Hyperplasia is understood to mean excessive cell growth, changes in shape and an increase in the number of endometrial glands (uterine lining). It affects either a separate section or a functional, less often basal, layer completely. In the reproductive period, a simple form is more often diagnosed (endometrial glandular hyperplasia), but atypical hyperplasia and endometrial polyps are mainly detected in pre and postmenopausal women.
What is dangerous endometrial hyperplasia during menopause?
Endometrial hyperplasia during menopause is dangerous for the development of cancer. During menopause, many women are afraid to be examined by a gynecologist and find out the diagnosis. If a thickening of the endometrium is detected, the size of which, on the contrary, should decrease, the doctor will immediately refer you to an additional examination in order to exclude the malignant process.
Symptoms of endometrial hyperplasia in menopause
The main manifestations of hyperplasia are:
- bleeding from the genital tract, which, unlike during the reproductive period, occurs between menstruation in the premenopausal period, while in postmenopausal women are characterized by secretions of varying intensity, but more often
- menopausal endometrial hyperplasia can occur without discharge,
- in the presence of polyps, pain in the lower abdomen of a cramping character may disturb a woman.
Ultrasound signs of endometrial hyperplasia in menopause
When performing ultrasound, you can clearly see the boundary between the mucous membrane and the muscular layer of the uterus. Evaluation of the endometrium gives a chance in time to detect pathological changes and prevent serious consequences.
With age, the thickness of the endometrium gradually decreases, and if menstruation is absent for 5 years or more, the size of the mucous layer should not exceed 4-5 mm. Due to the narrowing of the cervical canal of the cervix, a small amount of fluid is often found in the uterine cavity.
When there is a gaping in the uterus, the term "M-echo" is used. In this case, it is important to measure the thickness of both walls of the endometrium and the contents of the uterus. If the value of the M-echo does not increase, the boundaries of the cavity remain clear and even, of a uniform structure, then this is the norm.
Note! Dynamic observation with ultrasound once a year is necessary in any case.
In postmenopausal women, one polyp is more likely to be found, two and even more so 3 very rarely. In perimenopause, mainly glandular fibrous polyps are found, and in postmenopause, fibrous polyps. Adenomatous polyps are dangerous, they are attributed to precancerous conditions.
Echo signs of endometrial hyperplasia:
The duration of menopause, years
Endometrial thickness, mm
Against the background of HRT, the thickness of the endometrium reaches 10 mm, which is considered the norm, so the doctor should be warned about taking the drugs. With an increase of more than 10 mm carry out the correction of the therapy with repeated ultrasound. If taking gestagen-based drugs does not lead to a decrease in performance, then diagnostic curettage is prescribed, at best, under the control of hysteroscopy.
Scraping in menopause with endometrial hyperplasia
The most common manipulation of hyperplasia is curettage of the uterus and cervix of the cervix for diagnostic and therapeutic purposes. Due to the histological examination of the material taken, cancer cells can be detected in the early stages, which increases the effectiveness of treatment and prognosis.
If curettage is performed without endoscopic observation, then there is a chance of inadequate removal of the polyp, therefore hysteroscopy is the most successful option.
With endometrial thickening, uneven contours of the uterine cavity and detection of inclusions, hysteroscopy, separate diagnostic curettage with mandatory histological examination of scrapings is shown.
If in the postmenopausal period longer than 5 years, a thickening of up to 6-7 mm has been detected, endometrial biopsy and ultrasound are indicated every 3-6 months.
Unfortunately, surgical treatment is often resorted to, the volume of the operation depends on the type of hyperplasia and the presence of atypia.
In perimenopausal recurrence of endometrial hyperplasia without atypia in combination with adenomyosis or uterine myoma perform surgery. If recurrence is detected in postmenopause, then endometrial ablation is performed or the uterus with appendages is removed.
In atypical postmenopausal hyperplasia, the uterus with appendages is removed. In the presence of severe comorbidities and a high risk of surgical treatment, gestagens are prescribed continuously for a long time in combination with anticoagulants, antiplatelet agents and hepatoprotectors in usual dosages. The treatment is carried out under the control of ultrasound and aspiration biopsy after 6-12 months. Dispensary observation for life.
Folk remedies for endometrial hyperplasia in menopause
Alternative medicine has also found its admirers, although doctors do not use such methods as the main treatment - they can only be used as an adjunct to therapy.
In menopause with endometrial hyperplasia, various herbs are recommended:
- boron womb,
- vegetable juices (for example, carrot, beetroot) and many others.
Herbs are easy to use - they are either poured with boiling water, or decoctions and tinctures are prepared on the fire.
For the treatment of glandular hyperplasia of the endometrium in menopause, some practice clay in the form of compresses on the lower abdomen. This procedure is ineffective and even harmful due to the pronounced thermal effect.
Note! Before any procedure, you should consult with your doctor.
Vladlena Razmeritsa, obstetrician-gynecologist, especially for Mirmam.pro
Endometrial hyperplasia during menopause
In the period of menopause, age-related changes of the female body occur - the reproduction of sex hormones is reduced, the cyclic processes of renewal of the internal mucous membranes of the uterine cavity stop. With the onset of the climatic period, the likelihood of developing serious diseases increases. Endometrial hyperplasia is most commonly diagnosed in menopause. Not all patients, having heard this diagnosis, know what it is, what symptoms and treatment of the disease.
What is menopause and when does it occur
Menopause is a 12-month period after the last natural periodic discharge in women, occurring between the ages of 45 and 55 years. It is caused by the depletion of the follicle reserve. If menopause occurs before the age of 40, then this process is called ovarian exhaustion syndrome. Some women have a late menopause after 55 years.
There are cases when the pause is caused by artificial means. In this case, the woman stops menstruating due to surgical removal of the ovaries, chemotherapy, or medication.
During menopause, the female body changes. Changes caused by a lack of hormones, changes in the functioning of the ovaries. It is at this time that the risk of developing many gynecological pathologies, such as uterine cancer, endometrial hyperplasia, increases.
General information about the disease
The term "hyperplasia" physicians imply the growth of tissues. It arises due to excess cell production. The endometrium is the inner lining of the uterus. It provides the fetus optimal conditions for full development. Each menstrual cycle the thickness of the endometrium varies. The thinnest layer is immediately after the end of menstruation. During ovulation, the endometrium thickens to 8 mm under the influence of the hormone estrogen. If conception did not occur, the level of hormones decreases due to the production of progesterone, the internal mucous membranes of the organ are depleted, the egg cell leaves the body - menstruation begins.
During menopause, hormones are disturbed. Under the influence of elevated estrogen levels, the endometrium increases in volume. Due to the reduced level of progesterone, this process does not stop. In most cases, the growth of the endometrium is characterized by premenopause. Indeed, despite the presence of a monthly discharge in the body of a woman, age-related changes occur, accompanied by changes in the hormonal background.
During menopause, the endometrium becomes thinner. Its thickness varies within 5 mm. It is this indicator that doctors consider normal. Sometimes the growth of the endometrium with menopause reaches 7-8 millimeters. This indicator indicates a possible beginning of the pathological process, but is not yet classified as hyperplasia. For some patients, tissue thickness of 7-8 millimeters is the norm. But doctors recommend periodically undergoing ultrasound (every 3-6 months) to exercise dynamic control over the growth of tissues.
If the thickness of the endometrium reaches more than 8 mm, gynecologists recommend that the patient be curetted. It is necessary to confirm the development of the pathological process, study the structure of tissues and prescribe treatment.
There are several types of endometrial hyperplasia. They differ in the direction of tissue growth:
- The glandular form of endometrial hyperplasia is diagnosed if the layer of the inner lining of the uterus increases due to the modification of the glands located in it. The increase in volume occurs in the direction of the muscles of the organ.
- Cystic form. Cystic formations begin to form in the lining cavity. This kind of pathology is dangerous, since the cells produced by an excess of hormones can turn into malignant ones.
- Basal hyperplasia. During menopause, this form of the disease is rarely diagnosed. During its development, an increase in the thickness of the basal layer of the uterus is observed.
- Focal form. The thickness of the membrane increases irregularly, forming growths (polyps) on the walls of the uterus.
- Atypical hyperplasia. With climax, this type of pathology is rare. It is the most dangerous of all types of manifestations of the disease, as it quickly turns into cancer of the uterus. If the atypical form of endometrial hyperplasia has been confirmed, doctors remove the organ.
Most often, menopause is diagnosed with a glandular and cystic form of the disease. The main reasons for the development of these types of pathology is hormonal failure.
Causes of hyperplasia during menopause
There are several factors that cause endometrial hyperplasia in menopause. In most cases, they begin to form before the onset of menopause (in premenopause).
- Hormonal disbalance. This is the most common cause of pathology. In women after 45 years of age, there is a decrease in progesterone production and an increased level of estrogen. This imbalance provokes a modification of the endometrium.
- Metabolic disease. With age, most women have an overweight problem. Fat tissue provoke the production of estrogen, thereby exacerbating the hormonal failure, manifested in menopause.
- Malfunction of the endocrine system. For this reason, endometrial hyperplasia is often observed in postmenopausal women.
