If the inner layer of the uterus grows for some reason, and the number of cells noticeably exceeds the norm, endometrial hyperplasia is diagnosed. To formulate the diagnosis accurately, it is necessary to obtain samples of biological tissues and examine them under a microscope in the laboratory. This analysis is called histological. Some believe that endometrial hyperplasia indicates a malignant neoplasm, but in fact this is a misconception. There are several subspecies of the pathological condition. Some of them are associated with the risk of malignancy in the future, while others are benign. However, this does not mean that the problem should not be treated: hyperplasia, even benign, can lead to serious consequences.
It doesn't hurt to get checked
It is possible to detect endometrial hyperplasia in time if you regularly visit a gynecologist. On a preventive examination, the diagnosis will not be made, but signs may be noticed, onbased on which they are sent for additional analyses. Based on the results of the event, it will be possible to clarify in which scenario the pathological condition develops, what therapeutic measures are needed.
Histological examination, to which tissues are sent if endometrial hypoplasia is suspected, usually takes from a couple of days to two weeks. Specific terms depend on the equipment used in the laboratory. It is possible to examine not only the samples taken from the patient during the biopsy, but also the tissues obtained during the curettage of the uterus.
Types and features
Hyperplasia of the endometrium of the uterus is possible in two types: accompanied by non-standard cells or without it. Another classification option:
- simple;
- complex.
The second option is the formation of internal structures, adenomatosis. At the same time, such elements appear in the endometrium that are completely unusual for the uterine inner layer.
If the diagnosis is confirmed and uterine endometrial hyperplasia is detected, the doctor will report that the case belongs to both classifications.
If the pathology is simple, there are two options:
- glandular;
- cystic glandular.
Complex is usually called adenomatous, divided into the following types:
- foci;
- polyps.
You should be aware: adenomatosis is not a malignant formation. In more detail at the reception, the doctor will definitely tell you that this is endometrial hyperplasia. How to treat, the doctor will also bring up to date, focusing on the resultsresearch, chronic diseases, individual characteristics.
If adenomatosis is established, all research objects studied in the laboratory are sent for additional review to the oncologist. Based on the information received, you can choose the best course to combat pathology.
Often, the treatment of glandular endometrial hyperplasia, as well as glandular cystic, is defined as therapy for the underlying disease. At the same time, it is taken into account that the probability of degeneration of cells into malignant ones is close to zero, but still there. True, as medical practice shows, the term "background diseases" is currently rarely used by specialists, as it is considered insufficiently accurate.
Statistics and risks
If endometrial hyperplasia is established, you can immediately begin treatment, following the doctor's recommendations. Do not panic, considering that the condition is close to precancerous. On average, at present, the statistics of cell malignancy is as follows:
- with simple hyperplasia, the shape transition occurs in 1% of cases;
- with complex risk – 3%;
- with atypical downtime - 8%;
- complex atypical is accompanied by a risk of rebirth close to 29%.
Where did the trouble come from?
Before you figure out how to treat endometrial hyperplasia, you should understand why the pathological condition has developed. The main condition for the growth of cellular structures is hormonal disruptions. Estrogens (basic hormones of the female reproductive system) are compounds thatcapable of activating the growth and reproduction of endometrial cells.
If the hormonal background is normal, the second stage of the menstrual cycle is accompanied by the production of progesterone, which prevents the growth of cellular structures in excess. If the uterine layers are exposed to estrogens for a long time, and progesterone is not enough, endometrial hyperplasia develops (glandular, complex, with or without atypical cells, cystic).
The risk of hyperplasia is high if the ovaries function poorly or do not perform their tasks at all. It is known from statistics that endometrial hyperplasia is relatively often detected in menopause, shortly before this period in a woman's life. This is due to changes in the hormonal background of the body. In addition, the risk of a pathological condition is higher in people who are overweight, polycystic ovaries and tumors that produce hormonal compounds in this organ.
Hormones and pathology
In order to develop endometrial glandular hyperplasia, a cystic, complex form, not only an excess amount of estrogens is necessary, but also specific boundaries of their activity. Scientists have found that there are two types of estrogens:
- domestic;
- external.
The first group - formed by the structures of the body, the second - medicines, synthetic hormonal compounds, chosen unsuccessfully.
Internal estrogens are elevated during anovulation. They stimulate endometrial cells to grow more actively. The location of estrogen production is adipose tissue, ovaries. Maybethe presence of elevated concentrations of estrogens against the background of a tumor that affects the hormonal background.
