The onset of menstruation is regulated by cyclic changes in the endometrium. This mucous membrane, lining the inner surface of the uterus, reacts to the level of hormones, is rejected monthly, causing blood to secrete during regulation. The functional layer changes depending on the phase of the cycle. The outer basal stem cell is characterized by a constant structure and thickness.
Any endometrial pathology causes not only a cycle failure, but also complications during gestation, infertility. Thickening of the mucous membranes (endometrial fibrosis, endometritis) makes it difficult to attach the ovum, resulting in a spontaneous abortion in early pregnancy. When cells degenerate into malignant (atypical form), cancer occurs in 10–55% of cases.
Endometrial diseases have common symptoms:
- Abnormal bleeding. By the end of the second phase of the cycle, the inner mucous membrane layer is rejected, and menstruation appears. In case of violation of its structure, “desquamation” of tissues occurs more actively, acyclic bleeding may occur, the amount of discharge during menstruation increases. Metrorrhagia, hyperpolymenorrhea develops.
- Infertility. The main condition for successful attachment of a fertilized egg is the ability of its villus to penetrate the functional layer inside the uterus. With its thickening or thinning this will not happen.
- Miscarriages, spontaneous abortions. Any pathology of the functional layer of the uterus does not create the conditions necessary for the development of the fetus. Abortion is more common at 4–7 weeks.
- Pain during menstruation. Sex hormones estrogen with increasing concentration leads to the appearance of cramping pain in the lower abdomen, sacrum, lower back.
- Regular acyclic discharge of blood provokes significant changes in the analyzes. In the presence of inflammation, leukocytes in the blood increase, the ESR accelerates. With heavy bleeding, hemoglobin decreases, anemia may occur.
- The development of tumors. By benign include cysts, polyps, fibroids, fibroids. More dangerous are malignant tumors that develop from atypical endometrial cells.
- In postmenopausal pathology of the endometrium may indicate the appearance of symptoms such as bleeding, not related in time to possible menstruation, fatigue, irritability, headache and pain in the lower abdomen, thirst.
- Hormonal imbalance. In most cases, it becomes the impetus for the growth of the endometrium. Disruption of the balance of sex hormones (increased estrogen and reduced progesterone) threatens with infertility, habitual miscarriage, spontaneous miscarriage.
In the initial stages of the disease, the endometrium is asymptomatic. Only in the case of bacterial or viral inflammation, acute pain occurs, purulent discharges appear, and the temperature rises.
The pathology of the uterine lining depending on the presence of atypical cells is divided as follows:
- Benign education. These include cystic and glandular hyperplasia, polyps, endometriosis, endometritis.
- Malignant tumors: atypical endometrial hyperplasia, cancer. Atypical form is divided into adenomatous and glandular. The first is characterized by a large variety of morphology, progressive proliferative changes and a rapid transition to invasive cancer.
- atypical - identification of morphologically altered cells
- non-typical — during the cytology of mucosal tissue, only healthy cells are detected.
Causes of inflammatory processes can be infections, sexually transmitted diseases, and bacteria. Also, various background pathologies lead to an increase in the incidence - hormonal disruption, endocrine system malfunction.
What pathologies are
The growth or thinning of the endometrium, the appearance of atypical cells can cause pathologies of different manifestations - hypo or hyperplasia, atypical forms, adenomatosis, endometriosis, focal fibrosis of the stroma, polyps, papillomas, hypo and hypertrophy of the mucous membrane, endometritis.
Most pathologies have a connection with hormonal balance. Also, the uterine layer may be affected by gonococci, streptococci.
Thinned or thickened loose endometrium causes more dangerous diseases and pathologies of pregnancy. Most often, the first symptom is menstrual disorders, endometrial fibrosis may develop. In the presence of other pathologies, especially endocrine, as well as in the phase of menopause, the risk of malignant tissue degeneration increases.
Pathology in menopause
Climacteric changes on the background of hormonal imbalance cause not only the absence of menstruation, but also changes in the endometrium. The body's immune defense weakens, reproductive function fades away, estrogen and progesterone are practically not synthesized, which negatively affects the state of the uterine mucosa.
