Symptoms of endometrial hyperplasia

The mucous membrane lining the inside of the uterus is called the endometrium. Endometrial tissue is sensitive to female sex hormones: under the influence of estrogen, the mucous membrane grows and thickens, and the production of progesterone inhibits this process.

A significant growth of uterine mucosa cells with an increase in the thickness of its membrane in medical practice is defined by the term endometrial hyperplasia. The pathology can be local (focal) in nature or cover the entire surface of the uterus.

The cause of the formation of hyperplasia areas is the predominance of the hormone estrogen. In turn, shifts in hormonal balance are associated with:

• drug therapy including estrogen;
• polycystic ovary syndrome;
• overweight;
• menopause period.

Risk factors also include genitourinary infections, abortions, endocrine pathologies, genetic predisposition, a history of diabetes and hypertension, puberty and poor environmental conditions.

Signs of hyperplasia include lower abdominal pain and menstrual irregularities. Common symptoms of endometrial hyperplasia include:

• prolonged periods with heavy bleeding;
• spotting bleeding during menopause;
• the appearance of bleeding between periods;
• menstrual cycle irregularities (irregularity, uneven discharge, etc.);
• severe pain during menstruation (especially if such a syndrome has not been observed before);
• infertility.

However, the real danger lies in the asymptomatic course of the disease, which is quite common in clinical practice and is detected only during a visit to a gynecologist or directly during an ultrasound. The result of untimely diagnosis are various complications, as well as infertility and cancer.

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Symptoms of endometrial hyperplasia in menopause

According to experts, the formation of pathology of the uterine mucosa occurs long before menopause. And such factors as hereditary predisposition and the presence of benign diseases of the genitals play an important role here. In addition, with age, the body's defenses weaken, the situation is complicated by operations and chronic diseases (especially liver damage).

The menopause period is considered the most difficult due to the increased risk of gynecological diseases. Hyperplasia that appears at this time can develop into a malignant tumor of the uterus, which is why women are recommended to undergo routine examinations without waiting for alarming symptoms. The risk group includes women over 50, suffering from diabetes and hypertension, metabolic disorders, and those who are overweight.

Against the background of fluctuating hormonal levels and decreased ovarian function, symptoms of endometrial hyperplasia include:

• heavy and prolonged bleeding;
• spotting, bloody, scanty discharge;
• detection of polyps.

Unfortunately, symptoms of endometrial hyperplasia do not always manifest. Latent development of the pathological focus is fraught with late visits, when the disease process has reached its peak, and treatment requires colossal efforts.

The pathology can be diagnosed by transvaginal ultrasound or aspiration biopsy. The latter study often gives false data in case of focal lesions. The thickness of the endometrium is normally up to 5 mm for the climatic period. Finding the mucous membrane in the range from 6 to 7 mm is a reason for observation and repeated ultrasound. When the indicator reaches 8 mm, curettage of the mucous membrane is used with subsequent study of the biological material (before and after the procedure, the uterine cavity is examined using a special probe).

Symptoms of endometrial hyperplasia in postmenopause

Postmenopause lasts for several years, during which the ovarian function completely fades. The new physiological stage in a woman's life is characterized by a decrease in the production of sex hormones - estrogen and progesterone, which affect not only the reproductive organs, but also the digestive, nervous, musculoskeletal system, brain, skin and hair.

Enormous changes in the functioning of the ovaries often occur with the development of cysts, which do not make themselves known until the rupture or bending of the stalk, or, on the contrary, manifest themselves in severe pain syndrome. Such cysts and disordered division of endometrial cells often give a large percentage of malignant tumors.

As already mentioned, changes in the reproductive system during the postmenopausal period occur with a decrease in estrogen production, which explains the negative impact on the sexual sphere in the presence of various climatic dysfunctions. An alarming sign is the appearance of bloody discharge of any type - profuse, scanty, etc. Symptoms of endometrial hyperplasia in postmenopause include cramping pains in the lower abdomen, which characterize the development of large polyps. The postmenopausal period is characterized by single polyps against the background of atrophy of the mucous membrane.

Symptoms of endometrial glandular hyperplasia

The term "glandular hyperplasia" appeared as a result of the characteristic development and enlargement of the glands of the uterine endometrium. Glandular hyperplasia is considered a precancerous pathology. The absence of proper treatment leads to an atypical form of hyperplasia with the formation of cells resembling cancer cells in structure.

A clear sign of glandular pathology is considered to be a violation of menstrual function, manifested by various bleeding. Symptoms of glandular hyperplasia of the endometrium:

• cyclical bleeding (menorrhagia) – heavy and longer than normal menstruation;
• acyclic bleeding (metrorrhagia).

