Recurrent Endometrial Hyperplasia

What is the meaning of endometrial hyperplasia and what is thickening of the endometrium??

Recurrent Endometrial Hyperplasia is an abnormal proliferation (an increased growth, overgrowth) of the endometrium (the lining of the uterus) that becomes too thick. In norm the growth of the endometrium (pre-menstrual and post-menstrual growth of endometrial tissue) is regulated by estrogen that stimulates the lining to grow and thicken to prepare the uterus for pregnancy.

What is meant by simple endometrial hyperplasia?

Simple or mild endometrial hyperplasia (with or without atypia) is the most common type of hyperplasia. Using microscope photographs (micrographs), the tissue shows that the gland to stroma ratio is preserved but the glands have an irregular shape and/or are dilated and slightly increased in numbers, the excessive thickening of the endometrium is caused by an increase in the number of endometrial glands.

Is endometrial hyperplasia cancer?

Endometrial hyperplasia is not cancer, but usually precedes endometrial cancer and is classified by the degree of cytologic atypia (abnormal cellular change).

What is atypia of the endometrium?

Atypia (Vaginal intra-epithelial neoplasia or VAIN, squamous atypia, reparative atypia, glandular atypia) is a medical term used to describe a structural abnormality in a cell (atypical cells), Atypia can be diagnosed with a cervical vaginal smear (vaginal Pap smear, Pap test, cervical cytology).

What is simple endometrial hyperplasia without atypia?

Using microscope photographs (micrographs), the tissue shows a proliferation of dilated endometrial glands with no or minimal glandular outpouchings.

What is endometrial hyperplasia with atypia and what does a positive endometrial biopsy mean?

Endometrial hyperplasia with atypia means that precancerous changes of the endometrium has been diagnosed and confirmed by endometrial biopsy in women who have symptoms of endometrial cancer such as postmenopausal vaginal bleeding or abnormal menstrual bleeding. Over one quarter of these women will develop endometrial cancer.

What is pre cancer in the endometrium?

Atypical endometrial hyperplasia is a precancerous condition of the uterus that can develop in the endometrium. It is characterized by an overgrowth of abnormal cells, or it can develop from an overgrowth of normal cells (endometrial hyperplasia).

What is the normal thickness of the endometrium?

In norm the thickness of the endometrial layer is up to 10-11mm

Symptoms

What are the symptoms of endometrial hyperplasia?

1. Dysfunctional uterine bleeding, random bleeding with or without abdominal pain, observed especially after repeated endometrial curettage procedures
2. Depression and emotional liability
3. Weakness and lack of strength

Causes

What are the causes of recurrent endometrial hyperplasia?

Recurrent Endometrial Hyperplasia is observed in females with chronic hyperestrogenism and hypoprogesteronism (an abnormally decreased level of progesterone).

Treatment

How to treat recurrent endometrial hyperplasia?

Endometrial hyperplasia can be treated by:

1. Hormones (progestins)
2. Surgery

The optimal treatment is chosen depending on the degree of cytologic atypia (complexity of the lesion) and the patient’s desire to avoid hysterectomy.

Hormone therapy, the use of the norcolut preparation (norethendrone) 10mg from 5th day to 25th day of the menstrual cycle

Next steps management

How is endometrial hyperplasia diagnosed?

1. General clinical examination and taking a complete history disease
2. Ultrasound of the pelvis to check the thickness of the endometrial layer (in norm it’s up to 10mm)
3. Hysteroscopy and separate diagnostic curettage
4. Hormonal therapy

Verified by: Dr.Diab (October 9, 2017)

Citation: Dr.Diab. (October 9, 2017). Recurrent Endometrial Hyperplasia. Medcoi Journal of Medicine, 9(2). urn:medcoi:article15629.