Endometrial Hyperplasia

Overview of Endometrial Hyperplasia

Endometrial Hyperplasia Meaning in Urdu

اس بیماری کی وجہ سے رحم کا پردہ دبیز (موٹا) ہو جاتا ہے جس سے اعضائے مخصوصہ سے بہت زیادہ خون آ سکتا ہے۔ یہ بیماری زیادہ تر خواتین کو مینوپاز کے بعد شکار بناتی ہے۔ اس بیماری کی وجہ سے خواتین کو حیض کے بہت سے مسائل کا سامنا کرنا پڑتا ہے، کچھ خواتین کو حیض آتا ہی نہیں اور کئی خواتین کو ماہواری صرف چند دنوں کے لیے آتی ہے۔ اس کے علاوہ یہ بیماری خواتین میں درد کی وجہ بھی بن سکتی ہے، جب کہ کئی خواتین کو جنسی تعلق کے دوران تکلیف کا سامنا بھی کرنا پڑ سکتا ہے۔

Endometrial hyperplasia is a gynecology condition. It is a health condition in which the endometrium lining becomes thick. The endometrium is the layer of cells that lines the inside of your uterus. Thickening of the endometrium can lead to unusual bleeding. 

Endometrial hyperplasia is not a cancerous condition but it can lead to uterine cancer. Therefore, it is best to visit a doctor if you observe any changes in your health. 

What is Endometrial Hyperplasia

The endometrium is the inner lining of the womb (uterus). The lining of the endometrium changes during the menstrual cycle in a female. The endometrium thickens due to the production of estrogen from our ovaries. It helps prepare your uterus for any possible pregnancy

After ovulation (when the egg is released from the ovary), the level of progesterone increases. This hormone helps your uterus in getting ready to receive an egg. If the pregnancy does not happen, it makes your estrogen and progesterone level drops. This can lead to the shedding of the lining of the endometrium and cause menstruation. 

But, if there is a hormonal imbalance, the endometrium can still get thick and this abnormal growth is known as endometrial hyperplasia.

Prevalence

Endometrial hyperplasia is a rare condition. It normally occurs in people who are in the premenopause phase or just completed their menopause phase. It affects approximately 133 out of 100,000 women.

 

Signs and Symptoms of Endometrial Hyperplasia

The major common endometrial hyperplasia symptom is abnormal menstrual bleeding. You need to visit a certified gynecologist if you experience the following symptoms:

  • Heavy menstrual bleeding that lasts longer than usual
  • The period or menstrual cycle shorter than 21 days
  • Menstrual bleeding during the menstrual period
  • Not having a pre-menopause period
  • Vaginal or uterine bleeding during the postmenopausal phase

 

Types of Endometrial Hyperplasia

Based on the kind of changes in the cell endometrium endometrial hyperplasia is divided into the following three types:

  • Benign Endometrial Hyperplasia - It is a non-cancerous change in the cell of the endometrium lining.
  • Endometrial Intraepithelial Neoplasia (EIN) - It is a precancerous change in the endometrium lining. It is also known as atypical endometrial hyperplasia.
  • Endometrial Adenocarcinoma- It is an endometrioid type that is well differentiated and cancer changes in the lining of the endometrium.

Knowing the right type of endometrial hyperplasia is important as it can help you better understand the treatment options and most effective treatment.

 

Causes of Endometrial Hyperplasia

Not enough progesterone and too much estrogen cause endometrial hyperplasia. Both estrogen and progesterone play an important role in the menstrual cycle. When the level of progesterone is not enough then the uterus lining is not triggered for menstruation. Due to the high level of estrogen, the lining of the endometrium continues to thicken. The cells in the lining may crowd together and then become irregular.

 

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Risk Factors of Endometrial Hyperplasia

Endometrial hyperplasia is more likely to occur in women with the following risk factors:

  • Above 35 years of age
  • Never was pregnant
  • Irregular or no periods
  • Early menstruation 
  • Menopause at an older age
  • Obesity
  • Smoking cigarette 
  • Family history of ovarian cancer, colon cancer, or uterine cancer
  • Hormone Therapy
  • Certain breast cancer treatments
  • History of health conditions such as diabetes, PCOS, gallbladder disease, or thyroid disease
  • History of pelvic irradiation (radiation on your pelvis)
  • Weak immune system due to autoimmune disease

Health Complications of Endometrial Hyperplasia

All types of endometrial hyperplasia can cause heavy and abnormal bleeding that can lead to anaemia. Anemia occurs when our body doesn’t have enough iron-rich blood cells in the body. 

 

Untreated atypical endometrial hyperplasia can lead to cancer. Uterine or endometrial cancer can develop in 8% of females due to untreated simple atypical endometrial hyperplasia. About 30% of women can suffer from cancer due to untreated complex atypical endometrial hyperplasia. 

 

 

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Prevention

There is no concrete way to prevent endometrial hyperplasia. However, you can lower its risk with the help of the following steps:

  • Avoid smoking
  • Maintain a healthy body weight
  • Take progesterone along with the estrogen, if you are using hormone therapy
  • Take birth control methods to regulate the cycle of your hormones and periods

 

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Diagnosis

Many gynecological conditions can lead to abnormal uterine bleeding. To properly identify the reason and cause of symptoms, a certified doctor can recommend the following diagnostic tests:

  • Biopsy - In the endometrial biopsy, the tissue samples from the uterine lining are taken. Pathologists can study the cells taken in a  biopsy and then confirm or rule out cancer. 
  • Ultrasound - A transvaginal ultrasound or TVS ultrasound is also done. It used sound waves to produce images of the uterus. This ultrasound can confirm if the uterine lining is too thin or too thick.
  • Hysteroscopy- A hysteroscopy is used to examine the cervix and uterus. Along with this procedure, the doctor may opt for a biopsy or D&C (Dilation and curettage). Hysteroscopy is done to check if there is any abnormality within the endometrial cavity.

 

Treatment of Endometrial Hyperplasia | When to Consult a Doctor

In most cases, endometrial hyperplasia is treated. The treatment depends on the condition of the patient along with the type of endometrial hyperplasia they are suffering from. 

Progestin is the most common treatment for endometrial hyperplasia. It can be taken in the form of a shot, pills, vaginal cream, or as an intrauterine device. 

The doctor can also recommend a hysterectomy surgery to remove the uterus if:

  • The condition in endometrial hyperplasia worsens or leads to cancer cell production.
  • The condition does not improve even after taking the progestin.

There are other various treatment options depending on your condition. So, it's best to consult an Obs/Gynae for a customized treatment plan for yourself.