Discharges in glandular hyperplasia usually occur after a short delay or between periods. During adolescence, active bleeding with clots is possible.

Against the background of heavy and prolonged bleeding, symptoms of glandular endometrial hyperplasia include weakness, malaise, anemia and dizziness, even loss of consciousness.

Signs of endometrial hyperplasia by ultrasound

An ultrasound examination of the uterus is prescribed to assess changes occurring in the reproductive organ, to identify the thickness of the mucous membrane with the location of hyperplasia areas and polyps. The technique is carried out with a special sensor inserted into the vagina. Ultrasound is an inexpensive, non-invasive, painless and quite informative diagnostic method. Thanks to ultrasound examination, a qualitative and quantitative assessment is made according to echographic indicators corresponding to a certain menstrual phase.

The endometrial mucosa is characterized by clear contours and significant acoustic density compared to the myometrium (muscle layer), located in the middle relative to the external contour of the uterus. The thickness of the mucous membrane is affected by the monthly cycle: in the first phase, the wall size does not exceed 3-4 mm, in the second it reaches 12-15 mm. Uniform thickening with pronounced smooth contours and homogeneous echogenicity are signs of endometrial hyperplasia according to ultrasound. Polyps are neoplasms with clear boundaries, a thin echogenic rim and high acoustic density. Malignant changes are characterized by non-uniform echogenicity and jagged contours.

Signs of glandular hyperplasia of the endometrium

The glandular form of hyperplasia is characterized by thickening of the endometrium with active division of glandular cells, the location of which is not uniform (often group accumulation is observed). The pathological condition may occur in the absence of pronounced signs. That is why patients do not always describe the symptoms of endometrial hyperplasia, and complaints extend to metabolic and endocrine disorders:

• headache;
• sleep problems;
• excessive and unexplained weight gain;
• decreased performance;
• severe thirst;
• irritability.

The main signs of glandular hyperplasia of the endometrium are uterine bleeding, which occurs as a result of dysfunction of the monthly cycle. Discharge can be weak/strong, prolonged/short. The development of hyperplasia is also indicated by spotting, not associated with menstruation. Failure to conceive and pain syndrome localized in the lower abdomen are often harbingers of pathology of the uterine mucosa.

If you notice any of the listed negative conditions, do not delay your visit to the gynecologist. Timely diagnosis of hyperplasia allows for quality therapy and avoidance of unwanted complications.

Signs of focal endometrial hyperplasia

Focal hyperplasia is characterized by the growth of the endometrium in areas most sensitive to the action of hormones. Local lesions cover an area of several millimeters or centimeters. Externally, this is manifested by several polyps.

A sufficient level of progesterone and luteinizing hormone is required for the release of a mature egg from the follicle. Excess estrogen inhibits the egg, prolongs the first phase of the cycle, delays ovulation and provokes the growth of the uterine mucosa. The first signs of focal endometrial hyperplasia appear in the form of profuse and prolonged bleeding. The pathological process can be suspected by acyclic bloody, scanty discharge of a short duration.

It should be noted that the lack of estrogen hormone does not ensure the maturation of the egg and its subsequent exit from the follicle. In this case, the mucous membrane is partially rejected and polyps are formed. Symptoms of endometrial hyperplasia persist - menstruation of varying intensity lasts up to 10-14 days.

Echographic signs of endometrial hyperplasia

In order to differentiate hyperplasia and monitor the effectiveness of treatment, it is advisable to conduct an ultrasound examination on the 5th-7th day of the cycle. The accuracy of the study of identified hyperplastic transformations is 90%, and of detected endometrial polyps - 60-80%. The information content of the screening method varies depending on the patient's age, the experience of the diagnostician and the operating characteristics of the device itself.

Echographic signs of endometrial hyperplasia:

• the thickness of the median uterine structure ranges from 14.6 to 15.4 mm;
• polyps correspond to a size of 16.1-17.5 mm;
• Adenocarcinoma can be suspected when the values are 19.7-20.5 mm.

For the postmenopausal period, a sign of mucosal hyperplasia will be reaching an M-echo value of 5 millimeters or more.

The main ultrasound symptoms of endometrial hyperplasia:

• increased sound conductivity;
• smoothness/unevenness of the M-echo contour;
• the nature of endometrial heterogeneity;
• inclusion of echo-negative or echo-positive various structures;
• changes in the relief of the uterine mucosa.

The detection of the above-mentioned signs during ultrasound examination indicates the presence of hyperplasia.

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