Estrogens that are ingested with pills, patches, gels can provoke hyperplasia. Predominantly, the risk is associated with the use of these components without progesterone. If the product is balanced, contains both types of hormonal compounds, the likelihood of hyperplasia is minimal, and oncological processes are even lower.
How to notice?
The main symptom of endometrial hyperplasia is prolonged menstrual flow. The frequency increases, and the volumes of allocations become larger. The cycle is losing its regularity. Another symptom of endometrial hyperplasia is uterine bleeding.
Some women experience bleeding before or shortly after their periods. There may be discharge in the middle of the cycle. Sometimes it is possible to notice the pathology by long (several weeks), but small in volume, secretions containing blood.
As medical statistics show, most often women come to the doctor's office after discovering uterine bleeding. It is observed after a long period without menstruation, it comes completely unpredictably, so a woman often begins to panic, not understanding what kind of treatment is needed. A symptom of endometrial hyperplasia of this type causes the greatest fear during menopause.
Diagnosis
As follows from the reviews compiled by patients undergoing treatment, endometrial hyperplasia is not always confirmed. To be surediagnosis, as noted by women in whom hyperplasia was suspected, one has to undergo an ultrasound examination. A specific vaginal sensor is used in the work. With the help of such a device, you can study the state of the uterus from the inside, identify the features of the layers of tissues that make up the organ, assess the presence of thickenings, changes, if any. Additionally, they may prescribe an ultrasound examination of the ovaries for the presence of cysts, tumors and other diseases.
According to the results of ultrasound, they decide what additional methods of assessing the condition are necessary in a particular case. As follows from the reviews, endometrial hyperplasia (suspected, confirmed) is often the reason for the appointment of hysteroscopy. This is a procedure in which the uterine cavity is examined under high magnification using a hysteroscope. As a rule, at the same time, a woman is recorded for a scraping procedure.
With certain signals, the doctor may decide that a biopsy should be done first. For this procedure, a curette reassigned for one use is used, visually similar to the core of a conventional pen. The procedure itself does not cause pain and is not associated with additional risks, does not require hospitalization. The duration of the analysis is only a few minutes, but the amount of information obtained in this way is large enough to reliably assess the patient's condition. Based on the results of the procedure, the doctor will tell you exactly whether hyperplasia is taking place, in what scenario the pathology develops, and what measures need to be taken to combat it.
Whatdo?
Perhaps, the treatment of endometrial hyperplasia is a topic of maximum interest to women who are faced with such a diagnosis or assume it about themselves. The specificity of treatment is due to the key feature of the pathological condition, namely, its dependence on the hormonal background. In order to normalize the state of the endometrium, a hormonal therapeutic program should be developed, but it should be done in such a way as not to cause even more harm. For this reason, self-treatment of hyperplasia is strictly prohibited.
If simple endometrial hyperplasia is established, the treatment is to prevent cell degeneration. Additionally practice measures to prevent bleeding in the uterus. If atypical cellular structures are revealed during tissue examination, the patient is referred to an oncologist for the development of a course of treatment, since the risk of malignancy is assessed as unacceptably high.
You should not think that a pathological condition or its therapy puts an end to the future of a woman as a continuer of the family: as follows from the reviews, scraping with endometrial hyperplasia, a biopsy become a source of accurate data, so doctors choose a program that allows them to bring the reproductive organ into norm, after which pregnancy is possible. An exception is situations when atypical cells become a reason for removing an organ. The very fact of the presence of such structures does not mean that the operation cannot be avoided: perhaps hormonal preparations will be enough. The doctor responsible for the development of the course will tell you more about this at the appointment.
Hormon altreatment
The choice of therapy is determined by a number of factors. Several hormonal treatment strategies are known, but there is no reliable information about the advantages of any of the methods over others. As a rule, glandular, cystic hyperplasia of the endometrium is treated with the use of gestagens, progestins, that is, drugs that supply compounds to the body that are similar in their effect to progesterone.
Unfortunately, there are currently no such standard tools that could become a universal answer. What is suitable for one person causes unpredictable reactions in the body of another. Endometrial hyperplasia in postmenopause requires completely different approaches than in the reproductive period, and the presence of chronic pathologies, individual intolerance or even weight problems are factors that force the selection of funds strictly individually, by trial and error.
There is no universal scheme, generally accepted dosages of hormonal drugs. When developing a program, the doctor focuses on the age, weight, height, body type of the patient, financial capabilities (some medicines are very expensive). They prescribe funds, carry out curettage for endometrial hyperplasia, make a decision about the operation, focusing on the type of pathology, plans for pregnancy in the future, side effects provoked by various means.