- Frequent invasion of the uterus (gynecological surgery). Due to the frequent mechanical action, the membrane receptors no longer respond to progesterone levels. The more an abortion and curettage woman had to endure, the higher the likelihood of GGE development in the climatic period.
- Predisposition to pathology at the genetic level. Doctors confirm that this disease is more often diagnosed in patients whose relatives had the same problem.
Also, the growth of mucous membranes is observed against the background of fibroids and mastopathy. In some cases, the pathology of a malfunction of the immune system can be provoked.
The symptoms of postmenopausal endometrial hyperplasia are manifested individually. The main symptom of a hyperplastic pathological process is bloody discharge. But they are not observed in all patients. Sometimes thickening of the shell occurs without discharge. Other manifestations of the disease include:
- Very painful menstruation. In this case, the pain is spastic.
- Irregular menstrual cycle. Sometimes spotting appears twice in a month.
- Abundant and prolonged periods (10-14 days).
Sometimes the symptoms of endometrial hyperplasia of the uterus are accompanied by general malaise, insomnia, migraine, decreased performance, irritability. A woman feels intense thirst.
How to diagnose
In most cases, a gynecologist diagnoses a suspected endometrial hyperplasia, to whom a woman complains of painful or irregular menstruation. There are several methods for diagnosing the disease:
- Ultrasound. If during this diagnostic study it is revealed that the endometrial layer is 7-8 mm thick, the gynecologist will prescribe an additional examination.
- Hysteroscopy. During the procedure, the doctor makes a visual inspection of the uterine cavity using endoscopic equipment. The examination is performed under general anesthesia. In most cases, a biopsy of the tissues is performed simultaneously with the examination of the membrane.
- Curettage (diagnostic curettage of the endometrium). The procedure is prescribed in those cases if the thickness of the growing tissues exceeds 8 mm. Scraping is performed to further study the endometrium and eliminate the appearance of cancer cells.
If the thickening exceeds 10 mm, gynecologists recommend to undergo a separate curettage procedure, followed by irradiation of the organ cavity with radioactive phosphorus. The reagent is injected into the patient's vein, migrates through the body and accumulates in pathogenic areas of the membrane. The doctor for the histological examination takes biological material from these areas.
How to treat the disease during menopause
If the diagnosis of endometrial hyperplasia in menopause is confirmed, treatment is started immediately. After all, this is one of the pathologies, during the development of which there is a high probability of the degeneration of cells into malignant oncological formations. Depending on the stage of the disease, doctors use one of the methods of therapy.
It is recommended to treat endometrial hyperplasia with drugs if the tissue thickness does not exceed 6-7 mm. Therapy is based on the use of hormonal medications that trigger an increase in progesterone levels. The patient during the entire period of treatment (6-8 months of continuous medication intake) must undergo a scheduled ultrasound scan, during which the doctor keeps a constant check on changes in the tissue proliferation rates.
Drug treatment does not give 100% of the results. The probability of recurrence of the disease is high.
If drug therapy did not produce the expected results, surgical treatment of the pathology should be carried out. Depending on the results of previously conducted analyzes, use one of the methods of surgical intervention:
- Scraping the uterus. It is recommended if the thickness of the modified fabric exceeds 10 mm. The procedure lasts 30-40 minutes under local anesthesia.
- Moxibustion. This method of surgery is used for focal hyperplasia. During the procedure, the doctor acts on the foci of the modified tissue with cold, laser or electrical impulses.
- With an increased risk of developing malignant tumors, doctors recommend removing the uterus. During the hysterectomy procedure, the organ is completely excised. And if a woman has a lesion of the ovaries during menopause, they are also removed during the operation.
Which type of surgery to use, determines the attending physician individually. Sometimes during preparation for surgery, hormone therapy is used. It contributes to the rapid recovery of the body after the intervention.
Additional therapy with folk remedies
Most patients are not in a hurry to use traditional treatment of pathology, preferring to use traditional medicine recipes. Gynecologists advise not to regard herbs as the main therapy, but to use them in combination with medicines. The most common recipes of traditional medicine, proven to be effective in the treatment of HPE, are:
- Fresh juice from burdock root and golden mustache. These liquids are mixed in equal proportions and taken twice a day, 1 tablespoon. A significant disadvantage of this recipe is the possibility of therapy only in the warm season.
- Alcohol tincture of nettle (prepare yourself). 200 gr. Medicinal raw materials (fresh leaves and sprouts) pour 500 ml. alcohol (strong moonshine). Kept for three weeks in a warm dark place, occasionally shaking a container of liquid. Ready infusion filter and take 1 teaspoon twice a day.
Treatment of folk remedies should be accompanied by regular examination by a doctor. This will provide an opportunity to track the dynamics of the disease.
Does the disease itself go through menopause?
Even if the disease is not accompanied by pronounced symptoms and was diagnosed by chance, it alone cannot pass. Pathological changes occurring in the female body, without hormonal drugs will not be able to return to normal. Sometimes women believe that if the menopause passes, the hormones normalize and the endometrial layer becomes thinner.This is nothing more than a delusion. The earlier the treatment of the disease is started, the higher the chances of recovery.
Is relapse possible with menopause?
The possibility of recurrence of endometrial hyperplasia during menopause increases. Depending on the type of treatment chosen by the doctor, after which the growth of tissues continued, further actions are determined:
- If the disease recurs after drug therapy, and the layer thickness increases by more than 8 mm, it is recommended to undergo a curettage procedure.
- If the situation has recurred after curettage, complete removal of the uterus is performed.
The percentage of recurrent cases of pathology with initially well-chosen treatment is low. To prevent the possibility of relapse, the patient must constantly undergo a follow-up examination.
What is the danger
The growth of the menopausal endometrium is very dangerous for a woman. It is an insidious disease that tends to relapse and degenerate into oncological formations. Even after the cessation of monthly discharge, hyperplasia of the uterine membranes is dangerous for at least premenopausal menus. Therefore, women in the 12-month period after the end of the last menstruation must undergo a gynecological routine examination and ultrasound.
I was diagnosed with PCE several years ago. Appointed reception "Diferelin". On the Internet I read contradictory reviews about this drug, but I still started to drink. Endometrial thickness does not increase. And it pleases. There is hope to avoid scraping.
Oh, you were lucky. I was assigned both “Danazol” and “Zoladex” - everything turned out to be unsuccessful. I had to agree on scraping. The procedure is not the most pleasant, I must say. Now I take pills to avoid relapse.
And there are cases in which the endometrium itself returned to normal, without treatment? I'm just wondering, I've already passed 2 cleanings. A friend was treated only with herbs, so she went into the tumor ...
I think if you go to a doctor in time and drink pills, you can do without cleaning. At least, I have so far. Constantly observed, pass ultrasound. There is hope that everything will return to normal after menopause. But not by itself, of course, I still take medication.
Endometrial hyperplasia in menopause
After 45 years of age, certain hormonal changes occur in a woman’s body, which affect the work of various body systems. Endometrial hyperplasia in menopause is the most common abnormality, the danger of which lies in the likelihood of developing malignant tumors.
Endometrial hyperplasia with menopause: what is it?
Changes in the body of a woman after 45 years are characterized by a hormonal imbalance, which is the most common cause of hyperplasia.
The uterus of the woman consists of several layers, one of which is the endometrium. Under the action of estrogen, its cells begin to expand, which is characteristic of the beginning of the menstrual cycle - the body is preparing for pregnancy. If it does not occur, the cells are rejected with a small amount of bleeding, causing menstruation.
Under the influence of hormonal changes in women over 45, endometrial cells often penetrate other layers of the uterus. This process is called hyperplasia or adenomyosis. Often the disease can occur without obvious signs, so the woman can not guess about the presence of this disease.
When restoring the balance between estrogen and progesterone, adenomyosis passes on its own.
Depending on the course of the disease, the following types of it are distinguished:
- Glandular hyperplasia in menopause. It is expressed by uncontrolled growth of glands with preservation of their functions.
- Glandular cystic form (LCGE). It refers to a more pronounced, manifested by the formation of cysts, dysfunction of the glands.
- Cystic adenomyosis. The disease is formed by increasing the size of the glands on which cysts are formed. This manifestation is considered a precancerous condition, therefore, requires compulsory treatment.
- Focal type. A distinctive feature is the formation of a limited size, which are formed from connective tissue cells. Formations can be single or form polyps.
- Atypical adenomyosis. With the predominance of glandular tissue above the connective, atypical cells begin to appear, a characteristic feature of which is their uncontrolled division. Cellular pathologies can be observed on the entire epithelial surface or form islands. The danger lies in a high probability of transition to a malignant neoplasm.
Often, recurrent hyperplasia is diagnosed in postmenopausal women. She appears again after previous treatment.
Causes of endometrial hyperplasia in menopause
The pathological condition of the endometrium in the period of menopause is much more common than in other periods. This is due to a number of reasons that require compulsory treatment.
Climax for the female body - stress, which does not pass unnoticed. Diseases that were previously asymptomatic are activated. Among the main causes of adenomyosis are:
- Hormonal imbalance. The normal state of the reproductive system is ensured by a balanced release of estrogen and progesterone. With the decay of ovarian function, the existing balance is disturbed. Contribute to this may hormone therapy to reduce the manifestations of menopause, contraceptives.
