What is glandular hyperplasia of the endometrium?

Mucous membrane of the uterus, subject to cyclic changes throughout the menstrual cycle, is called the endometrium. At the beginning of the menstrual cycle, this envelope under the influence of hormones begins to expand and change its structure, preparing to receive the embryo. If fertilization does not occur, the endometrium gradually moves away from the base and leaves the uterus along with blood secretions - menstruation begins, and with it a new cycle of endometrial development begins. In the case of excessive overgrowth of the endometrium, there is a disease of endometrial hyperplasia.

This disease most often manifests itself as uterine bleeding, having dysfunctional character, which occur after the delay of ovulation, as well as against the general background of a regular cycle. However, there are cases of asymptomatic hyperplasia, when the diagnosis is first put in the process of a comprehensive survey of infertility. The absence of pregnancy is explained by the fact that glandular hyperplasia of the endometrium is a pathological dyshormonal state, in the presence of which ovulation may be completely absent. In addition, implantation of the embryo is impossible due to changes in the uterine mucosa.

There are several varieties of hyperplasia differing in different histological patterns:

- atypical hyperplasia;

- glandular-cystic hyperplasia;

- glandular hyperplasia of the endometrium;

- polyps of the endometrium.

The glandular-cystic hyperplasia and simple glandular endometrial hyperplasia are very similar in appearance, but the first form is more pronounced. Endometrial polyps are a local, limited hyperplasia, and in the presence of structural rearrangement of the uterine mucosa and a more pronounced growth of specific glands, atypical endometrial hypoplasia is diagnosed, which is regarded as a precancerous disease of the mucosa. Also very wary doctors treat ferruginous hyperplasia, which again arises after scraping, and to hormone-resistant hyperplastic processes.

Glandular endometrial hyperplasia: causes

The reasons for the development of this disease are quite diverse. First of all, they include hormonal disorders, pathologies of lipid and carbohydrate balance, gynecological diseases, reproductive and menstrual disorders, as well as surgical interventions in the uterus and appendages. In addition, glandular endometrial hyperplasia often occurs in women who have such diseases as hyperestrogenia, uterine fibroids, mastopathy, endometriosis, ovarian polycystosis, fat metabolism disorders, hypertension, elevated blood sugar levels, liver disease with disruption of hormone utilization.

Timely detection of endometrial hyperplasia is of great importance for the treatment and prevention of infertility, as well as for the prevention of endometrial cancer. To identify this disease using a variety of methods, the most common, but not always reliable (the accuracy of the method is not more than 60%), is the method of ultrasound. Aspiration or biopsy of the mucous membrane of the uterus is also performed to diagnose hyperplasia in the second half of the cycle. The most informative method of diagnosis is hysteroscopy, which involves insertion of a special optical system into the uterine cavity, through which a targeted biopsy is performed. In addition, this method of diagnosis allows you to assess visually the condition of the walls of the uterus.

Glandular endometrial hyperplasia: treatment

First of all, the treatment consists in removing that part of the mucosa that has undergone pathological changes. For this, a scraping controlled by means of hysteroscopy is performed, followed by a histological examination. After the focus of inflammation is removed, hormonal therapy is performed. Depending on the characteristics of the clinical picture of the disease, oral contraceptives use estrogen-progestogen drugs, agonists of SNG or pure gestagens. Treatment is strictly individual, conducted within a minimum of three months. After that, an additional examination of the endometrium is necessary.