations are most often bilateral, accompanied by endometriotic foci and adhesive process in the small pelvis. Ultrasound is used to diagnose this lesion.
• Hyperplasia of the ovarian endometrium is not a tumor, but refers to tumor processes. In the cystic form of the pathology, endometrioid cysts reach large sizes, which leads to a significant increase in glands. This type of disease occurs almost asymptomatically with minimal manifestations. They detect hyperplasia when examined by a gynecologist. For more detailed diagnosis, ultrasound and histological examination are used to study endometrial tissue.

Hyperplasia of the right ovary

Hyperplasia of the right ovary is more common than bilateral defeat. At first glance, the left and right ovaries do not differ, but doctors say that this is not the case. This pathology is associated with increased blood supply to the right ovary, as the artery from the aorta, and to the left ovary from the kidneys, flows to it. As a rule, hyperplasia of the right ovary occurs in women after 40 years, that is, during the menopause.

There are many reasons that can trigger the appearance of hyperplasia. Basically, it is the hormonal changes in the body and the changes in the blood supply of the small pelvis. It can occur against the background of a prolonged course of the inflammatory process in the ovary with other hormone-dependent diseases.

Symptoms are manifested as pain in the region of the right ovary, which are wavy in character. To diagnose a woman, perform ultrasound and histological analysis, which results in a treatment plan. For treatment, medicinal therapy can be used, in particularly difficult cases - surgical intervention.

Hyperplasia of the left ovary

Hyperplasia of the left ovary is rare and indicates violations of the functioning of the pelvic organs and glands in particular. Hyperplasia can occur in patients of any age. The main cause of the disease is hormonal changes in the body. Increased production of hormones or vice versa, their lack, can provoke abnormal growth of endometrial cells and stroma. As a result, the gland begins to function poorly, increases in size, delivers painful sensations.

The main symptomatology, which should serve as a cause for concern and subsequent treatment to the gynecologist, is frequent pain in the lower abdomen, regardless of the cycle, discomfort or pain during intercourse, irregular menstruation, the appearance of bloody discharge, general malaise. For diagnosis, ultrasound is used, which results in an effective treatment plan.

Ovarian stromal hyperplasia

Stromal ovarian hyperplasia is a disease in which the stroma of the glands proliferates along with the processes of androgen hyperproduction. As a rule, the stromal form is observed in women in the period of premenopause and postmenopause. The lesion can have an estrogenic or androgenic manifestation, cause obesity, hypertension, glucose metabolism disorders and others.

Stromal hyperplasia does not always lead to an increase in glands. If the increase is small, then it has fuzzy pale yellow nodules in the stroma. When conducting a microscopic examination, stromal cells detect oxidative enzymes that are responsible for the production of steroid hormones.

• To confirm stromal ovarian hyperplasia, doctors conduct differential diagnosis with fibroma, cancer processes or stromal endometrial sarcoma.
• It is mandatory to perform ultrasound and laparoscopic biopsy. Hormonal studies can identify abnormalities that have led to a high level of testosterone.
• When carrying out a histological examination, the stromal form is characterized by the presence of large luteinized cells with a high lipid content with a small number of atretic follicles.

Treatment of stromal form and other hyperplastic processes (tecomatosis, hypertecosis) at the beginning, is carried out with the help of drug therapy. A course of anti-inflammatory and microwave therapy, endonasal electrophoresis with vitamins B1 and B6 is waiting for the woman. If these methods do not give a positive result, then the patient is given laparotomy or laparoscopy. Resection allows to normalize menstrual function and general condition. But after an operation, it is very difficult to restore reproductive functions. If the stromal form occurs in elderly patients, then the glands are removed, since there is a high risk of malignant tumors.

Diagnosis of ovarian hyperplasia

Diagnosis of ovarian hyperplasia is carried out in the presence of clinical symptoms. It is painful sensations and discomfort that are the reason to go to the examination to the gynecologist, who will appoint further diagnostics. Hyperplasia of the ovary may not manifest itself for a long time. And this is not surprising, because not all women worry about bleeding after and between menstruation. The gynecologist is treated if this pathology has caused a lack of menstruation or a month's abundant and can not stop. With ovarian hyperplasia in the period of premenopause and menopause, the symptomatology is more pronounced. The woman has prolonged spontaneous bleeding and pain, which leads to anemia.