- Violation of metabolic processes, as a result of which there is excess weight, increases body fat. They also produce estrogens, causing an imbalance in the balance.
- Diseases of the endocrine system. Diabetes, thyroid dysfunction, and other abnormalities lead to the release of substances indirectly affecting the production of estrogen.
- The thinning of the mucous membranes of the reproductive system, caused by climacteric changes, triggers autoimmune processes, the result of which is an increased rate of endometrial cell division.
- Genetic characteristics of women. Scientists have identified a link between heredity and the flow characteristics of all stages of menopause.
- Frequent injury to the uterus (abortion, surgery, curettage). This reduces the body's perception of progesterone action, causing accelerated endometrial cell division.
The normal thickness of the endometrium of the uterus - 4-5 mm. With an increase in this indicator, additional diagnostic procedures are performed.
Treatment of hyperplasia in menopause is possible only with individual drugs, which the doctor will prescribe after a detailed examination, including the following diagnostic methods:
- Ultrasound procedure. It is carried out regularly with a discreteness of 1 year, it allows timely identification of the echo signs of the disease.
- Scraping. Additional procedure carried out with a mucous thickness of 6-8 mm.
- Histology. The study is carried out with the germination of cells in other layers to a depth of 10-12 mm.
- Hysteroscopy. A modern diagnostic method, in which a special thin apparatus is inserted into the uterine cavity, which allows studying the inner walls.
Treatment is prescribed individually, based on the results of a preliminary examination, a diagnosis, in some cases may include mandatory surgery, medication, mud therapy with clay. It should adhere to the prescribed therapy, because adenomyosis can be transformed into cancer. If you need to make an appointment with a gynecologist, use the free consultation, go to http: //45plyus.rf/registration/.
Over the age of 45, the risk of hyperplasia is significantly increased.
A woman during menopause must attend preventive examinations. You should immediately contact your doctor if you stop menstruation for more than 3-4 months, followed by renewal, sharp pains in the lower abdomen, the appearance of bleeding in the middle of the menstrual cycle.
What is menopause, the age of its occurrence
When the hormones are completed in the ovaries, the menstruation stops completely and irreversibly, menopause begins. Specialists have a rather conventional age range for the onset of menopause.
This process depends on a combination of important factors. It takes into account the general condition of the body, the presence of bad habits, heredity and even the physical activity of a woman. Chronic illnesses can affect menopause. Stress and intense feelings can also accelerate the onset of menopause. On average, it occurs when a woman is at the age of 50 years. There are cases when it comes a few years earlier or later. All individually. Experts note that the onset of menopause depends on the sexual activity of the woman, place of residence, and the environmental situation.
Causes of pathology in menopause
Endometrial hyperplasia in menopause occurs for a number of reasons:
- Hormonal disbalance. During menopause, the production of hormones in a woman's body is significantly reduced, but if there is a violation of their correct ratio in the direction of estrogen, then the mucous layer of the uterus begins the process of active growth.
- Endocrine diseases are a common cause of endometrial growth. Diseases could be before menopause, but this period intensified their development, becoming the cause of the pathology.
- Obesity. Estrogens are produced not only in the ovaries, but also in adipose tissue. With obesity, their number exceeds the amount of progesterone and gpe develops.
- Aging tissues of the whole body. In premenopause, the process of aging of all tissues begins. The mucous membrane of the female genital organs becomes more susceptible to infections and possible damage. The result of the disease can be a violation of the development of endometrial cells.
- Surgical intervention. Abortions, scraping are injuries to the internal mucous membrane of the uterus. This may cause endometrial hyperplasia to develop during menopause.
- Heredity. This factor is taken into account when collecting the history. Some patients are genetically predisposed to the development of pathology.
Postmenopausal endometrial hyperplasia occurs for a number of similar reasons. In different stages of the climacteric period, an individual treatment plan is selected by a specialist.
Signs and symptoms
Pathology is dangerous because it has no characteristic signs, so a woman can miss the beginning of the development of the disease. During the premenopausal period, women go through periods; if the pathology has already begun to develop, then a violation of the cycle can indicate to it. Symptoms of endometrial hyperplasia of the uterus - bleeding that occurs between menstruation. During menstruation, pains in the lower abdomen increase, their duration increases, and discharge becomes abundant.
Postmenopausal endometrial hyperplasia, the main symptoms of which are bleeding 0.5-1 year after the last menstrual period, should force a woman to see a doctor immediately. A characteristic sign of pathology is cramping pain in the lower abdomen without discharge. This period is dangerous in that the immune system is weakened, and the woman puts herself at the risk of morbidizing into a malignant cancer.
The likelihood of developing a hyperplastic process is increased if a woman is suffering from diabetes, obesity, has previously undergone myoma, mastopathy.
If you suspect the presence of endometrial hyperplasia during menopause, the specialist prescribes a number of diagnostic measures.
- Ultrasound. The study is performed using a transvaginal probe, which measures the endometrial layer. During menopause, the norm rate is 5-8 mm, if it is indicatively increased, the thickness reaches 8-10 mm, the necessary therapy is prescribed.
- Scraping. During curettage, an enlarged endometrium layer is removed. This procedure prevents the degeneration of healthy cells into malignant. Also, the biomaterial obtained as a result of scraping is sent for histological examination.
- A biopsy is used to diagnose diffuse hyperplasia. In the process, the doctor receives the biomaterial for further research.
- Hysteroscopy is also carried out - a special device is inserted into the uterine cavity, allowing the specialist to see the condition of the mucosa and determine the presence of pathology.
A comprehensive study allows you to quickly determine the presence of pathology, and the doctor proceeds to the necessary therapy.
Endometrial hyperplasia in menopause, the treatment of which must necessarily be timely can be reborn into a malignant neoplasm. The method of therapy is chosen by the doctor after the patient has completed the full range of diagnostics. Independently change the doctor's appointment is strictly prohibited. This pathology is a precancerous condition that cannot be ignored by refusing treatment.
Surgical treatment is prescribed if the course of drug therapy did not give the desired result, provoked a relapse of the pathology or atypical cells were detected. There are several types of surgical treatment:
- Curettage - in the process of scraping, the mucous layer is removed, the thickness of which exceeds 10 mm. Surgery lasts up to 30 minutes using local anesthesia.
- Cauterization - the method has proven particularly effective if there is a proliferation of foci of pathology. They can be cauterized by cold, electric current, diathermocoagulation.
- Uterus removal. If atypical endometrial cells and a large depth of organ damage are detected, then hysterectomy is the only chance to prevent the development of cancer. If damage to the ovaries is detected, then they are removed during the operation.
Traditional methods of therapy in the treatment of pathology never form the basis of therapy. They may be additional funds. Medicinal herbs are used for decoctions and douches, but not all of them are able to give a positive effect. Before you start using traditional medicine, be sure to consult with your doctor.
Nettle and burdock root is considered a good folk remedy. These ingredients are suitable for becoming the basis of alcohol tinctures. Have to take:
Mix components in a glass container, close, insist 15 days in a dark place. After 15 days, filter the infusion, take on an empty stomach 30 drops and the same amount of tincture before bedtime. Therapy is carried out to alleviate the condition.
Improper use of unconventional drugs, exceeding the dosage can cause deterioration of health.
The likelihood of recurrence of pathology during menopause after drug treatment is quite high. In this situation, the doctor may prescribe surgery, so that in the future it will not be repeated. Pathology recurs after conservative treatment, if there are abnormal cells. The specialist prescribes a repeated comprehensive examination, then changes the tactics of treatment.
In the presence of recurrent factors, the specialist prescribes surgery. This is the only way to protect women from the process of transformation of healthy cells into malignant cells.
Endometrial thickness of the uterus during menopause: symptoms of hyperplasia
Climax is the length of time that inevitably occurs in the life of every woman. It is characterized by changes in the entire body associated with exposure to hormonal levels.
The reproductive system is the most influential: the ovaries gradually cease to function, the genital organs are reduced in size, the mucous membranes of the uterus and vagina atrophy.
But if there are unfavorable factors (bad genetics, hormonal disruptions, damage during curettage of the uterus), the involution process in the uterus (reverse development) is disturbed, and endometrial hyperplasia develops in menopause.
Pathological thickness of the endometrium during menopause
The diagnosis of endometrial hyperplasia during climacteric changes is made when the mucus ball inside the uterus is too thick and begins to cause unpleasant symptoms.
In reproductive age, the functional layer changes its thickness during the entire menstrual cycle. 2-3 days before the expected date of menstruation, it can reach more than 18 mm, then detachment and removal of mucus and blood through the vagina occurs.
In premenopause, the endometrium begins to grow on the basal sphere more slowly and gradually ceases to form completely.
Its thickness decreases with each cycle until it reaches 5 mm or less, then menstrual bleeding stops and menopause occurs.
The proliferation of the endometrium at the beginning of menopause is rarely diagnosed, a slight thickening of it leads to a longer premenopausal period.
With a slight increase in climacteric endometrium (up to 8 mm), the patient is assigned a dynamic observation, since in individual cases even this thickness can be considered the norm.
