A woman's he alth is constantly dependent on hormonal levels. Any changes in it can cause deviations in the work of the body. Some of the most serious hormonal changes occur during a woman's menopause. For the most part, this concerns changes in the production of estrogen and progesterone. This affects the atrophy of the mucous surfaces of the uterus, which ultimately leads to the complete cessation of menstruation and the extinction of the woman's reproductive function. But in addition to the above, hormonal disruptions can cause the development of pathological processes. For example, there is a norm for the thickness of the endometrium during menopause. Deviation from it may indicate the development of serious diseases. What should be the endometrium with menopause and what are the methods of treatment for deviations, we will consider in the article.
Determination of the endometrium
Endometrium is the mucous membrane of the cavityuterus, which plays an important role in the process of bearing a child and prevents the walls of the organ from sticking together. The endometrium is very susceptible to any changes in the hormonal background, as it contains a large number of receptors that provide high sensitivity of the mucosa to hormones. So, in the middle of the menstrual cycle, there is an overwhelming number of receptors that respond to estrogen, and in the second half of the cycle - to progesterone.
Endometrial growth continues throughout the cycle, preparing for eventual conception and embryo implantation. By the end of the cycle, its thickness can exceed the initial one by 10 times. If pregnancy does not occur, then the uterus rejects the functional layer of the mucosa, which is manifested by the onset of menstruation.
The norm of the endometrium of the uterus with menopause
In women of reproductive age, the thickness of the uterine mucosa is constantly changing under the influence of its cyclical nature. During menopause, the amount of hormones produced by the ovaries gradually decreases. In this regard, there is a gradual thinning of the endometrium, it becomes more loose. The end result of these changes should be fixing the thickness of the uterine mucosa at 5 mm. If the results of the analyzes revealed an increase in this value, we can talk about the development of a pathological process. In most cases, there is an excess of the norm of values, which is a sign of endometrial hyperplasia. The norm of endometrial thickness during menopause can fluctuate, but not more than 1-2 mm. To confirm the diagnosis, a series ofdiagnostic measures and, if confirmed, start the necessary treatment. If the results of the examinations indicated an increase in the thickness of the mucosa to 6-7 mm, the patient is placed under medical supervision, systematically undergoing an ultrasound procedure. Excessive growth of the endometrium can lead to serious consequences.
Types of endometrial hyperplasia
Currently, endometrial hyperplasia during menopause is usually divided into the following types:
- Glandular. At the same time, the connective tissue of the uterus remains unchanged, and it is the glandular cells that grow. It is the most common form of pathology, which, if detected early, is quite successfully treatable. Developing into a malignant nature is rare.
- Cystic. With this form of the disease, cysts form, and the epithelial tissue undergoes changes. This form of hyperplasia is dangerous, as it can develop into oncological formations.
- Glandular cystic. A mixed form of pathology in which overgrown glandular cells form cysts.
- Focal. It occurs quite rarely, but it is considered quite dangerous, as it is characterized by the appearance of polyps that are predisposed to malignancy. Bleeding may occur. With this form of hyperplasia, strict medical supervision is carried out.
- Atypical. The most dangerous form of the disease. Active reproduction is observed, as well as the degeneration of mucosal cells. The deep layers of the endometrium also undergo changes. This type of pathology requires surgicalintervention, as in 60% of cases it ceases to be in oncology. As a rule, during surgery, the uterus is removed.
Reasons
The reasons for the increase in the size of the endometrium during menopause are quite extensive. Consider them in more detail:
- Hormonal disorders. The most common factor in the development of hyperplasia. Endocrine disruptions can cause estrogen levels to rise, resulting in an imbalance.
- Metabolic disorders and obesity. Fat cells are able to synthesize estrogen, exacerbating the imbalance of hormones during menopause.
- Ovarian dysfunction.
- Uterine neoplasms.
- Polycystic.
- Diabetes mellitus.
- Surgical interventions, including abortions and curettage.
- Genetic predisposition.
- Hypertension.
- Liver dysfunction.
- Diseases of the kidneys, adrenal glands and pancreas.
- Endocrine diseases.
- Mastopathy.
- Autoimmune pathological conditions.
- Smoking and excessive drinking.
- Wrong diet.
- Long-term use of hormonal drugs or their illiterate prescription.
