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Transcript of Endometrial hyperplasia
What is endometrial hyperplasia?
What is the cause of endometrial hyperplasia?
What are its symptoms?
What are the complications?
How to diagnose?
What are the risk factors?
What is the treatment?
Endometrial hyperplasia is abnormal thickening of the lining of the uterus. Endometrim grows and thickens every month for pregnancy. If does not occur, the lining is shed, known as a menstrual period, controlled by: estrogen & progesterone.
Estrogen is responsible for building up , and progesterone maintains and controls this buildup.
Most cases of endometrial hyperplasia result from high levels of estrogens, combined with insufficient levels of the progesterone-like hormones which ordinarily counteract estrogen's proliferative effects on this tissue.
1- Too much estrogen and not enough progesterone can cause overgrowth of the cells that line the uterus.
2- Women who take estrogen hormone therapy without taking any form of progesterone to balance the effects of estrogen are at risk for the development of endometrial hyperplasia and cancer.
3.It may also occur because of chronic diseases, such as diabetes, obesity, and polycystic ovarian syndrome.
What are its types?
Endometrial hyperplasia (simple or complex)
Irregularity and cystic expansion of glands (simple) or crowding and budding of glands (complex) without worrisome changes in the appearance of individual gland cells.
Atypical endometrial hyperplasia (simple or complex)
Simple or complex architectural changes, with worrisome (atypical) changes in gland cells, including cell stratification, tufting, loss of nuclear polarity, enlarged nuclei, and an increase in mitotic activity. These changes are similar to those seen in true cancer cells, but atypical hyperplasia does not show invasion into the connective tissues, the defining characteristic of cancer.
• Symptoms of include changes in menstrual periods. Some women also experience symptoms that are outside of the reproductive system, such as hot flashes (also known as hot flushes), which are feelings of intense heat along with excessive sweating and a rapid heart rate.
• Fainting or change in level of consciousness
• Rapid heart rate (tachycardia)
• Severe abdominal pain
2- Bleeding between menstrual periods
3- Dryness of the vagina
4- Excessive growth of body hair
6- Hot flashes
7- Missed menstrual periods
8- Mood swings
9- Pain during sexual intercourse
• Anemia (low red blood cell count)
• Cancer of the uterus
• Inability to participate normally in activities
• Menorrhagia (heavy bleeding during your menstrual period)
Diagnosis can be made by endometrial biopsy which is done through :-
1. Curettage of the uterine cavity to obtain endometrial tissue for histopathologic analysis.
2. pap smear : presence of atypical glandular cells for endometrial disease
3. Endometrial brush .
• Estrogen therapy without taking progesterone
• Menopause or the years around menopause
• Missed menstrual periods
• Polycystic ovarian syndrome
How to Reducing risk of endometrial hyperplasia ?
• Keeping track of your menstrual periods
• losing weight
• Managing your diabetes
• Taking contraceptives to help regulate your menstrual periods
it depends on the patient stage in life and the severity of symptoms :-
1- Women who experience endometrial hyperplasia as a symptom of perimenopause or menopause may be given a course of hormone replacement therapy (HRT). These medications contain female hormones but long-term HRTmay increase risk of breast cancer, heart disease, and stroke .
2. For women who do not respond to medical therapy, especially if there is a high risk of endometrial cancer, a hysterectomy may be required.
Treatment of endometrial hyperplasia during menstruation
Younger women may benefit from hormone-releasing contraceptives including:
• Birth control patch
• Birth control pill
• Birth control vaginal ring
• Intrauterine device (IUD)
1- Endometrial hyperplasia. ACOG, American Congress of Obstetricians and Gynecologists.
2- Dysfunctional uterine bleeding (DUB). MedlinePlus, a service of the National Library of Medicine National Institutes of Health. www.nlm.nih.gov/medlineplus/ency/article/000903.htm
Directed by Mohamed moussa