But if the ball with each subsequent study increases, then the doctor makes a diagnosis of postmenopausal endometrial hyperplasia.
Characteristics of normal endometrium
The normal thickness of the endometrium during menopause should not exceed 5 mm, although in rare cases there may be exceptions, which are confirmed by conducting diagnostic studies.
The precautionary measures consist in prescribing an ultrasound diagnosis of the uterine internal ball, which is performed three times at intervals of three months.
Normal endometrium in menopause stops changing, unless the woman takes hormonal drugs.
Important! It should be borne in mind that the size and type of the normal uterus in the postmenopausal period differ from the physiological values of the organ in reproductive age.
It shortens, becomes more dense, in addition, in its cavity can accumulate fluid, which is often confused with polyps or the development of cancer.
Causes of the growth of the mucous layer in menopause
The reasons for the development of hyperplasia can reach even from the reproductive period of the girl, they include:
- genetic factor - if close female relatives suffered from pathology, the risk of getting sick significantly increases,
- diseases of the genital organs that have arisen in puberty,
- frequent failures in the menstrual cycle in history,
- pathologies associated with the endocrine system or metabolism, for example, diabetes,
- excess weight,
- a history of arterial hypertension,
- long-term use of drugs or contraception that contain large amounts of estrogen,
- surgery in the uterus (curettage, abortion, helix),
- liver disease.
Often the problem arises from those who lead an unhealthy lifestyle. Therefore, in order to reduce the risk of hyperplasia, it is important to quit smoking, play sports and consume less alcohol.
Forms and symptoms of pathology
Depending on the clinical picture and the nature of changes in the layers of the uterus, there are several forms of adenomyosis (hyperplasia):
Accompanied by excessive reproduction of glandular tissue of the uterus, which occurs due to the pathological placement of glands in the functional layer of the inner shell.
With timely treatment, the disease passes quickly and without consequences, without causing complications.
It can develop itself, but more often it occurs after a long course of glandular adenomyosis. In the uterus, there are many cysts and other neoplasms.
The danger of this form is that pathology may soon become a cancer process.
A rare form during which the endometrium of the basal layer is drawn into the disease.
It grows slowly, but is poorly susceptible to hormone therapy. Therefore, the doctor most often prescribes surgery.
It affects not the entire mucous layer of the uterus, but only selected areas. The most bleeding form of hyperplasia, for the diagnosis and treatment of the uterine cavity curettage.
Also, an emergency scraping is carried out if there is a large blood loss.
The hardest kind of pathology. The cells of the mucous layers of the uterus multiply rapidly and lead to a significant thickening of the inner ball in a short period of time.
In addition, they often reborn into cancer structures. When atypical adenomyosis is diagnosed, the patient is immediately recommended to remove the uterus and appendages to avoid ovarian tumors or cancer of the uterus.
The characteristic symptoms of a hyperplastic process in the uterine cavity appear only in the later stages of development, when the mucous sphere begins to reject.
Before that, a woman can pay attention to the appearance of whitish-gray discharge and weak, aching sensations in the lower abdomen.
In the first stages of the rejection of the endometrium, a spotting of blood appears, and then bleeding occurs, resembling menstruation.
The treatment of endometrial hyperplasia in menopause is a gynecologist. He examines and examines, determines the stage and type of adenomyosis, and prescribes the correct therapy.
Important! Do not ignore the signs and symptoms, but begin treatment by contacting a specialist.
Non-traditional methods of treatment can be excellent helpers in the fight against adenomyosis, but they should be resorted to only after consulting a doctor.
Important! Do not focus on popular recipes and do not forget about the appointment of a specialist.
Traditional medicine recommends to use decoctions, alcohol and water tinctures of nettle, peony, plantain, celandine and other herbs that affect the hormonal state.
Hirudotherapy, which tones the entire body, has also proven itself well.
Consequences and complications
The instability of the hormonal background and permanent changes in the structure of the endometrium, which occur over a long time, can lead to the appearance of complications:
- tumors and cysts of the uterus,
- anemia due to frequent bleeding,
To avoid unpleasant consequences, you must begin to treat hyperplasia at an early stage.
Important! Every six months, undergo a routine examination by a gynecologist to identify changes that have not yet provoked the onset of symptoms.
What should be the normal state of the endometrium
The mucous membrane of the uterus protects the walls from damage and damage, and after the onset of pregnancy, it retains and nourishes the embryo. The endometrium consists of the outer (functional) and inner (basal) layers. In a woman of reproductive age, the functional epithelium periodically exfoliates (if conception did not occur) and is displayed in the form of menstruation. After this, a new endometrium appears from the developing basal cells.
With the onset of menopause, it remains only a protective function. It begins atrophy (reduction in volume and thickness). If before the beginning of menstruation, the thickness reached 18 mm, then during menopause it is 5 mm. Such changes are considered the physiological norm. However, sometimes the thickness of the mucous does not decrease, but increases. Endometrial hyperplasia in menopause leads to serious complications.
In young women, endometrial hypoplasia (an abnormal reduction of mucosal thickness) is also considered a pathology. It also leads to infertility. However, during menopause, hypoplasia is a normal physiological process, and cannot be cured.
Types of hyperplasia
The following types of disease exist:
Ferruginous. The thickness of the epithelial layer increases due to the growth and violation of the shape of the glands located in it. Overgrowth occurs in the direction of uterine muscle tissue.
Cystic. Epithelial cells overlap the outlet openings of the glands, which begin to swell, forming cavities (cysts). In this form of the disease, malignant cell degeneration is possible.
Basal. A rare form of hyperplasia associated with germination deep into the uterus of the inner (basal) layer of the epithelial sheath.
Polypous (focal). Outgrowths on the thin stem (polyps) are formed from the cells of the glands. Separate areas of endometrial growth appear at the site of their formation.
Atypical. During menopause, this form is rare, since the processes in the body slow down. Meanwhile, atypical hyperplasia is associated with rapid abnormal changes in the shape and size of endometrial cells, which actively grow into other tissues. This form is most dangerous because it goes into cancer. Hyperplasia of this type is not treated, the uterus is removed.
Causes of endometrial hyperplasia during menopause
The emergence of this pathology contribute to disruption in the work of some body systems. Health problems can appear before the onset of menopause, and aging only exacerbates the consequences.
Hormonal disorders. The main factor affecting the state of the endometrium, is the content of estrogen in the blood. Endometrial hyperplasia occurs when the level of this hormone exceeds the norm. In turn, the content of estrogen is regulated by the second female sex hormone - progesterone, which suppresses the synthesis of excess amount of estrogen. During menopause, there is a decrease in the production of both of these hormones. However, the violation of their ratio in favor of estrogen causes pathological growth of the mucous membrane in the uterus.
Endometrial hyperplasia in menopause may occur, for example, if a woman uses hormone replacement therapy to alleviate the symptoms of menopause. The emergence of the disease contributes to the use of drugs containing only estrogen. Safer are the combined means, which also contains progesterone. They restore the right balance of hormones, preventing the appearance of hyperplasia.
Using hormonal contraception, a woman should consult a doctor about the effect of contraceptive drugs on the body. It is necessary to select the means in accordance with the hormonal background, which must be constantly monitored.
Endocrine diseases. The hormones produced by the thyroid gland, adrenal glands and other organs of the endocrine system also affect the hormones of the body. Violations in the work of these organs can lead to an abnormal increase in the content of estrogen.
Metabolic disorders, obesity. In addition to the ovaries, estrogens are also produced in adipose tissue. In obesity, their level exceeds the level of progesterone, which leads to the appearance of pathologies in the uterus, as well as diseases of the mammary glands, liver and other organs.
Aging body tissue. As a result of aging, the mucous membranes of the genital organs become more susceptible to damage and infection. Age-related weakening of the immune system contributes to the occurrence of inflammatory processes in the uterus and appendages. As a result, cell development can be disrupted, including in the endometrium.
Injuries and surgery on the uterus. During curettage and abortion, the mucous membrane of the uterus is destroyed, which creates the prerequisites for the incorrect formation of cells and the appearance of tumors of a different nature.
Heredity. Some women have a genetic predisposition to the appearance of such diseases.
Addition: The risk of disease is increased in nonpartum women, as well as those whose menstruation appeared at a too young age. Early and late onset of menopause are also provoking factors.
Signs of hyperplasia with menopause
Typical symptoms of this disease are usually absent. In the premenopausal period, when the woman still has monthly periods, in the presence of hyperplasia, the regularity of the cycle is disturbed, bleeding from the genitals appears between the periods. Menstruation can become very painful, profuse and prolonged.
In menopause, if menstruation comes again after a break of 0.5-1 years, this can also be a sign of hyperplasia. In the postmenopausal period, when the appearance of any blood discharge is an abnormality, their renewal clearly indicates the occurrence of endometrial hyperplasia or a malignant tumor in the uterus. During this period, the weakening of the body’s immune defenses and the complications of chronic diseases create an additional risk of hyperplasia becoming cancer.
Note: The likelihood of hyperplastic processes in the uterus increases in too full women, as well as having a myoma or mastopathy. With diabetes, liver disease, with hypertension, the risk of the disease is also great.