Glandular hyperplasia: risk group
As statistics show, more often a pathological condition is diagnosed in women who have undergone:
- polycystic ovaries;
- scraping;
- abortion;
- gynecological surgery;
- uterine fibroids.
With certain risks associated with the rejection of hormonal birth control, late onset of menopause. More often, hyperplasia is detected in nulliparous women than in women with children.
The risk group includes people suffering from:
- diabetes;
- overweight;
- high blood pressure;
- liver pathologies;
- impaired thyroid function;
- mastopathy.
Nuances of therapy
The main purpose of curettage is to prevent repeated heavy bleeding. It is the measures to stop such volumetric discharges that are the primary task of the doctor.
Uterine scraping is an intervention that has nothing to do with abortion, embryo scraping. During an abortion, the work of the hormonal system is disrupted, but curettage during hyperplasia helps prevent bleeding, since during the procedure the doctor removes the tissue that is its source.
Among the currently popular medicines, the following deserve special attention:
- Yarina.
- Utrozhestan.
- Janine.
Sometimes doctors recommend stopping at Regulon or Duphaston. The duration of admission is from three months to six months, after which changes in the state are checked.
An alternative option is to install a special Mirena coil.
If the patient's age is 30 years and older, then medications are used, due to which the body is temporarily introduced into a state similar to menopause.
To increase the effectiveness of such treatment, it is necessary to maintain the body's strength with vitamin complexes, undergo physiotherapy procedures prescribed by the doctor, and also take measures to correct anemia, if it accompanies hyperplasia.
Control ultrasound examination is usually carried out a quarter of a year after the completion of the course, and a second examination - six months after the elimination of hyperplasia. Also, as the therapeutic program is completed, the patient is referred for a second biopsy. It is taken into account that the pathological condition can recur. If the problem recurs, surgical intervention is prescribed: ablation or resection.
Causes and consequences
The absence of ovulation for a certain period of time can cause a pathological condition or illness. When treating hyperplasia, it is important to keep the patient's condition under control in order to notice signs of new he alth problems in time. Anovulation can trigger:
- polycystic ovaries;
- rheumatism;
- excessively excited, nervous state;
- metabolic syndrome;
- neoplasms in the pituitary gland.
Features of symptoms
The possible manifestations of hyperplasia were indicated above. Medical statistics show that not every woman is worried about such phenomena. In a large percentage of cases, the pathology proceeds hidden, notmanifesting itself in some way. The only way to determine hyperplasia in this case is a regular preventive gynecological examination. Often, hyperplasia is detected as part of an ultrasound examination, if the patient makes an appointment with a doctor for a reason not related to the functioning of the reproductive system (the examination is prescribed to compile a complete picture of the condition).
Doctors pay attention: do not neglect preventive medical examinations, as hyperplasia can cause fertility, malignant neoplasms.
Sometimes hyperplasia is detected when finding out the reasons for the impossibility of conception. Infertility and severe soreness during cyclic discharge are signs that allow you to suspect a pathological condition.
Changes in the walls of the uterus begin long before menopause. It is known that the risk of cell proliferation is higher if among close relatives there were persons with benign, malignant neoplasms. Age also plays a role: with aging, the body weakens, it is difficult to resist aggressive factors, the risk of getting sick or surviving an operation is higher.
Gynecological diseases of any kind are more common in menopausal women than in younger women. In addition, the likelihood of cell malignancy in older women is higher. From 50 years of age and older, it is recommended to regularly come to the examination to the gynecologist, even if there are no symptoms to suspect something was wrong in the body.
Home conditions: how to help yourself?
Knownfolk remedies for endometrial hyperplasia, but their use should be agreed with the doctor. A reasonable approach is a combination of traditional methods and recipes proven by generations, but you should not abandon the first in favor of the second - this can lead to fatal consequences. Mostly folk remedies are aimed at maintaining the body's strength, stimulating regenerative processes. If surgery is performed, they will support the immune system and prevent inflammation.
The sacred vitex is used quite often. For the preparation of preparations, the fruits of the plant are taken. For a long time, they have established themselves as an effective remedy for stopping inflammatory processes, disinfecting and sedative. Vitex stimulates the normal functioning of glandular structures that affect the menstrual cycle, supplies compounds similar to hormones produced by internal organs.
Using vitex is quite simple: take a full glass of alcohol for half a glass of fruit, mix everything and insist for a long time. When ready, the drink is filtered and used twice daily, ten drops in food.
