Lobular hyperplasia of the endometrium: what it is, treatment, and signs of the disease

Hormonal imbalances caused by abortion, uncontrolled use gormonosoderzhaschih medications, infections, stress often causes the development of such pathology as lobular hyperplasia Endometrial.

Another name - polyps (growths in the case of the unit) or polyps (when there are several). Distinguish simple and complex form of the disease.

Lobular hyperplasia - it

The uterus is lined with women three layers of the endometrium. The first is the endometrium. That it happens fetal development. This is followed by muscle, which is coated with a thin outer mucosa.

endometrium itself consists of basal and functional layers. Last undergoes monthly cyclical changes - grows with increasing concentrations of estrogen in the first phase of the cycle, increases the amount of iron, when the egg leaves the ovary, rejected and removed during menses.

When anovulatory cycles, the amount of estrogen is constantly greater, causing the growth of the endometrium. When the functional layer is increased locally, in certain areas, there arises lobular hyperplasia. Proliferation of basal layer are less common.

The nature of the disease is determined of estrogen concentration. The more, the more noticeable thickening of the functional layer. Pathology is not dependent on the menstrual cycle, is determined only by the ratio and the level of female hormones in the body.

Of the total number of gynecological pathologies, this affects more than 5% of women. Most often affects the fairer sex in the reproductive phase, but is diagnosed in adolescents, as well as in the period of premenopause, which is associated with abrupt hormonal fluctuations.

How to diagnose disease

In the diagnosis of this pathology as lobular hyperplasia of the endometrium, women accounted for complaint. The doctor must be aware of the progress and regularity of menstruation, the volume of lost blood, the presence of pain or spotting between periods.

Externally taped skin paleness due to anemia, which develops against the background of long-term blood loss, as well as tumors in the breast, such as fibroadenoma, which points to a hormonal imbalance. When the initial examination visualized uterus, the vaginal wall, color and consistency endometrial polyps and other formations.

But the outcome of diagnostic imaging methods are modern internal organs - ultrasound, hysteroscopy, curettage, as well as the study of blood hormone levels.

Dilatation and curettage procedure - curettage

Diagnosis using curettage allows us to study directly with the particles of the endometrium, which has undergone hyperplasia. The procedure is an invasive intervention and requires delivery of analyzes particularly careful preparation. Scraping hyperplasia carried out in a hospital under general anesthesia using intravenous anesthesia. The use of anesthetics is not required only if the manipulation is performed immediately after abortion or delivery, when the neck is extended.

Scraping the inner layer is carried out by means of the expander, which discloses the cervical canal. Carefully surgical spoon (curette) is scraped off a small portion of the endometrium from the different sites. Less commonly used vacuum aspirator.

Manipulation takes place almost blindly, rarely to control using a hysteroscope. It allows you to display an image on the monitor, where the visualized area of ​​tissue sampling clearly.

In focal hyperplasia scraping option is not desirable, because during the procedure remains the risk of endometrial sampling particles from healthy sites. If struck the entire surface, collecting tissue from any part of it will accurately carry out a study material.

Manipulation is considered not only diagnostic, but also is used in the treatment of various diseases, including endometrial hyperplasia. When the procedure of the upper layer of the uterus is removed, allowing you to stop the bleeding quickly.

The emergence of pathologies

The prerequisites for the development of pathology are the following factors:

1. Age-related fluctuations in hormones. endometrial lesion can occur at any age after menarche and menopause to the full, but more often - in adolescence and pre-menopausal. This is due to the fact that in this phase of a woman's life in the maximum fluctuation of hormones background, the increase in the concentration of estrogen, which causes hyperplasia. Also, the risk of disease increases after abortion, childbirth, miscarriage.
2. Progesterone deficiency and / or increased estrogen concentration. Such hormonal failure may occur in endocrine pathologies, strong stress, various gynecological diseases, including inflammatory, elevated blood pressure, metabolism disorder, diabetes, heart and vascular lesions, mammary glands and adrenal.
3. Heredity. Proven relationship of focal hyperplasia of the basal layer of the endometrium or relatives on the maternal line.
4. Chronic inflammatory lesions, uterine fibroids, adenomatosis, polycystic ovary syndrome (PCOS) - also cause hormonal failure and, as a consequence, hyperplasia.

Ascertain the cause of pathology often is possible only after removal (scraping) of the endometrium and subsequent histological examination of cells.

Classification

Violation of endometrial hyperplasia structure at developing unevenly, and depending on the nature of the disease is divided into several types.

glandular

The basis - the activity of proliferative processes in tissues of the glandular mucosa. Hyperplastic changes often progress and undergo transformation, which increases the risk of malignancy tissues. The diagnosis is made only upon histological examination.

Hyperplastic transformation is often observed in the transitional phase of a woman's life that are associated with hormonal fluctuations - in menopause, and adolescent girls. Increase the risk of fibroids, polycystic ovarian disease, endometritis, endometriosis and other uterine disease.

Development of diagnostic pathology precede or abortive curettage, surgery on the genitals.

When glandular hyperplasia of the endometrium practically disappears separation into two layers - the basal and functional. Gland gets bigger, they are located unevenly, have different shapes.

