Endometrial Hyperplasia with Cysts: Symptoms, Diagnostic Procedures, and Treatment Options
Endometrial hyperplasia is a common condition that affects the lining of the uterus. In this article, we will explore the causes, symptoms, diagnosis, and treatment options for endometrial hyperplasia.
Types of Endometrial Hyperplasia
Endometrial hyperplasia can be classified histologically into three main types:
- Simple hyperplasia without atypia
- Complex hyperplasia without atypia
- Atypical hyperplasia (also called complex atypical hyperplasia)
Atypical hyperplasia is a precancerous condition that carries the highest risk of malignant transformation.
Causes of Endometrial Hyperplasia
Prolonged unopposed estrogen exposure is the main cause of endometrial hyperplasia. This can be due to various factors such as:
- Obesity (peripheral conversion of androgens to estrogens)
- Estrogen therapy without progesterone
- Polycystic ovary syndrome (PCOS)
- Estrogen-secreting tumors
- Anovulatory cycles (common in perimenopausal women)
Other risk factors include diabetes, hypertension, early menarche, and late menopause.
Symptoms of Endometrial Hyperplasia
Endometrial hyperplasia most commonly presents as abnormal uterine bleeding, including irregular, prolonged, or heavy menstrual bleeding, and postmenopausal vaginal bleeding. Symptoms arise due to irregular shedding of the hyperplastic endometrium.
Diagnosis of Endometrial Hyperplasia
Diagnosis of endometrial hyperplasia involves a clinical evaluation, ultrasound, endometrial biopsy or curettage, and histopathology. A doctor will typically arrange an ultrasound scan to measure the lining of the uterus and check for other causes of bleeding. If the lining of the uterus is too thick, a doctor may recommend an endometrial biopsy.
Prevention and Treatment of Endometrial Hyperplasia
Minimizing unopposed estrogen exposure is key to preventing endometrial hyperplasia. This can be achieved by using combined hormonal therapy (estrogen with progesterone) in hormone replacement therapy, weight management to reduce peripheral estrogen production, and treating underlying causes of anovulation such as PCOS.
Treatment options for endometrial hyperplasia depend on the type and severity of the condition. Because of the high risk of progression to endometrial cancer, atypical hyperplasia usually requires prompt treatment, which may involve hysterectomy or progestin therapy.
When to See a Doctor
If you experience periods that are heavier, last longer, or are more frequent than is typical, fewer than 21 days between each period, bleeding between periods, bleeding after menopause, having no periods before menopause, unusual vaginal discharge, or no periods before menopause, it is important to contact your doctor. A doctor may recommend a hysteroscopy to check for irregularities inside the uterus.
Living with Endometrial Hyperplasia
If you are diagnosed with endometrial hyperplasia, your doctor will typically arrange regular follow-ups to monitor your condition. A person will need at least two negative biopsies 6 months apart before no longer needing treatment. If you are prescribed progestin, it may be in the form of birth control pills, vaginal cream, injections, or an intrauterine device (IUD).
In conclusion, endometrial hyperplasia is a condition that affects the lining of the uterus and can be caused by prolonged unopposed estrogen exposure. Symptoms include abnormal uterine bleeding, and diagnosis involves a clinical evaluation, ultrasound, endometrial biopsy, and histopathology. Treatment options depend on the type and severity of the condition, and may involve hysterectomy or progestin therapy. If you experience any symptoms of endometrial hyperplasia, it is important to contact your doctor for further evaluation and treatment.
- Atypical hyperplasia, a precancerous condition, presents the highest risk of malignant transformation in cases of endometrial hyperplasia.
- Abnormal uterine bleeding, such as irregular, prolonged, or heavy menstrual bleeding, may indicate endometrial hyperplasia during menstruation.
- Menopause-related symptoms, like postmenopausal vaginal bleeding, could be signs of endometrial hyperplasia.
- In the context of health and wellness, it is essential for women to recognize symptoms of endometrial hyperplasia, like longer, heavier periods, and address them promptly to ensure proper diagnosis and treatment to maintain women's health.