With the onset of menopause, a woman needs to undergo a gynecological examination 1-2 times a year, with the most information about the state of the endometrium given by ultrasound. It will also allow time to identify and treat inflammatory diseases of the genital organs.
Tip: In old age, women are not recommended to drink beer, as well as excessively carried away with dairy products. They are sources of estrogen. It is useful to eat tomatoes, beets, pineapples, olive oil and other "anti-cancer" products.
With great care should be used hormonal and herbal remedies that increase the level of estrogen in the body. It is necessary to control the diet, not allowing a significant increase in body weight.
The main cause of adenomyosis is hormonal imbalance. The fact is that although the amount of estrogen in menopause is significantly reduced, compared with progestins, their concentration is significantly exceeded. There is a certain imbalance in the ratio of hormones, through the fault of which this endometrial pathology arises in menopause.
Atrophic processes characteristic of the menopausal period, lead to a thinning of the mucous layer of the uterus. This makes the endometrium vulnerable to infections and inflammatory processes of various kinds. The immune system begins to actively control the course of these processes, which indirectly stimulates the growth of endometrial cells.
The essence of this type of disease lies in the overgrowth of glandular tissue, its thickening. This is one of the most common forms of adenomyosis, which is also considered the least dangerous (in terms of creating conditions for the development of oncological processes),
Proceeding from the name, it is easy to understand that with this type of disease, the formation of cysts is observed, which in some cases are capable of reborn into oncological formations,
The main symptoms of endometrial hyperplasia in menopause
Unfortunately, adenomyosis in menopause in many cases is almost asymptomatic. At least, it lacks the characteristic features unique to this disease. Sometimes hyperplasia can manifest itself as symptoms that are inherently similar to the symptoms of other gynecological ailments.
During the premenopausal period, when menstrual bleeding still occasionally occurs, endometrial hyperplasia can turn out to be disruptions in the cycle, metrorrhagia (unplanned bleeding), copious and painful menstruation.
Postmenopausal endometrial hyperplasia is most often accompanied by a resumption of uterine bleeding. Any blood discharge (abundant or spotting) should not appear a priori if a year or more has passed since the last month.
Concomitant symptoms of the disease may be: decreased performance, general weakness, frequent headaches.
Diagnosis of the disease during menopause
Identify overgrown endometrium in menopause is not difficult. As mentioned above, sometimes a woman does not even suspect that any pathological process takes place in her genitals. Often the disease is detected during the routine inspection, and its presence becomes a complete surprise for the patient.
A preliminary diagnosis is made even in the process of visual inspection on the gynecological chair. To confirm it, an intravaginal ultrasound examination is carried out to determine the actual thickness of the endometrium and the form of the developed pathology. This examination is also called uterus echo.
How much should the endometrial layer be in a healthy woman during menopause? The norm m-echo should not exceed 5 mm. If the mucous layer is 6 or 7 mm, then opt-out tactics of observation are chosen in order to track the dynamics of the process. For monitoring, ultrasound is repeated (after 3 months and six months). In menopause, such a pathological overgrowth is very often able to self-destruct under the influence of a natural decrease in estrogen levels.
The thickness of the m-echo component of 8-9 mm, requires more attention. To eliminate the dangerous consequences, scraping is often carried out in order to further study the material and the choice of treatment tactics.
If the norm of the endometrium is exceeded by 2 times, that is, it reaches 10 mm, then this is a signal to take immediate measures of treatment. First of all, the material collected by curettage is sent for histological examination in order to exclude the onset of oncological cell degeneration. In parallel, sometimes applied research using radioactive phosphorus.
Additionally, the doctor will prescribe a blood test for hormone concentration.
Treatment of adenomyosis with menopause
In menopause, the treatment of hyperplasia can be carried out in two directions: medical and surgical. If there is a moderate proliferation of tissue, and there are no fibrous polyps, then most often the treatment begins with hormone therapy.
Usually, hormones are used in this disease, the effectiveness of which is confirmed by positive feedback from doctors and patients. In particular, the most commonly practiced appointment:
- Medroxyprogesterone Injection,
- Zoladex capsules
- Norethisterone tablets
- injections of Buserelin,
- Danazol capsules
- Gestrinona capsules,
- Capsules goserelin.
To take pills or prick injections, as a rule, it is necessary from 3 months to six months. In some cases, treatment with the above preparations is a step that precedes surgery.
Treatment of postmenopausal endometrial hyperplasia involves the parallel administration of drugs that have a protective and regenerating effect on the liver (Essentiale Forte, Phosphogliv) and blood thinning (Heparin, Hepatrombin).
Surgical treatment of hyperplasia is a common practice.It is not possible to avoid it if there are recurrences of the disease, or there is a suspicion of a pathological degeneration of cells. Inevitable is surgery for the detection of a polypoid form of adenomyosis.
The hyperplastic process can be removed using the following operational manipulations:
- Scraping is a commonly used method when the endometrial thickness in menopause reaches 10 mm. The material collected during the intervention is an informative source for determining the characteristics of the disease.
- Cauterization by laser is used if there are isolated foci of hyperplasia. Abnormal cells in this procedure die off and spontaneously derive,
- Cryodistructure is a peculiar analogue of cautery, which uses the effect of low temperatures. It is used in focal adenomyosis.
- Hysterectomy - complete removal of the uterus. This radical method has to be resorted to when an atypical form of hyperplasia develops, creating an increased risk of developing oncology. Read in our article about the rehabilitation period and the possible discharge after removal of the uterus.
Traditional medicine in the fight against endometrial hyperplasia
The use of traditional medicine for endometrial hyperplasia is possible only as an adjuvant therapy. But in no case should you rely solely on naturopathy. Today, medicine offers the best options to combat this serious disease, which help to qualitatively and quickly eliminate the disease.
If the desire to use herbal preparations is very high, then you should discuss with your doctor the possibility of using the following tools:
- burdock root juice mixed with golden mustache juice
- tinctures or decoction of nettle,
- infusion of plantain leaf,
- infusion cuff,
- infusion of celandine (inside and local),
The main thing that should be remembered for every woman who is in the menopausal period is that it is extremely important to visit a gynecologist at least 2 times a year. Such prophylaxis will allow timely notice the appearance of the slightest deviations and prevent the development of dangerous consequences.
Types of disease
Endometrial hyperplasia is classified according to the type of focal changes.
In medicine, the following types of hyperplasia:
- Ferrous. The glandular tissue of the endometrium grows and thickens.
- Cystic. Epithelial cells clog the glandular openings, and as a result the endometrial glands swell, forming cysts. This is the most dangerous form of pathology, as it has a tendency to degenerate into cancer.
- Basal. This species is characterized by germination of the basal uterine layer into the body.
- Polypous. Polyps form on the surface of the endometrium, around them the endometriosis layer thickens.
- Atypical. There is an accelerated pathological change in endometrial cells, their active germination in adjacent tissues. This type of hyperplasia often turns into a cancerous tumor.
The rate of endometrial thickness during menopause
In reproductive age, the endometrium performs a protective function, that is, it prevents sticking of the walls of the uterus. Also contributes to the attachment of the embryo to the uterine wall and the further development of pregnancy.
During menopause, the woman loses the ability to conceive, so the endometrium performs only the function of protection. During this period, its thickness decreases.
If the endometrium does not decrease, but increases, then they are talking about hyperplasia. The boundary state is considered a layer of 6-7 mm, which requires dynamic observation. Pathological is a layer thickness of more than 8 mm.
Symptoms in menopause
The main symptom of hyperplasia in menopause is bloody discharge. They may be scarce or abundant. The occurrence of the disease indicates bleeding, which began after a long pause. In any case, bleeding is a reason to consult a doctor. Very often the disease is asymptomatic, a pathological increase in the endometrium is detected only on ultrasound.
The following symptoms should alert the woman:
- Chronic feeling of fatigue.
- Increased blood pressure.
- Headache of unclear genesis.
- Lower abdominal pain and lower back.
- Sharp weight loss.
Probability of pathology
Despite many provoking factors, hyperplasia does not necessarily appear in all women of climacteric age. The state of hyperestrogenia may occur as a result of endocrine disorders.
Diseases provoking increased estrogen production:
- Pathology of the kidney.
- Dysfunction of the adrenal glands.
- Uterine fibroids.
- Arterial hypertension.
At risk are non-pregnant women, as well as those who have had an early onset of menopause. Increased likelihood of hyperplasia in women who frequently undergo abortions and who have misused hormonal contraceptives. Should not be excluded and hereditary predisposition.
In women with obesity 2-4 degrees, the risk of pathology increases by 50%.
Hyperplasia develops in the period of premenopause and menopause. In postmenopausal women, the disease does not occur.
Danger of disease
The main complications of the disease:
- Iron-deficiency anemia. It develops as a result of permanent uterine bleeding.
- Magnilization. That is, rebirth into a malignant tumor. Of particular danger is an atypical type of hyperplasia. It is considered a precancerous condition requiring removal of the uterus.
Treatment with drugs is carried out only in the case of the glandular and cystic forms of the disease. For this purpose, hormone preparations are prescribed. These are progestins and progestins. They contain progesterone - a hormone that inhibits the growth of the endometrium. Modern hormonal preparations contain adequate progesterone standards that help to reduce the endometriotic layer and prevent magnilization..
