Endometrial hyperplasia is a condition in which the lining of your uterus becomes too thick.
In some women, this condition can lead to uterine cancer . Endometrial hyperplasia is rare, but it affects about 133 out of 100,000 women.
While this condition is not cancerous, it can sometimes be a sign of uterine cancer, so it’s a good idea to check with your doctor to see if there are any changes.
To learn about the health disorder Endometrial Hyperplasia, here is an explanation of the signs, how to diagnose it, and how to prevent it.
Get to Know What Endometrial Hyperplasia Is?
Endometrial hyperplasia refers to the thickening of the endometrium, or the layer of cells that lines the inside of your uterus. When your endometrium thickens, it can cause unusual bleeding.
Web MD explains that the endometrium that women have is part of the uterine lining. During your menstrual cycle, your endometrium changes. The estrogen produced by your ovaries makes your endometrium thicken. This is what prepares your uterus for a possible pregnancy.
After the release of an egg from your ovary ( ovulation ), progesterone levels rise. This hormone prepares your uterus to receive an egg. If pregnancy does not occur, your estrogen and progesterone levels drop. This causes the lining to shed (menstruation).
However, if there is a hormonal imbalance, your endometrium can thicken and grow too much. This abnormal growth is called endometrial hyperplasia.
Types of Endometrial Hyperplasia
There are two types of endometrial hyperplasia based on the type of cell changes in your endometrium:
- Simple endometrial hyperplasia (without atypia). This type consists of normal cells that are unlikely to become cancerous. This condition may improve without treatment.
- Simple or complex atypical endometrial hyperplasia. This type is precancerous and results from the overgrowth of abnormal cells. If left untreated, it can turn into uterine or endometrial cancer.
Symptoms of Endometrial Hyperplasia
What are the symptoms of endometrial hyperplasia? The Cleveland Clinic website explains that women with endometrial hyperplasia may experience the following symptoms:
- Abnormal menstruation, such as short menstrual cycles (Menstrual cycles shorter than 21 days)
- heavy menstrual bleeding
- Bleeding that occurs after menopause
Causes of Endometrial Hyperplasia
Your menstrual cycle is primarily dependent on the hormones estrogen and progesterone. Estrogen helps grow the cells in the lining of your uterus. When no pregnancy occurs, your progesterone levels drop, which tells your uterus to shed its lining. That starts your menstrual cycle again.
When these two hormones are in balance, everything runs smoothly. But if you have too much or too little of either hormone, things can get out of sync.
Healthline writes that the most common cause of endometrial hyperplasia is having too much estrogen and not enough progesterone. That leads to excessive cell growth.
There are several reasons you might have a hormonal imbalance:
- You have reached menopause. This means you are no longer ovulating and your body is not producing progesterone.
- You are in perimenopause. Ovulation is no longer occurring regularly.
- You are beyond menopause and have taken or are taking estrogen (hormone replacement therapy).
- You have irregular cycles, infertility , or polycystic ovary syndrome.
- You are taking medication that ‘mimics’ estrogen
- Overweight
Other things that can increase the risk of endometrial hyperplasia include:
- over 35 years old
- starting menstruation at a young age
- reaching menopause at an advanced age
- have other health conditions such as diabetes
- have a family history of uterine, ovarian, or colon cancer
- Menopausal transition (perimenopause) or menopause
- Never been pregnant
- Obesity
- Polycystic ovary syndrome ( PCOS )
- Smoke
- Gallbladder disease
- thyroid disease
- Certain breast cancer treatments
- Hormone therapy
- Older age of menopause
Diagnosis
How is endometrial hyperplasia diagnosed?
Many conditions can cause abnormal bleeding. To identify what type of bleeding is happening, Endometrial hyperplasia or not, you can do the following tests, as recommended by the Cleveland Clinic.
- Ultrasound: A transvaginal ultrasound uses sound waves to produce images of the uterus. The images can show if the lining is thick.
- Biopsy: with an endometrial biopsy test a pathologist studies the cells to confirm or rule out the possibility of cancer.
- Hysteroscopy: In this test, your doctor will use a thin, lighted instrument called a hysteroscope to examine your cervix and look inside your uterus. Your provider may do this procedure along with a dilation and curettage (D&C) or a biopsy. With a hysteroscopy, your doctor can see abnormalities inside the endometrial cavity and take targeted biopsies of any suspicious areas.
When to call a doctor?
You should contact your healthcare provider if you experience:
- Heavy or abnormal bleeding
- Vaginal bleeding after menopause
- Painful cramps (dysmenorrhea)
- Painful urination (dysuria)
- Painful sexual intercourse (dyspareunia)
- Pelvic pain
- Unusual vaginal discharge
- Frequently missed menstrual periods
Handling
Treatment for this health problem generally consists of hormone therapy or surgery. Your choice will depend on several factors, such as:
- Were atypical cells found?
- Have you reached menopause?
- How to plan for future pregnancy
- personal and family history of cancer
- If you have simple hyperplasia without atypia, your doctor may suggest just monitoring your symptoms. Sometimes, the condition does not get worse and goes away on its own.
The Healthline page writes that endometrial hyperplasia can be treated with:
- Hormone therapy. Progestin, a synthetic form of progesterone, is available in pill form as well as injections or intrauterine devices.
Regarding this medication, Web MD explains, Your doctor may prescribe progestin in a few different ways:
- by oral medication
- By injection
- In vaginal cream
- In contraceptive devices (IUD)
You will likely need to be treated for at least six months. You are at higher risk of recurrence if you are obese or treated with oral progestins, and you may need yearly follow-up appointments.
- If you have atypical hyperplasia, having your uterus removed will lower your risk of cancer. Having this surgery means you won’t be able to get pregnant. This may be a good option if you have reached menopause, are not planning to get pregnant, or have a high risk of cancer.
Prevention
How to prevent endometrial hyperplasia?
Certain steps can reduce your chances of developing endometrial hyperplasia, including the following, as explained on the Cleveland Clinic website:
- Use progesterone along with estrogen after menopause (if you are using hormone therapy).
- Take birth control pills
- Quit smoking
- Maintain a healthy weight
- Quit smoking
- Use contraception to regulate your menstrual cycle and hormones.
Endometrial hyperplasia sometimes resolves on its own. Unless you are taking hormones, the growth tends to slow down.
In most cases, endometrial hyperplasia is not cancerous and will resolve with proper treatment.
The important thing to note is that you must ensure that hyperplasia does not develop into atypical cells. Continue to have regular check-ups and let your doctor know if there are any changes or new symptoms. Hopefully, this is useful.
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Republished with permission from theAsianParent Indonesia
