Endometrial benign hyperplasia

Introduction

Endometrial hyperplasia is a condition characterized by the excessive proliferation of the cells of the endometrium. Endometrium is the lining of the uterus that grows thicker every month at a certain point in the cycle, so it can host a fertilized egg. Of the egg is not fertilized, the endometirum is expelled through menstrual bleeding.

In endometrial hyperplasia, the proliferating glands may vary in size and may eventually lead to cytological atypia, with an increased risk of endometrial cancer.

This condition is mainly caused by high levels of estrogen, combined with inadequate levels of progesterone-like hormones. Such high levels of estrogen may occur due to polycystic ovary syndrome, hormone replacement therapy and some tumors that produce estrogen.

Endometrial hyperplasia can be benign but it does involve a risk of eventually developing endometrial cancer, which is why this condition must be monitored.

Classification

At first, endometrial hyperplasia can be completely benign and present only a physiological response to high levels of estrogen. However, the overgrowing gland-forming cells can eventually undergo changes that will make them cancerous or pre-cancerous.

Simple or complex endometrial hyperplasia is characterized by single or clustered expanded glands of the endometrium without suspicious changes in them. It is estimated that 1,6% pf patients with this diagnosis eventually develop endometrial cancer. On the other hand, atypical endometrial hyperplasia involves a higher risk of cancer.

Risk factors

Risk factors for endometrial hyperplasia are the same as those for endometrial cancer. These include polycystic ovary syndrome, high levels of estrogen, obesity, hypertension, infertility, never having had children, late menopause, breast cancer, ovarian cancer, diet rich in animal fats, regular consumption of alcohol and age over 35.

Treatment

The treatment for benign endometrial hyperplasia, whether it is simple or complex, aims to prevent abnormal uterine bleeding, which is the most common and most noticeable symptom of this condition. Treatment also consists of measures of control and prevention of endometrial cancer.

In most cases the treatment consists of progestins, which were found to be very efficient. They activate progesterone receptors and thus reverse the abnormal proliferation of endometrial glands. This form of treatment is particularly effective for non-atypical cases of endometrial hyperplasia and for simple endometrial hyperplasia.

Patients with complex endometrial hyperplasia are either put on progestins or observed. Every woman diagnosed with this condition should see her doctor on regular basis, as a part of monitoring process for cancer, even though the risk is believed to be relatively low.