The following drugs are most commonly used.:
- Megestrol acetate. Reduces the level of estrogen, inhibits the growth of hormone-sensitive cells. It prevents the growth of hormone-producing tumors.
- Levonorgestrel. Slows the growth of endometrial cells, prevents the increased production of estrogens.
- Buserelin Depot. It is an anticancer drug, widely used to treat hyperplasia. Reduces the synthesis of sex hormones in the ovaries.
Opinions of doctors about the safety of hormonal treatment for women after 50 years of age differ. Most do not recommend gestagen therapy because of the high risk of hyperplasia rebirth.. In women in menopause, the issue of preserving fertility is irrelevant, so doctors prefer more radical methods of treating the disease.
Treatment of dietary supplements and folk methods
The use of traditional medicine or various dietary supplements for the treatment of endometrial hyperplasia is justified in complex therapy. As monotherapy, it is useless. Any funds must be approved by the attending physician so as not to aggravate the situation..
Of the dietary supplements, the most famous is Indinol. It is used in combination with hormonal drugs. It prevents the recurrence of hyperplasia.
From the means of traditional medicine use herbs that have a hemostatic effect, stop the pathological growth of cells.
The most famous recipes:
- Decoction boron uterus. Apply 2-3 times a day.
- Infusion of licorice root. Root pour boiling water and insist 6 hours. Drink 100 ml three times a day.
- A mixture of propolis with honey. It is saturated with a gauze pad and placed in the vagina overnight.
- Bath oat broth. Oats poured boiling water, insist. Then add to the bath. It is necessary to be in such bath within 30 minutes.
What is this disease?
Endometrial hyperplasia with menopause is an abnormal proliferation of the uterine mucosa, as well as a change in its glands. Such increased reproduction of cells can lead to a change in their structure. Postmenopausal hyperplasia is likely to cause cancer.
Endometrium is the uterine mucosa, which consists of two layers: external (functional) and internal (basal). During the reproductive period, when conception does not occur, the functional epithelium exfoliates and is excreted with menstrual bleeding. From the developing basal cells, a new functional layer of the endometrium appears.
These processes in the female body occur under the influence of different sex hormones. At the beginning of the menstrual cycle, when the functional layer grows, the hormones estrogen dominate.
The dominance of the hormone progesterone leads to the cessation of epithelial growth. Therefore, experts agreed that endometrial hyperplasia provokes an elevated level of estrogen with a reduced level of progesterone.
During menopause, menstruation stops and endometrial atrophy begins, which already performs only protective functions. Moreover, the volume and thickness of the mucous membrane is reduced. If before the beginning of menstruation, its thickness was about 18 mm, then with the onset of menopause, it decreases to 5 mm. Such physiological changes occurring in the female body are considered the norm.
At the same time, the reverse processes, an increase in mucosal thickness, lead to hyperplasia during menopause. For many reasons, endometrial cells begin to grow into the muscle layer of the uterus and the thickness of the mucous membrane increases.
What types of hyperplasia are
Types of endometrial hyperplasia in menopause depend on which mucosal cells predominate in abnormal formation.
Experts identify the following types of the disease:
- Glandular - mucosa grows in the direction of uterine tissue by increasing the size of the glands located in it.
However, their form is violated.
- Cystic - due to the fact that the cells of the mucous membrane overlap the glands, they begin to swell and form cysts.
The probability of the transformation of this type of disease into oncology is very high.
- Focal (polypous) polyps grow from the gland cells (growths on a thin stem), around which separate areas (foci) of endometrial growth appear.
- Atypical (adenomatous) - due to the rapid change in the shape and size of the cells of the mucous membrane of the endometrium is very actively growing in the tissue of other organs.
This form of the disease is very dangerous, because in a short period of time it turns into cancer. In the period of menopause and postmenopausal is quite rare, since hormonal adjustment leads to a slowdown of all processes occurring in the body.
- Basal - a very rare type of disease in which cells of the basal layer of the endometrium grow into the depths of the uterus.
A woman may have a combined form of the disease. For example, glandular cystic hyperplasia. In this case, in addition to growths of the mucous membrane, which consist of glandular tissue, cysts and nodules are formed.
What are the symptoms of the disease at different stages of menopause
The endometrial hyperplastic process at all stages of the climacteric period is different. Therefore, the symptoms of the disease in each phase of menopause are different. Let us dwell on this issue in more detail.
The climacteric period has several important stages (phases):
- Premenopause - the period from the first manifestations of menopause to the last menstrual.
Endometrial hyperplasia in premenopausal disease has the following symptoms: menstrual disorders and the appearance of bleeding between menstruation. The appearance of pain during menstruation and an increase in the number of days during which the menstrual periods pass, as well as an increase in the amount of menstrual flow, should alert the lady.
Menopause is the last independent menstruation.
Since it can only be determined retrospectively, this period takes 12 months after the last menstrual periods for which there was no menstrual discharge. Hyperplasia at this stage may be without secretions, and may appear secretions in 0.5-1 year after menstruation. Therefore, if the bleeding began six months later and more from the last menstrual period, the lady should make an appointment with a gynecologist.
Postmenopausal endometrial hyperplasia has a whole bunch of symptoms. The most striking manifestation of the disease is sudden bleeding. They can be intense or smearing. The second bright symptom - pain in the lower abdomen, pulling character. In addition, they also distinguish such characteristic signs of the development of the disease: irritability, frequent headaches, and fast fatigue. A woman is tormented by bouts of intense thirst due to a sharp rise in blood sugar levels. The lady starts to gain weight.
Sometimes, endometrial hyperplasia in menopause and premenopausal disease is almost asymptomatic and can only be detected during a gynecological examination. As you can see, the disease during postmenopause has symptoms similar to menopausal manifestations. Therefore, many women take the symptoms of a developing disease for manifestations of menopause.
The above facts once again confirm that it is very important for a woman to maintain her health regularly, at least once a year, to visit a gynecologist.
Even the most "scary" menopause can be defeated at home! Just do not forget two or three times a day.
Causes of the disease
Since endometrial hyperplasia with menopause is a very dangerous disease, it will be helpful for all women to know what causes its development and who is at risk.
There are such main causes of the disease:
- Hormonal imbalance in which the amount of estrogen exceeds the norm, and progesterone, on the contrary, is lacking.
This leads to uncontrolled hormonal medications intended to reduce the intensity of symptoms of menopausal symptoms. After all, the composition of most of these drugs is only estrogen. The same consequences can lead to the use of birth control pills. Preference should be given to complex hormonal agents that contain both estrogen and progesterone.
With age, a failure in metabolism can trigger the development of diabetes mellitus, liver pathology, and problems with blood vessels. All these changes in the work of the organs and systems of the female body lead to a thickening of the endometrium during menopause. In addition, women with impaired metabolism accumulates excess weight. Adipose tissue has the ability to produce estrogen. Therefore, the higher the indicator of overweight in women, the greater the balance of hormones tends toward estrogen.
The thyroid and pancreas, as well as the adrenal glands produce hormones that affect the entire body of the woman. Malfunctions in their work can lead to an excess of estrogen.
As a result of abortions and scraping during the reproductive age, endometrial receptors can barely respond to the effects of progesterone. Taking into account the fact that during menopause, the level of progesterone decreases, then the cells under the influence of estrogen begin to multiply vigorously.
According to experts, one of the most significant reasons for the development of the disease is a genetic predisposition. Conducted studies have confirmed that most women who suffer from endometrial hyperplasia, the ancestors of the female line had the same diagnosis. At risk are women with fibroids and mastopathy.
What treatment is used
Endometrial hyperplasia in menopause requires treatment with traditional medicine methods. Since the disease can turn into cancer, women should not try to treat it only with folk remedies. They can be taken as an addition to the main treatment, but only after consulting with your doctor.
Elena Malysheva, a popular TV presenter on health, in a program dedicated to the treatment of endometrial hyperplasia emphasized that if you suspect an illness, you should immediately see a doctor and undergo a comprehensive examination.
The optimal method of treatment is chosen only by the doctor, depending on the stage of the disease and the general state of health of the patient. Treatment with folk recipes will only take precious time and lead to an overgrowth of the endometrium.
This method provides treatment with hormonal drugs that contain progesterone. Medication can take about six months.
During the course of treatment, women are constantly undergoing ultrasound to determine the thickness of the endometrium. The attending physician according to the results of the examination adjusts the dose of drugs.
It is absolutely impossible to self-medicate. When a woman independently increases or decreases the dosage of the drug, she can provoke a relapse of the disease.
To alleviate the condition of the lady, the doctor may prescribe herbal medicine in addition. After completion of treatment, a woman needs to undergo an ultrasound every 3-6 months in order to monitor the condition of the endometrium.
If a woman has a recurrence of the disease after taking a course of drugs, then use the operative method of treating endometrial hyperplasia. In postmenopausal treatment of the disease is carried out by both methods.
The following surgical options are possible:
- Curettage (curettage) is prescribed to patients whose endometrial thickness exceeds 10 mm.
The operation is performed under local anesthesia and lasts approximately half an hour. Fragments of the removed endometrium must be sent for histological examination, in order to identify cancer cells. If the result is positive, the decision is made to remove the uterus.