What else to try?
Treatment of endometrial hyperplasia with folk remedies involves the use of Dioscorea. On the rhizomes of the plant, an infusion is prepared that provides the body with progesterone of natural origin. Thanks to this medicine, it is possible to normalize the activity of the glands of the reproductive system, cure inflammatory foci and normalize the adrenal cortex, which is responsible for the production of certainhormonal compounds.
To prepare the medicine, the rhizomes are taken prepared: first they are dried, then carefully crushed. The product is poured with boiling water, taking 100 ml of water for each spoon. Let the infusion stand, then use it twice a day for a couple of tablespoons.
Another good option is the shepherd's purse. It is mixed with wormwood and celandine in a ratio of 3:2:2. For seven tablespoons of the composition, you will have to boil a liter of water, then insist the mixture in a water bath and use it for food. The recommended regimen is 30 ml daily. The effectiveness of the course of therapy will show if you use the medicine for food regularly and for a long time: about six months.
Upland uterus and burdock against hyperplasia
On the upland uterus with endometrial hyperplasia, a medicinal tincture is prepared. For 50 g of dry grass, half a liter of vodka is required. I mix the products and let them brew in a dark, cool room for at least a month, then decant the liquid. You need to take such a drug in a teaspoon every day for at least three months in a row. A feature of the upland uterus is the ability to control the hormonal background. The plant has a mild effect, so there will be no harm from it (when using the medicine in reasonable quantities). The red brush grass has a similar effect. To enhance the effect of treatment, you can use decoctions and infusions to prevent inflammatory processes. These are prepared with mint, lemon balm and other medicinal herbs.
For the preparation of burdock medicine, take rhizomesplants dug up in early autumn. The natural product is crushed, juice is squeezed out, used as food twice daily: in the morning and in the evening. Single dosage - a tablespoon. To increase the effectiveness of the preparation, you can mix the juice of the golden mustache. The use of such a composition twice daily allows you to notice improvements in the condition already a month after the start of the program. Six months of treatment or even longer is required to obtain a lasting result.
Nettle is considered useful. On the plant, you can make a tincture with alcohol: for 200 g of grass - half a liter of liquid. The mixture is insisted for at least three weeks in a darkened cool room, then used for food twice daily, in the morning and shortly before going to bed. Such a remedy not only has a positive effect on the uterine endometrium, but also strengthens the immune system.
Hyperplasia: is it possible to do without curettage?
This procedure causes fear in many and even gives rise to a feeling of panic. However, not everything is so scary: sometimes you can do without it. How much the event is necessary, the doctor will tell at the reception. The doctor will explain the risks of not taking it.
Taking measures to stabilize the condition, first prescribe hormonal contraceptives, which contain different types of substances. The activity of the ovaries is suppressed, which means that cell proliferation slows down. The doctor will explain in what dosage to use the drugs. Often, at first you need to eat a couple, or even three tablets every day, gradually reducing these volumes. Usually speedendometrial growth returns to normal by the end of the first month of treatment. Noticeable progress will be signaled by the absence of bleeding.
To improve the condition, the doctor may additionally prescribe calcium gluconate or Dicinon, Vikasol, Tranexam.
To prevent the growth of uterine tissue in excess of the norm, it is important to provide the patient with antagonists of the compounds responsible for proliferation. To do this, take:
- Norkolut.
- Premolyut-Nor.
- Norluten.
The doctor will choose the best option. He will also explain on which days of the cycle you need to use the pills: 10-28 or 16-25. At the same time, the first menstrual phase is reduced, which means that the endometrium has only a small time period for growth, but the luteal stage is lengthened - at this time, the mucous membrane of the reproductive organ is stable. Injections of progesterone may be given to increase effectiveness.
To replenish blood reserves, improve well-being in general, it is recommended to inject vitamin complexes intramuscularly, take special preparations to maintain immunity.
Initial stage
If it was possible to identify hyperplasia when the problem is still developing, local treatment will be effective and sufficient. A good option is Mirena. This is an intrauterine device that supplies the female body with levonorgestrel, a hormonal compound obtained during the transformation of progesterone. Every day, the mucous membranes of the body are under the influence of active ingredients supplied in equalvolumes at a constant time. This leads to a gradual decrease in the thickness of tissues, prevents abnormal proliferation, which means that disturbing bleeding disappears. After three months of constant use of the spiral, amenorrhea is possible.
Doctors note: you can use this remedy for no more than five years in a row. The risk of recurrence after coil removal is estimated to be extremely low.