During pre-climacteric, postmenopausal endometrium, hyperplasia is predominantly exposed. This is facilitated by:
- liver pathologies,
- hypertonic disease,
In normal condition, the M-echo of the uterus does not exceed 5 mm. With an increase in the layer to 6–7 mm, dynamic monitoring is carried out with regular ultrasound of the cervix and uterus every 3 months. On the pathological process says the thickness of the endometrium more than 8 mm. Scraping is carried out if it exceeds 12–13 mm, which is a signal of a possible malignancy of the cells.
- Atypical. Such a condition of the mucous is considered precancerous, in a quarter of cases there is a degeneration into a malignant neoplasm.
- Non-atypical - focal, glandular-cystic, glandular.
The most common is glandular hyperplasia. In menopause develops long-term, asymptomatic, but can be reborn without treatment.
Glandular-cystic forms are diagnosed less frequently, in 6% of cases there is an atypical course. Focal hyperplasia is the most dangerous, characterized by the appearance of polyps predisposed to malignancy.
In the period of menopause, the pathology is manifested by the following symptoms:
- irregular and painful menstruation,
- appearance of blood smears twice in a cycle,
- frequent delays
- uterine bleeding,
- increase in duration up to 10–14 days.
As the reproductive capacity decays, the stroma function is disturbed, the endometrium is prone to growth and the appearance of tumors. Even with a successful course of menopause and the absence of symptoms, it is necessary to conduct examinations and monitor the condition of the uterine mucosa.
Thinning or thickening of the inner uterine membrane threatens with fetal complications, female infertility and other pathologies. The thickness of the endometrium for conception in the first trimester should be 7-15 mm. In hypoplasia (thinning), this probability is reduced, since there are no conditions for a steady implantation of the egg. With hyperplasia (thickening), anovulatory cycles predominate, and in the event of pregnancy, the fertilized egg can not be fixed on the wall of the uterus.
The reasons for changes in the structure of the endometrial layer during pregnancy are the following factors:
- hypoplasia of the uterus - a genetically determined insufficient synthesis of hormones, the underdevelopment of the reproductive system,
- hormonal imbalance - violation of the luteal phase, increase in prolactin,
- circulatory disorders - vascular system structure features, acquired pathologies on the background of inflammatory diseases, surgical interventions,
- endometrial injuries after curettage of a portion of uterine tissue, labor, and abortion.
Endometrial disorders can cause pregnancy pathologies such as:
- premature interruption
- placental abruption,
- fetal death,
- endometrial detachment,
- abnormal placenta with impaired blood flow.
Endometrial pathology therapy is carried out before pregnancy. Usually use hormonal agents, less often - surgical methods.
Menstrual cycle after removal of the endometrium
Scraping is a routine diagnostic procedure, rarely performed urgently in a condition that threatens a woman’s life. Manipulation is performed 2–4 days before the beginning of a new cycle; during the menstruation, no tissue is taken for research.
After curettage of the endometrium, menstruation does not begin immediately, and later cycle failures may occur. Within 5–7 days, daubing occurs due to microdamages of the mucous membrane. Maximum on the 10th day after the removal of the endometrium should go full monthly.
The following cases are considered violations:
- bleeding lasts 10 days or more,
- heavy bleeding begins,
- monthly periods abruptly stop
- there is a secretion of yellow and green with an unpleasant smell,
- subfebrile or fever,
- there is pain in the lower back or abdomen.
Complications of classical curettage can be:
- cycle failure after removal - usually lengthening up to 35 days or more,
- formation of adhesions,
- decrease in the amount of monthly discharge, which can be observed on the background of a spasm of the cervical canal.
Pregnancy planning after removal of the uterine layer can be no earlier than 3 months.
Methods of diagnosis of diseases
The most informative procedure that allows to study the structure, thickness of the endometrium, is diagnostic curettage. It is carried out in the following cases:
- suspected cancer,
- diseases of the uterus,
- finding out the cause of infertility
- bleeding from the uterus of unknown origin,
- complicated by bleeding premenstrual syndrome.
For therapeutic purposes, the procedure is used to remove synechias and polyps. Also, the procedure is carried out in the case of an abortion performed abnormally, curettage is performed during a missed abortion, after giving birth in the presence of placental remnants.