- Cauterization - gives the maximum effect in the case when there are separate foci of the disease.
Cauterization is performed in several ways: cold (cryodestruction), electric current (diathermocoagulation) or laser beam (laser destruction).
- Hysterectomy - involves amputation of the uterus.
If the ovaries are affected, they are removed along with the uterus. This method is used in the case when the uterus tissue is affected very deeply or adenomatous endometrial hyperplasia is detected, which can lead to the development of cancer.
Surgical treatment of postmenopausal endometrial hyperplasia is used when a woman has polyps or abnormal cells that are likely to turn into cancer cells.
Endometrial hyperplasia during menopause threatens the ladies more than before. This disease can trigger the development of cancer tumors. In the early stages of the disease can be cured with medication, without resorting to surgical treatment.
Therefore, it is very important to undergo a gynecological examination and ultrasound, which will help to identify the disease in the early stages, at least once a year. In addition, it should be possible to eliminate all risk factors for the development of hyperplasia. Good health to you!
And what do you know about such a serious disease?
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Endometrial hyperplasia in women with menopause is a pathological condition with a concomitant proliferation of the mucous uterine layer. With the progression of the disease, the endometrium begins to grow into the muscle structures of the uterus. This pathology is a violation of the processes of division of cellular structures and rejection of the endometrium.
Normally, the endometrial layer grows in the first half of the menstrual cycle and, in the absence of the onset of pregnancy, is rejected, goes along with the menstrual blood. Patients in the menopausal period may have a disturbance in the functioning of the reproductive system, in which the basal endometrial layer continues to grow, but delamination does not occur naturally, which leads to hyperplasia.
Such a pathological condition is fraught with the development of disorders in the functioning of the hormonal, reproductive, endocrine systems and can cause cancer.
Types of endometrial hyperplasia of the uterus in menopause:
- Glandular hyperplasia - accompanied by growth and deformation of the glands localized in the endometrium, which leads to its increase, penetration deep into the uterine muscular structures.
- Cystic hyperplasia of the endometrium - characterized by a specific growth of the epithelium, leading to the overlap of the openings of the exit gland with the subsequent formation of cystic tumors. This form of pathology can provoke oncology.
- Focal - accompanied by the formation of polyps, they form foci of endometrial growth.
- Basal - One of the rarest varieties of the disease, in which the inner layer of the epithelial membrane begins to grow deep into the uterus.
Symptoms and treatment of different forms of hyperplasia may differ slightly.
Causes of endometrial hyperplasia
Endometrial hyperplasia in postmenopausal and menopause can be triggered by numerous factors. Often the pathological process begins to develop long before the onset of menopause. The causes of endometrial hyperplasia in premenopausal and menopausal periods are:
- violation of exchange processes,
- diseases of the pancreas, thyroid, adrenal glands contribute to the production of an increased amount of estrogen and the development of adenomyosis,
- changes in the mucous membranes of the genital organs of an age nature with a concomitant decrease in local immunity,
- past cure, abortions, surgical interventions in the uterus,
- genetic predisposition
- autoimmune processes in which the body perceives uterine mucous membranes as an alien element, which activates the processes of their growth,
- hormonal disorders.
The cause of menopausal disorder can be a prolonged, uncontrolled use of drugs, the action of which is aimed at eliminating the manifestations of menopausal syndrome, the presence of tumor neoplasms, myomas, polyps, mastopathy.
To the greatest extent the disease affects the representatives of the weaker sex in the age category up to 50 years. Postmenopausal hyperplasia is a rare phenomenon.
The high-risk group includes patients diagnosed with early menopause, occurring in the age group under 45 years of age. For preventive purposes and for modern diagnostics, women with predisposing factors for the development of adenomyosis are recommended to undergo gynecological examinations and ultrasound examination of the genital organs at least 2 times a year.
Manifestations of pathology
The main manifestations of menopausal pathology are vaginal bleeding. There are other clinical symptoms characteristic of endometrial hyperplasia in menopause:
- uterine bleeding,
- painful sensations localized in the lower abdomen, which are predominantly cramping,
- increased fatigue
- increase in weight category
- exacerbation of chronic diseases,
- bouts of headaches.
In rare cases, the disease proceeds without discharge. In this case, women complain of a pronounced pain syndrome, general weakness, migraine, causeless irritability.
Endometrial hyperplasia in premenopause can also be manifested by the following symptoms:
- failure of the menstrual cycle
- painful, prolonged periods, lasting about 2 weeks,
- excessively intense, heavy menstrual bleeding,
- discharge the bloody character twice throughout the cycle,
- delayed menstruation followed by profuse discharge.
- Indicators of the norm and deviations of the endometrium in menopause
An expert can make an accurate diagnosis and prescribe a therapeutic course after a preliminary examination, when echoal signs of endometrial hyperplasia are detected.
What to do if endometrial hyperplasia is suspected? Noticing the alarming symptoms characteristic of this disease, a woman should consult a gynecologist. The specialist will conduct an examination and for the formulation of an accurate diagnosis will appoint the following types of studies:
- Ultrasound procedure - using a transvaginal sensor allows you to measure the thickness of the endometrial layer. If the obtained figures exceed the limits of the norm and are more than 5 mm, the procedure is repeated several times. With indicators of about 10 mm, the patient is prescribed curettage or a course of drug therapy.
- X-ray of the uterine cavity - allows you to assess changes in the structure of the endometrial system, to identify the presence of polyps and other neoplasms.
- Scraping uterine cavity - recommended at high risk of developing malignant processes, as well as for diagnostic purposes. The resulting endometrial cells are sent to the laboratory for histological examination.
- Ehosalpingography - conducted to determine the patency of the fallopian tubes. During the procedure, the cavity is filled with a contrast fluid through a catheter.
The most informative diagnostic method is ultrasound, the accuracy of which is about 80%. Experts identify the following echographic signs of endometrial hyperplasia:
- the presence of polyps of 16 mm - 17 mm,
- change of relief of the mucous,
- disturbances in the conductivity of the ultrasound signal,
- heterogeneity of the endometrial layer.
Based on the results obtained, the specialist diagnoses the patient and develops a therapeutic course that is optimal for a particular clinical case. Pathology treatment is carried out by different methods, depending on the form and stage of the pathological process.
Methods of traditional medicine
Treatment by folk methods is allowed, but only as an auxiliary component of the complex therapy. The use of herbal medicine, infusions and decoctions based on nettle, burdock, golden whisker gives a good effect.
It is impossible to cure the endometrial hyperplastic pathology in the menopausal and postmenopausal period with folk remedies alone, and self-medication can lead to extremely serious, unfavorable consequences.
To prevent endometrial hyperplasia with menopause, patients in the age group over 45 years old are recommended to undergo regular physical examination by a gynecologist and donate blood for a hormonal study. The following expert recommendations will be helpful:
- keep track of your weight, avoid overeating, live a mobile lifestyle,
- refrain from using medication, especially hormonal drugs, without a doctor's prescription,
- to eat well balanced
- to lead a regular, but at the same time moderate intimate life.
You should pay attention to nutrition, reducing the content in the diet of dairy products, brewer's yeast, considered sources of estrogen. The menu should include tomatoes, olive oil, beets.
Endometrial hyperplasia in menopause is a disease that occurs on the background of hormonal changes. In the absence of adequate therapy, the pathology progresses and can lead to serious consequences, including the development of oncological processes.
Women who have been treated for endometrial hyperplasia confirm that the pathology is curable, provided that they seek medical attention in a timely manner:
"I am 52 years old. I had a hyperplasia of the endometrial layer, frolicking against the background of menopause. Tormented by severe pain, mood swings, weakness, bleeding. After the curettage procedure and the course of medications prescribed by the doctor, the condition stabilized. ”
"I am 49 years old. The signs of endometrial hyperplasia showed up early, even before menopause. She appealed to the doctor in time, which is why she managed to avoid the operation, and only managed hormone therapy. ”
"I am 53 years old. A year ago, on examination, focal hyperplasia was discovered. Has passed the procedure of laser therapy. Very effective and not at all painful. Now everything is fine with health, there is no relapse. ”
What is menopause and menopause?
In modern literature, instead of “menopause”, the term “perimenopause” is used, and instead of “menopause” - “postmenopause”.
- Menopause is the last physiological menstrual bleeding. The exact date of menopause set retrospectively - not earlier than one year after a stable cessation of menstruation.
/ The estimated age is /
Periods of a woman's life
Causes of chronic estrogenia in menopause
After 40-45 years, women against the background of the age-related restructuring of the whole organism, a gradual extinction of the reproductive system. The formation of estrogen in the ovaries is reduced, so the menstrual cycle is disturbed. It becomes anovulatory: the egg does not come out of the follicle. Once ovulation does not occur, then a full-fledged yellow body does not develop and does not produce progesterone.
An estrogen / progesterone imbalance occurs and the endometrium is under the continuous influence of estrogens. Their concentration is low, but the effect is long. It has been established that even low doses of estrogen, up to 20-50 ng / ml, are capable of supporting the pathological growth of the endometrium.
