Endometrial hyperplasia in postmenopause (uterus in menopause): curettage (reviews), ultrasound norm

Not all women who are faced with the symptoms of menopause are in a hurry to see a specialist. This leads to the development of pathological processes. Endometrial hyperplasia in postmenopausal women is the most dangerous complication, as it often develops into a cancerous tumor.

In order not to become a victim of irreversible consequences, every woman must learn to recognize the symptoms of hyperplasia at an early stage (after all, the early stages of the disease are cured and do not threaten life). It will also be useful to find out what leads to endometrial pathologies in menopause and how doctors deal with them.

Endometrium in menopause

Fluctuations in the hormonal background, especially noticeable in the menopausal period, affect the thickness of the functional membrane:

Endometrium (structural link)
Estrogen level
Progesterone
Epithelium of the glands
Activates cell proliferation
Prevents tissue growth.
Uterine glands
Stimulates growth
Limits growth. It activates the secretion of the glands, ensures their structural restructuring.
Stroma
Weakly affect
Accelerates growth.

In pre-menopause

The menstrual cycle is disrupted, ovulation occurs less and less. A healthy woman has a transitional endometrium.

In menopause (the period of the last menstrual period)

The mucous tissue begins to grow a little (if this happens slowly, do not worry). About half of women develop cysts. Before menstruation, the endometrium is slightly thickened, after the last cyclic bleeding it becomes thinner. Then functional hypoplasia develops.

Postmenopausal

The transitional form of the mucous layer remains in this period, but only for 3-5 years. Over time, physiological atrophy and termination of endometrial functionality occurs.

But not always changes in the thickness of the mucous layer during menopause are of a physiological nature. Its excessive growth indicates the presence of a pathological process and requires treatment. At the slightest suspicion of a violation, the doctor prescribes an ultrasound (ultrasound) scan, which will show the extent of the problem with maximum accuracy.

If, according to the results of ultrasound in menopause, the thickness of the endometrium is not more than 5 mm, this is the norm. Patients with increased rates are assigned ultrasound monitoring, which allows monitoring the further development of events (the study is carried out every 3 months).

The thickness of the lining of the uterus exceeding the 7 mm mark indicates the presence of the disease. To find out the cause of the disorder, the patient is referred for diagnostic curettage.

If the thickness of the mucosa is 12 mm or more, each layer is scraped out separately for examination of the biomaterial in a histological laboratory. This is the most important diagnostic measure that allows you to choose the optimal method of treatment.

The climacteric period negatively affects the state of the female body and especially the functionality of the reproductive system. A regular visit to a gynecologist will help to identify problems at the initial stage, to avoid the development of incurable complications.

Forms of GGE

Hyperplasia is a pathological proliferation of cells and thickening of the mucous membrane of the genital organ. The main "culprit" of GGE is hormonal imbalance caused by the extinction of ovarian function.

Almost half of women in menopause develop endometrial hyperplasia of the uterus.

The prognosis of the disease depends on the timeliness and correctness of treatment, and in the early stages it is completely cured. In 70% of cases, medical neglect leads to the development of malignant processes.

No less often with menopause, adenomyosis is diagnosed - a type of pathology, with a characteristic proliferation of the functional layer in the uterine cavity.

Each form of GGE has its own characteristics:

1. Glandular hyperplasia. Pathological growth and improper location of glandular tissue, not accompanied by changes in connective tissue structures. Launched on its own, it can develop into a glandular-cystic (precancerous) form with the formation of cysts in the glandular layer.
2. Glandular cystic. On the mucous membrane of the genital organ, cystic formations are formed, filled with secretory fluid. In menopause, glandular cystic hyperplasia of the endometrium of the uterus is rarely diagnosed, and without timely treatment, 7% of patients develop into cancer.
3. Polypoid hyperplasia (focal). One of the most dangerous forms. Uneven proliferation of endometrial tissue leads to the formation of polyps. Benign growths on a thin stalk are of different sizes and tend to become malignant.
4. Atypical hyperplasia. A dangerous, but fortunately rare form of pathology. It is characterized by a pronounced pathological change in the deep layer of the endometrium. Often leads to tissue degeneration and is practically not amenable to treatment (the only effective way is to remove the uterus). In 10% of cases it ends with oncology.

By localization, hyperplasia is divided into groups:

• diffuse (the mucous membrane grows evenly, undergoes mixed transformations);
• focal (uneven growth of various parts of the endometrium).

Attention! Self-medication of hyperplasia is unacceptable. Only a gynecologist, familiar with the results of analyzes and ultrasound studies, is able to determine the form, stage of the pathological process and only after that prescribe treatment.