The doctor collects an anamnesis of the disease and conducts a gynecological examination, in the process of which ovarian hyperplasia can be suspected. For an accurate diagnosis, use a more detailed examination:

• Ultrasound diagnosis - allows to confirm the presence of this pathology and to reveal other pathological processes in the pelvic area.
• Histological examination and cytology - reveal morphological changes in the glands, hyperplastic epithelium and stroma.
• Hormonal research - tests for the level of progesterone and estrogens.

In the process of diagnosis, it is very important not only to confirm the disease, but also to determine its morphological features.

[11], [12]

Treatment of ovarian hyperplasia

Treatment of ovarian hyperplasia depends on the morphology of the disease and the extent to which the glands are affected (both ovaries, left or right). Treatment begins with the application of conservative methods. The patient is prescribed anti-inflammatory treatment, dehydration therapy and other procedures. The basis of drug treatment is hormone therapy with the use of combined oral contraceptives. The purpose of such treatment is to normalize the hormonal background through a decrease in the level of estrogens and a decrease in the foci of pathology.

• Combined oral contraceptives are most often prescribed to young nulliparous girls and women who have an irregular menstrual cycle. Such treatment allows to restore normal operation of the ovaries and prevent surgical intervention. Scheme and duration of taking pills, is the doctor.
• Synthetic analogues of progesterone are prescribed for women of any age with any form of pathology. Long-term therapy, about 6 months. In the process of taking medications, bleeding and pain in the area of the affected gland are possible.
• Hyperplasia of the ovaries is treated with Dufaston and Norkolut preparations. The duration of the treatment and the schedule of the drug administration is prescribed by the doctor. A gynecologist may advise putting an intrauterine spiral of Marena. The spiral is a hormonal therapy and a contraceptive.
• Another method of conservative treatment of ovarian hyperplasia is gonadotropin releasing hormone agonists. The drug shows effective results of treatment and has a convenient mode of admission. The active substances block the production of sex hormones, which leads to inhibition of the proliferation of tissues and cells. As a result, the hormonal background and normal gland function are restored.

Combination treatment can be used for treatment. This method involves a combination of surgical treatment and restorative hormone therapy. Hormone therapy can be performed before surgery, to reduce its volume and impact on foci that are out of reach for surgical removal.

If the drug is ineffective, the patient is treated promptly. For treatment, wedge resection is used. It is possible to perform laparoscopic electrocoagulation, that is, cauterization of the ovary at 4-8 points with the help of an electrode. If not one of the above methods has not helped in the treatment, then the woman is removed glands, that is, ovariectomy. Typically, this treatment is carried out for patients during the postmenopause. Removal helps prevent the appearance of malignant neoplasms. After such treatment, the patient is prescribed hormone replacement therapy, which will ease the general condition after the operation.

Prevention of ovarian hyperplasia

Prevention of ovarian hyperplasia is a complex of measures aimed at preventing the disease. Since the main cause of the pathology is hormonal disorders, it is necessary to maintain and maintain the hormonal balance. To do this, it is recommended to reduce stressful effects on the body. Another method of prevention is the fight against obesity. Excess weight leads to hormonal disorders, malfunction of the menstrual cycle, ovarian hyperplasia and other gynecological diseases and endocrine disorders.

Particular attention should be paid to the menstrual cycle. If there are violations, it is better to consult a gynecologist and cure them. Do not forget about prophylactic examinations and ultrasound examination of the pelvic organs. This will allow to reveal in time pathologies in the functioning of the ovaries and the reproductive system as a whole.

To prevent hyperplasia in young patients, doctors recommend the preventive intake of hormonal drugs, which significantly reduce the risk of the disease. At the first symptoms of hyperplasia, which can manifest as spotting between menstruation, pain in the lower abdomen, discomfort in the glands, excessive uterine bleeding or the absence of menstruation, it is necessary to consult a doctor.

Prognosis of ovarian hyperplasia

The prognosis of ovarian hyperplasia depends on the form of the disease, the degree of its neglect, the age of the patient, the state of her health, the presence of chronic diseases, including gynecological ones. If the pathology was detected at an early stage, then medication will help to stop the process, and the methods of prevention will prevent it from appearing in the future. In this case, we can talk about a favorable forecast. If ovarian hyperplasia was detected at a late stage and developed into a cystic or cancerous process, the prognosis is unfavorable. The woman undergoes surgical removal of the gland and subsequent hormonal therapy for recovery.

Ovarian hyperplasia is a pathological process that, without proper treatment, can lead to serious consequences. Careful attitude to their health, regular examinations at the gynecologist, prevention of infectious and inflammatory diseases is an ideal method of preventing this pathology and other gynecological diseases.