Anovulatory menstrual cycle
Anovulatory menstrual cycle is a characteristic cause of hormonal imbalance and endometrial hyperplasia characteristic of pre- and menopause.
Interestingly, in the conditions of local (affecting the endometrium) estrogenia, the total content of female hormones in the blood can remain normal at first, then decrease, up to severe hypoestrogenism.
2. Hyperplastic changes or tumors in the ovaries - non-classical steroidogenesis.
Simultaneously with the age-related depletion of the follicular apparatus in the ovaries, a compensatory growth of the hormone-producing connective tissue begins: tekomatoz, stromal ovarian hyperplasia, tech- and granulocystic ovarian tumors.
These abnormal hormone-active structures secrete a large number of so-called non-classical estrogens that initiate uterine endometrial hyperplasia in menopause.
In older age, the formation of estrogen in adipose tissue increases by 2-4 times.
Internal fat - "trap and storage" of steroid hormones. Menopause is characterized by enhanced androgen synthesis in the adrenal cortex, in the medulla of the ovaries. They accumulate in fat depots and turn into (aromatize) estrogens.
With disorders of lipid metabolism, type 2 diabetes, obesity, the aromatization of androgens into estrogens increases significantly and the level of the latter in the woman’s body rises (hyperestrogenism).
Overweight in menopause
Obesity leads to hyperestrogenism and hyperplasia of the uterine endometrium in menopause.
In addition to estrogenia, neuroendocrine, immune and metabolic disorders occupy an important place in the pathogenesis of endometrial hyperplasia.
What diseases increase the risk of endometrial hyperplasia in older age:
- Diseases of the liver and biliary tract
- Uterine myoma
- Pathology of the ovaries (tumor, PCOS)
- Hypothalamic syndrome
- Adrenal Diseases
- Immunosuppression, autoimmune disorders
What is the danger of endometrial hyperplasia in menopause?
- First, endometrial hyperplasia provokes uterine bleeding and iron deficiency anemia.
- Secondly, there is evidence of the mutagenic effect of estrogen metabolites on cellular DNA. The risk of rebirth of typical recurrent endometrial hyperplasia in endometrial cancer against the background of chronic menopausal estrogenia is very high.
- Of particular danger is the atypical form of endometrial hyperplasia. It occurs due to gene mutations in the endometrial cells. In older women, immunity is reduced in women, the metabolism is disturbed - these and other, not quite clear reasons initiate the development of chromosomal abnormalities and foci of atypia.
Atypical endometrial hyperplasia develops against the background of “breakdown” of cellular DNA. This form of hyperplasia is considered an endometrial precancer (non-invasive cancer, cancer in situ). In older women, this pathology requires immediate radical surgical treatment.
Diagnosis of endometrial hyperplasia in menopause
- Hysteroscopy with separate diagnostic curettage.
- Histological examination.
- Histoimmunochemistry study (immunohistochemistry of IHC).
The only correct way to diagnose endometrial hyperplasia in menopause is by curettage of the uterine mucosa followed by examination of the removed endometrium under a microscope (a histological study).
Diagnostic curettage of the uterus
To determine the degree of malignancy and the differential diagnosis of complex, atypical hyperplasia, endometrial cancer, histo-immuno-chemical analysis (IHC) is used.
Endometrial aspiration biopsy with subsequent cytological examination of aspirate cannot be considered an alternative to fractional diagnostic curettage.
Biopsy is used to monitor the effectiveness of treatment of hyperplasia.
Endometrial hyperplasia in menopause often indicates ovarian pathology. Ultrasonography and endoscopic ovarian biopsy is performed to detect hormone-active ovarian structures.
Treatment of endometrial hyperplasia of the uterus in menopause
Diagnostic fractional curettage of the uterine lining is the first stage in the treatment of endometrial hyperplasia.
- stop uterine bleeding,
- remove pathological endometrial tissue.
Endometrial hyperplasia, its symptoms and treatment during menopause are ambiguous.
Individual patient management tactics are selected after a histological conclusion. Be sure to take into account the general health of women: somatic and combined gynecological pathology.
For the treatment of endometrial hyperplasia in patients over 45 years of age, estrogen-progestin oral contraceptives (COCs) are not recommended.
For women of menopausal age, the issue of preserving childbearing is not relevant. The main goal of treatment during this period is to minimize the risk of endometrial cancer. Therefore, recurrent typical and atypical endometrial hyperplasia in menopause are treated surgically.
Endometrial hyperplasia: features of the disease
Endometrium is called the inner layer of the uterus, consisting of two sublayers: the basal and functional.During the cycle, the functional layer is subject to change.
There are two outcomes of events with its increase: conception and pregnancy or the appearance of menstruation. With endometrial hyperplasia, there is a change in the structures and growth of the glands.
Violations can also be expressed in various ways:
- glands are distributed incorrectly
- violated the partition into layers
- gland growth increases,
- deformation in their structure.
It should be remembered - arising endometrial hyperplasia, what is a disease during menopause, which in itself cannot develop, appears as a result, as a result of hormonal disorders.
This disease is benign. However, due to the fact that it manifests itself in various forms, there is a possibility of complication in the form of the appearance of atypical changes, simply speaking, the formation of cancer.
Causes of hyperplasia in menopause
The development of hyperplasia begins at the time of the appearance of favorable conditions for it. The main impetus is hormonal dysfunction. The main factors affecting the appearance of the disease can be considered:
- Metabolic disease. With an excess of adipose tissue, estrogen begins to be actively produced, which leads to the disease.
- Disruption of the immune system. Immune cells mistakenly attack the uterine lining, which leads to abnormal cell division.
- Changes in the genitals due to age. Often it happens that endometrial hyperplasia occurs due to a change in the hormonal background during menopause.
With menopause, due to serious hormonal changes, a number of diseases can occur, such as endometrial hyperplasia, which can be easily treated under favorable circumstances.
- Genetic factor. This disease can be transmitted at the genetic level from mother to daughter.
- Changes in the central nervous system. Organs that regulate hormonal function undergo pathological processes.
- Diseases of the genitourinary system.
It is important to know: All of the reasons listed are not directly related to the occurrence of endometrial hyperplasia. With menopause, this phenomenon means that irreversible changes in the hormonal background occur.
The main symptoms of adenomyosis
This disease can occur in women aged 35-40 years, and in adolescents, at the beginning of puberty. As a result of research, doctors concluded that the occurrence of adenomyosis and the general condition of the body are related.
Endometrial hyperplasia, what is it with menopause is known firsthand to women during menopause, occurs due to a decrease in immunity and, as a result, a low resistance of the organism to diseases appears.
Often, the disease does not manifest itself, i.e. There are no obvious signs of its development. If she does not interfere with a woman in everyday life, then she does not require special intervention. However, when symptoms occur, consult a doctor.
Symptoms of adenomyosis during menopause is manifested as follows:
- the appearance of bleeding in varying degrees of profusion (this is one of the main signs),
- pain syndrome of a different nature,
- general malaise: weakness, lethargy, fatigue.
For any negative symptoms during menopause, it is worth conducting a detailed examination to find out what these symptoms mean and whether such manifestations are dangerous.
If these signs are present, medication is prescribed and ultrasound is performed.
Be careful! In the presence of bleeding during menopause, you should immediately consult a doctor.
Types of endometrial hyperplasia during menopause
In medicine, there are several types of endometrial hyperplasia with menopause, differing in histological structure:
- glandular and cystic,
The table below lists each type and its features:
Types of endometrial hyperplasia in menopause, what are and what it is
When you need to see a doctor urgently
Due to the fact that endometrial hyperplasia has all chances to develop into a malignant tumor, it should be identified as soon as possible and treatment can begin. To do this, twice a year, you need to visit a gynecologist and be examined. Climax is not a reason to postpone the trip to the clinic.
If, for some reason, a woman does not plan to visit the gynecologist, then the following symptoms should alert her:
- rapid fatigue and drowsiness,
- the appearance of blood discharge
- pain in the pelvic area.
With the appearance of these signs, a trip to a specialist is required. The clinic will conduct all necessary examinations, take tests and conduct histological diagnostics. An ultrasound scan is also assigned to indicate the presence of a change in the endometrial layers.
An alarm for an alarm should be to increase the layer to 7 mm or more, at a rate of 5 mm.
Complications of endometrial hyperplasia during menopause
Every disease, even the most innocuous, can carry complications. Endometrial hyperplasia is no exception. Especially often they appear during menopause, when the immune system of a woman's body weakens. The danger is that often the disease does not manifest itself and can be detected too late.
The main consequences of hyperplasia may be problems with the urogenital system. The appearance of tumors is the cause of the clamping of the urinary organs, and the flow of urine is disturbed.
Abundant uterine bleeding causes anemia, the level of hemoglobin in the blood decreases, and the woman feels constant fatigue and malaise.
The worst thing is that not detected disease in time, can lead to cancers and will have to remove the uterus. To prevent this, hormone preparations are prescribed.
It is important to know! Cancers occur, in most cases, with an atypical type of endometrial hyperplasia. This type is a running stage. In order not to get it, you should regularly undergo examinations by a gynecologist.
Endometrial hyperplasia is a treatable disease. The main thing is to recognize it in time and not allow it to pass into a cancerous form.