The reasons for the development of hyperplasia

After 43–47 years, the growth of the endometrium is due to hormonal disorders (an acute shortage of progesterone and the unlimited effect of estrogen on the functional layer of the uterus). Especially often, the reasons for the enlarged endometrium in the uterus during menopause are as follows:

1. Heredity (if close relatives have encountered a similar diagnosis, the risk of developing hyperplasia increases).
2. Diseases of the reproductive system, including those that have arisen during puberty.
3. Irregular menstrual cycle.
4. Endocrine system pathologies (thyroid dysfunction, diabetes mellitus).
5. Metabolic disease.
6. The presence of polyposis foci.
7. Myoma, uterine adenocarcinoma, endometriosis.
8. Chronic endometritis.
9. High blood pressure (above 140/90 mm. rt. Art.).
10. Overweight, obesity.
11. Long-term and uncontrolled use of estrogen drugs, contraceptives.
12. Manipulations in the uterine cavity (curettage, cesarean section, abortion, IUD insertion, surgery).
13. Pathology of the liver, biliary tract.
14. Age-related changes in the mucous membranes, accompanied by a decrease in local immunity.
15. The presence of bad habits (smoking, alcohol).
16. Decreased immune properties, disorders of the autoimmune nature.

It is important to understand that with the onset of menopause, even an absolutely healthy, with good genetics, a lady is vulnerable to any kind of disease. And it's not even about age, but about the deficiency of female sex hormones. After all, it is estrogens with progesterones that ensure the full functioning of organs and systems.

Signs of hyperplasia during menopause

Some women are not even aware of their illness. The fact is that forms of hyperplasia can have an asymptomatic course, but this does not happen often. Often, the hyperplastic process in the uterine cavity has characteristic manifestations.

In most premenopausal patients, their periods are 1–3 months late, and then come for a long time and are abundant (more than 3 pads per day). Cyclicity persists much less often. But in such cases, menstruation is accompanied by severe pain. In isolated cases, bleeding with clots occurs after the cessation of menstruation.

As practice shows, pronounced symptoms appear in the late stages, in the phase of rejection of the mucous layer. First, a bloody "daub" appears on the underwear, then profuse bleeding begins, as during menstruation.

Also may be present:

1. Obesity.
2. Increased insulin levels in the blood.
3. Pronounced manifestation of masculine traits: male-pattern hairiness, coarsening of the voice.

Specific symptoms of hyperplasia include:

• the development of secondary infertility (a rich intimate life during the year does not lead to conception);
• early miscarriages;
• chronic pathologies of the organs of the reproductive system;
• mastopathy;
• uterine fibroids;
• aching pains in the lower abdomen (usually with polyps);
• whitish-grayish discharge;
• spotting during sexual intercourse.

Attention! Uterine bleeding that occurs during menopause or postmenopause requires an urgent gynecological examination and diagnosis.

Treatment methods

Dysplasia of the endometrium of the uterus, diagnosed during menopause, is treated conservatively or surgically:

The essence of drug treatment is the elimination of hormonal imbalance caused by a decrease in the functionality of the ovaries.

To stabilize the estrogen-progesterone level, synthetic progestogenic hormones are prescribed. They are injected or taken as pills.

Some patients are offered hormonal IUDs. But this method of treatment is suitable for young girls and completely unacceptable for women of menopause.

If the bleeding does not stop, threatening the patient's life, or there is a possibility of the degeneration of the hyperplastic process into oncology, a surgical operation is prescribed:

1. To diagnose and stop severe bleeding, fractional curettage is used - the mucous membrane is scraped off the uterine walls with an instrument.
2. If malignant cells, deep tissue damage or a high probability of degeneration are detected, a hysterectomy is prescribed (partial or complete removal of an organ with a laparoscope). If the ovaries are involved in the pathological process, they are also removed.

You should not categorically refuse surgical intervention, because sometimes drug treatment does not give the desired result. If you doubt the advisability of curettage, study the reviews of women who have cured endometrial hyperplasia in postmenopausal women with surgery. Yes, the procedure is not the most pleasant and requires further medical support, but is this too high a price to pay for a pain-free life?

ethnoscience

Nettle, peony, plantain, hawthorn and many other herbs are able to regulate hormonal levels, but their use for hyperplasia is possible only after consultation with a doctor. Otherwise, hormone-containing components or allergens can cause a negative reaction of the body, aggravate the course of the disease.

Possible complications

It is dangerous to ignore hyperplastic processes in the uterus. Neglect of medical help and refusal of treatment can lead to serious consequences:

• tumors, cystic formations in the appendages;
• anemia provoked by profuse, prolonged bleeding;
• oncological pathologies.

Age-related changes in hormonal levels bring many "surprises" in the form of diseases of the reproductive system. Most of them threaten a woman's life and require urgent therapy. Regular monitoring of the state of the mucous layer of the uterus for endometriosis with menopause is the only right solution for the timely detection of a disease, a developing polyp, endometrial hyperplasia, oncological neoplasms, etc. etc. Monitor the state of your body and your efforts will not be wasted.