Biopsy - taking particles of the layer for further histological examination. It is carried out with a syringe, which with the help of a special design creates negative pressure inside the cylinder and sucks mucous cells inside.
The study of pathology on ultrasound allows you to set the exact thickness of the endometrium. Ultrasound is also used for therapeutic purposes in certain pathologies of the uterine lining.
- borders, exact dimensions and position of the uterus,
- echo wall,
- endometrial layer thickness.
When diagnosing, echo signs of malignant cell degeneration can be detected. In this case, a more informative examination is required, most often a biopsy.
Prevention of complications
Treatment of endometrial pathologies is carried out depending on the cause of the disease:
- Conservative methods. Used drugs based on hormones. Also used for detoxification of the body and antibacterial drugs.
- Surgical treatment. Curettage or other methods of curettage are used for heavy bleeding and for simultaneous taking of material and further examination. A hysteroresectoscopy is also used, during which polyps and the diseased endometrial layer are removed. The most radical surgical method is hysterectomy. In this case, simultaneous removal of the organ with the ovaries is possible.
With the preventive purpose use other drugs:
- immunostimulants to strengthen the body's defenses
- anti-inflammatory drugs
- antispasmodics and painkillers - shown in case of acute or aching pains, to relieve uterine spasm,
- antipyretic - used symptomatically.
Intrauterine systems can also be used with the gradual release of therapeutic substances, mainly hormones. If the pathology causes a delay, acyclic bleeding, optimally the regular use of COC.
Locally used suppositories that are inserted into the vagina, with the content of antiseptics, bactericidal substances. Self-cooking candles are suitable for supplementing therapy prescribed by a doctor.
To minimize the risk of complications of endometrial pathologies using regular gynecological examinations, transvaginal ultrasound to clarify the thickness of the layer, reduce the frequency of scraping and abortion.
Endometrial pathologies are diverse both in clinical manifestations and in causes. The most characteristic and primary symptom is menstrual disorder - the appearance of bleeding in any phase of the cycle, profusion and / or soreness.
Causes of pathologies
The inner mucous layer of the uterus is called the endometrium. It is because of his rejection during menstruation that bloody discharge occurs.
Depending on the phase of the menstrual cycle, the endometrium will have a different thickness. This layer is intended for implantation of the embryo and its further development in the uterus, if this function is not performed, that is, conception has not passed, the endometrium exfoliates and leaves the female organ in the form of menstrual discharge. After the end of the monthly endometrium begins to grow again.
Inflammatory processes in the uterus, and infectious diseases can provoke problems in the development of the endometrium. There are a number of other causes of diseases of the inner uterine layer:
- endocrine diseases
- gynecological interventions
- polypous growths
- hormonal imbalance.
Endometrium may grow excessively due to a decrease in estrogen production in the body. In this case, the inner layer is not rejected, but accumulates. Problems with metabolism, thyroid disease, hypothalamus, pituitary, and tumors in these organs can affect the normal functioning of the endometrium. Medical or diagnostic operations can adversely affect the state of the inner uterine layer. Also, endometrial diseases can be inherited by the genus. In women of reproductive age, the most common causes of these problems are sexually transmitted diseases, abortions and complicated births.
Endometrial pathologies may have a number of specific symptoms, but they also have common symptoms, at the appearance of which a woman must necessarily seek the help of a specialist:
- bleeding. This can be a profuse anovulatory blood loss, which occurs after a long delay of menstruation, discharge goes long and abundantly, there may be many clots. Bleeding can occur between the regulations, and in the intermenopausal bleeding will be smearing,
- pain sensations. Pain is not typical for all diseases of the endometrium, in some cases it may be mild discomfort or moderate pain in the lower abdomen, most often there is no pain at all,
- infertility. Sometimes the long-term inability to conceive a child is evidence of endometrial diseases, with absolutely no other symptoms. Infertility is not characteristic of all diseases of the internal uterine layer,
- pale skin, increased fatigue, dizziness - these signs are consequences of anemia caused by severe blood loss,
- menstrual irregularities. The cycle may become irregular, periods pass too plentifully and with severe pain.