Symptomatics
As a rule, deviations from the norm of the endometrium of the uterus during menopause do not have symptoms specific to this pathology. With a more serious overgrowth, bleeding may occur, which is often confused with menstrualbleeding, which can still occur during the initial stage of menopause. In most cases, profuse, painful bleeding is observed, but spotting may also be disturbing. Sometimes they appear white or gray.
Decreased performance, headaches and general weakness may also be of concern.
Diagnosis
Detection of deviations from the norm of the endometrium in menopause is not difficult. First of all, if any symptoms appear, you should contact a gynecologist who will conduct an examination and prescribe diagnostic measures, as a result of which effective therapy will be prescribed. To make the most accurate diagnosis, a comprehensive diagnosis is performed, which includes a number of laboratory and instrumental examinations. Let's take a closer look at them.
- The main diagnostic measure is ultrasound, which is performed intravaginally.
- If the results of ultrasound indicate the growth of the endometrium up to 8-9 mm, in most cases, a diagnostic curettage of the functional layer of the uterus is performed, which is performed under general anesthesia. Further, the cleaned material is sent for histological examination in order to detect atypical cells.
- Biopsy, which allows you to determine not only deviations from the norm of the thickness of the endometrium during menopause, but also the presence of pathological processes in it and malignant cells.
- Sometimes an examination using radioactive phosphorus is required. Giventhe substance has the ability to accumulate in pathologically altered cells, due to which, using a certain sensor, it is possible to detect foci of cell growth.
Laboratory methods
Laboratory diagnostic methods include:
- General analysis of urine and blood.
- Pap swabs.
- A blood test for hormones.
Treatment
Currently, there are several ways to treat the endometrium with menopause in case of its growth, the main of which are conservative and surgical.
Conservative treatment primarily involves the use of hormonal drugs, since any gynecological disorders during menopause are caused by hormonal imbalances.
With an increased size of the endometrium during menopause, the following drugs are prescribed:
- "Dufaston".
- "Danazol".
- "Gestrinone".
- "Goserelin" and others.
Hormonal treatment with these drugs has virtually no side effects. They also normalize the state of mucosal cells and prevent their degeneration into a malignant form. This category of medications should be taken from 3 months to a year under the supervision of a doctor.
During hormone therapy, drugs are prescribed in parallel that have a protective and restorative effect on the liver. These include Essentiale Forte. Medicines that thin the skin may also be recommended.blood - "Hepatrombin" and others.
It happens that the doctor decides to prescribe gonadotropin-releasing hormone agonists, the side effect of which is an increase in menopausal symptoms.
Surgical treatment method
An operative method for the treatment of endometrial hyperplasia is used quite often. Surgical intervention is used in cases of recurrence of the disease, with a polypoid form of pathology and in cases where there is a suspicion of the degeneration of mucosal cells into malignant tumors.
The operation can be carried out in several ways, from which we will describe below.
- Scraping. This procedure can be used as a diagnostic measure to identify atypical mucosal cells. The operation allows you to slow down the development of the pathological process and stop bleeding.
- Laser cautery. A very effective method of treatment, in which minimal damage is caused to the female body. This method is used to remove individual foci of hyperplasia.
- Cryodistruction. It is used for focal hyperplasia. Cauterization is carried out by exposing the pathological focus to low temperatures.
- Hysterectomy. This term means the complete removal of the uterus. It is used in the most extreme case, when atypical hyperplasia develops, in which there is a high probability of developing oncology.
Traditional medicine
Sometimes when the values of the norm of the endometrium deviate whenmenopause as an auxiliary therapy, the use of traditional medicine is used. Such treatment helps to normalize the hormonal background and reduces the risk of inflammatory processes. It is important to remember that you should consult your doctor before taking herbal medicines.
The most popular recipes for endometrial growth are:
- Linseed oil.
- Upland uterus.
- Infusion of celandine.
- Burdock roots.
- Nettle tincture.
- Infusion of the cuff.
- Infusion of plantain leaves.
- Beet and carrot juices.
An important point in the treatment of hyperplasia is to follow a diet in which it is necessary to minimize the consumption of fatty, starchy, sweet, smoked foods. Eat more grains, nuts, fruits and vegetables, and foods rich in vitamin C.
Conclusion
Climax is a very difficult period for a woman, both psychologically and emotionally. There is a global hormonal restructuring, during which pathological conditions can develop. Therefore, it is extremely important not to neglect planned visits to the doctor. If deviations from the norm of the endometrium are detected during menopause, it is necessary to pass the necessary tests and begin treatment. With timely therapy, the likelihood of a successful outcome is quite high.