Characteristic symptoms:

• cycle disorder;
• abnormal bleeding from the vagina;
• profuse blood loss of over 90 ml per day;
• increasing the duration of menstruation;
• metrorrhagia.

Over time, may develop anemia, dizziness, weakness, anovulatory cycles, infertility.

Glandulocystica form

Glandular-cystic hyperplasia characterized menometrorrhagias - abundant menstruation. During menopause there are acyclic bleeding. The active form of the disease occur iron deficiency anemia, dizziness, decreased performance, and constant weakness.

Cystic changes characterized by an abnormal proliferation of the endometrium on the background of hormonal disorders. Is affected only a functional layer formed from tissue cysts glands in the form of cavities filled with an estrogen. If any function of endometrial estrogen appears undigested in the intercellular space, forming tumors.

Contributing factors are the genital diseases (endometriosis, endometritis, tumors and dysfunction of the ovaries), diabetes, breast disease, hypertension, obesity.

In the absence of therapy appear atypical changes - precancerous condition of uterine tissue. Glandular cells change their structure, develops adenomatosis (excessive proliferation). In 10% of cases of invasive cancer is possible.

basal

Thickening basal (sprout) layer not over the entire surface and at specific sites leads to the development of basal hyperplasia. The pathology appears after 30 years.

The inner layer of the uterus grows rapidly and uniformly, different volumes of tissue clumps formed. The value of new growths increases the closer they are to the bottom of the uterus.

The pathology is characterized by bleeding during menstruation. Perhaps the appearance of discharge between menstrual periods. Cyclical broken, blood loss more than the norm, there is tenderness. Anemia, breast fibroadenoma and other neoplasms.

atypical

Atypical cystic glandular hyperplasia is the most dangerous form of disease, since it leads to the development of cancer. There is a growth of cells, unusual in function and form to the endometrium.

Atypia extends from the functional layer, then affects the entire uterus and cervix. Most often it occurs in women after 45 years. Simultaneously the cycle is broken, there breakthrough bleeding.

The uncontrolled growth of glands contribute to the transition to the cancer in 10-50% of all cases. Atypical changes can occur both in function and in the basal layer of the endometrium or cover the entire mucous membrane, since the spreading to adjacent tissues.

Lobular hyperplasia simple

A simple form is characterized by thickening of the endometrial hyperplasia, with the presence of healthy cells without signs of atypia. More likely to develop in women after 30-35 years, the maximum number of cases registered in the period predklimaksa.

Changes in the uterine wall, in this case no signs of degeneration. The disease belongs to the background pathology, the risk of malignancy is minimal.

The modified intrauterine layer occurs thickening tissue grows local benign formation - endometrial polyp. He responds well to hormone therapy.

When a simple form of pathology may fertilization, but hampered by the attachment of the ovum and gestation, an increased risk of spontaneous abortion in the early stages.

Complex

Changing the structure with considerable endometrial glandular proliferation - complex form hyperplasia. There are structural disorders shape glands balance between stromal and glandular components mother layer.

The complex can be hyperplasia with atypia or without it. The absence of atypical changes mean that there is no risk of cancer. The presence of altered cells suggests the possibility of transformation into malignant tissues (according to various sources in 10-40% of cases).

It is changing not only the structure of the glands, reducing the amount of connective tissue elements, uterine vessels. In the presence of atypia occurs uncontrolled rapid transformation of cells, which covers not only the endometrium and myometrium but the further spread throughout the body.

Therapy

The main treatment of any form of hyperplasia - hormonal. With proper selection of drugs possible deceleration stage endometrial cell proliferation, hemorrhages and stop hormonal stabilization.

When used as a contraceptive therapy hyperplasia is restored ovulatory cycles to stabilize the ratio of progesterone and estrogen reduced thickness uterine layer.

After application of hormones is appointed:

• laser ablation - the removal of foci hyperplasia laser pulse;
• cryosurgery - moxibustion plots thickened endometrium.

Radical treatment - hysterectomy. Removal of the uterus with appendages (sometimes without them) is carried out only after prior therapy with hormones and with no effect.

ethnoscience

hyperplasia treatment of folk remedies permissible only in combination with hormone therapy. Apply these herbs and natural ingredients:

• linseed oil - used in the acute phase hyperplasia, taken orally for one month;
• aloe tincture with honey - is used for oral administration, and for douches, suppository preparations;
• peony extract, juice of burdock, nettle tincture or cucumber lashes;
• upland uterus - is considered the most effective means of reducing the active growth of the endometrium, improves immunity, suppresses inflammatory focus.

An important condition for the treatment of the disease is the observance of the principles of diet therapy. The diet includes foods rich in fiber, essential fatty acids, vitamins. Reduced consumption of sweets, fatty foods, the use of spices. To maintain the water balance of the daily fluid intake is not less than 2 liters.

Any form of hyperplasia requires an integrated approach and the proper selection of gormonosoderzhaschih drugs. According to various data to hysterectomy as a method of therapy resorting not more than 5% of cases. In women 40-45 years at the time of the operation is left appendages, to delay the onset of menopause.