Endometrial Hyperplasia - Symptoms, Risk factors and Treatment

Endometrial hyperplasia is a condition in which the endometrium- a layer that lines the uterus thickens. Endometrium, when thickens, leads to unusual vaginal bleeding. Endometrial hyperplasia is not cancerous but it should be closely monitored as it may have the tendency to become cancerous.


Anatomy of the female internal reproductive organs


The female reproductive organs constitute the ovaries, fallopian tubes, uterus, and vagina.

The ovaries are responsible for producing an egg (ovum) every month and the uterus is responsible for bearing the fetus throughout the pregnancy. The fallopian tubes, also known as oviducts, connect the uterus with the ovaries giving a passage for the egg to come to the uterus. The uterus is connected to the vagina or birth canal-a muscular canal that is responsible for the reception of the penis during sexual intercourse and the provision of a passageway for the baby during childbirth. The vagina connects the uterus to the external reproductive organs.


Types


Endometrial hyperplasia can be divided into two types depending upon the involvement of unusual cells.


The types of endometrial hyperplasia are:


Endometrial hyperplasia without atypia- a type of endometrial hyperplasia that does not involve unusual cells.


A typical endometrial hyperplasia-a type of endometrial hyperplasia that involves unusual cells. This type is considered precancerous and should be monitored closely. It means if left untreated it can turn into cancer.


How do you know that you have endometrial hyperplasia?


The characteristic symptom of endometrial hyperplasia is abnormal uterine bleeding. It can cause the following signs and symptoms.


  • Periods that get heavy and longer than usual

  • The interval between period gets shorter than 21 days

  • Experiencing vaginal bleeding even after menopause 



What causes endometrial hyperplasia?


The main cause of endometrial hyperplasia is having too much estrogen and too little progesterone which leads to cell overgrowth. Due to which everything in the female reproductive system gets disrupted. Normally estrogen prepares your uterus for a possible pregnancy by growing the lining of the uterus. When fertilization does not occur, the progesterone levels decline, and, therefore, the uterus sheds its lining. That is when the period starts. In this way, estrogen and progesterone regulate the menstrual cycle. If any disbalance occurs in both, regulation of the menstrual cycle also deviates from normal.


Other reasons for endometrial hyperplasia can be;


  • Reaching menopause

  • Reaching perimenopausal stage

  • Have reached beyond menopause 

  • Have taken or currently taking hormone replacement therapy as estrogen

  • Having an irregular menstrual cycle 

  • Infertility 

  • Polycystic ovarian syndrome

  • Taking medicines that imitate estrogen 

  • Being obese 

  • Being above 35 years of age 

  • Starting menstruating at a young age

  • Reaching menopause at a late age

  • Having other health conditions like gallbladder disease, thyroid problems, and diabetes

  • Having a family history of uterine, ovarian, or colon cancer


Treatment 


To treat endometrial hyperplasia the healthcare providers will prescribe hormonal therapy like progestin- a synthetic form of progesterone available as a pill, injection, and intrauterine device. 


Hysterectomy- complete removal of the uterus. If you have atypical hyperplasia, removing the uterus can help lower the risk of cancer. But you can not get pregnant after that. 


Conclusion 


Endometrial hyperplasia is a condition in which the endometrium - a layer that lines the uterus thickens. Endometrium, when thickens, leads to unusual vaginal bleeding. Endometrial hyperplasia is not cancerous but it should be closely monitored as it may have the tendency to become cancerous. The healthcare providers will monitor closely through frequent ultrasounds and pap smear tests. You must attend follow-up visits and scans to keep an eye on the replication of cells so that they do not turn into cancer. If the healthcare providers would suspect something suspicious, they would remove your uterus, a procedure called a hysterectomy.


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