Some endometrial diseases may have their own symptoms, which will help the doctor in determining the diagnosis:
- endometritis may be accompanied by increased body temperature up to 38-39 ° C, excessive sweating, depression, purulent impurities may occur in the menstrual flow,
- with endometriosis haemorrhage may occur a few days after the end of menstruation, in special cases, bleeding may appear in the urine or out of the anus, navel or nose.
Diagnosis of endometrial diseases involves the following procedures:
- gynecological examination, during which the gynecologist can detect foci of endometriosis in the genital area, different in color from the surrounding tissues,
- after gynecological examination and examination of the patient for diagnosis the doctor must prescribe an ultrasound, which can be performed both transvaginally and abdominally. Ultrasound shows the degree of development of the disease, the nature of the processes occurring in the tissues and the structure of the formations. This diagnostic method is well detectable cysts and other structures with a diameter of less than 1 cm,
- If endometriotic lesions are suspected outside the reproductive system, laparoscopy may be prescribed, during which, in addition to diagnostics, a disease can be treated,
- if the doctor does not have a clear idea of the disease, it can be assigned biopsy of the affected area,
- hysteroscopy - surgical method for the study of the uterus, which is carried out in an outpatient clinic or hospital.During the procedure, the image of the inner layer of the uterus is displayed on a computer monitor, and the doctor during hysteroscopy has the opportunity not only to determine the degree of development of the pathology, but also to remove a small tumor.
We give feedback from women who know first-hand what endometrial diseases are and how they should be treated in each specific case:
3 months ago I became a mother, but, despite breastfeeding, as early as 56 days after giving birth I started my first menstrual periods, I turned to a gynecologist. He appointed an ultrasound of the pelvic organs, which I did on day 13 of the cycle. It turned out that already at this time the thickness of the endometrium was 1.5 cm. The doctor diagnosed “endometrial pathology, endometrial hyperplasia in question.” An analysis of hormones showed that I have an increased concentration of estrogen, and progesterone is not enough, which provoked the advent of regul, despite lactation, and the growth of the inner layer of the uterus. Now I was prescribed hormone therapy, if it does not help, they will be curettage,
Valentine, 30 years old
It all started with an irregular cycle, I did not pay attention to it, but in vain. After another delay, bleeding began, and scraping was performed in the hospital. Histology showed that I have glandular hyperplasia. They prescribed a course of antibiotics, then Janine’s oral contraceptives, which after 6 months were replaced with Duphaston. The whole treatment took about one and a half years, now I am preparing for pregnancy,
Somehow I was diagnosed with uterine endometrial hyperplasia. The doctor decided not to resort to scraping, but prescribed hormone therapy for me. Analysis of hormones showed a lack of progesterone, so the gynecologist prescribed Utrozhestan. After 5 months, my condition improved, and the menstrual cycle returned to normal.
How can I classify?
Often, under the influence of hormonal disruptions, hyperplasia or aplasia of the endometrium occurs. Hyperplastic processes in turn divide:
- Endometrial polyposis.
- Polyps. They relate to both the pathologies of the mucous membrane and the pathologies of the endometrium of the uterus.
- Hyperplasia is not typical (adenomatosis).
Also refer to the pathologies of the endometrium:
- Various kinds of adhesions arising after abortions, surgical interventions, coils, endometritis.
- Onco endometrial disease.
- Particles of the ovum.
Symptoms of the most common pathology - hyperplasia
Symptoms of endometrial hyperplasia are a consequence of hormonal failure, namely, an excessive amount of the hormone estrogen. Symptoms in women can manifest themselves in different ways, but perhaps the process is generally asymptomatic. Typical symptoms:
- Bleeding. They can be anovulatory - after a delay in menstruation, copious, prolonged, blood with clots. Bleeding between periods. Spotting, smearing observed in intermenopause.
- Pain. It may not be a sign, as in some cases it is absent, or moderate pain is observed in the lower abdomen.
- Infertility. Smith, which can sometimes be the only sign of hyperplasia. Although the direct cause of hyperplasia is not.
- Pallor, fatigue, dizziness - effects of anemia from severe uterine bleeding.
Another disease caused by pathological changes in the endometrium is the endometrial polyp of the uterus.
Polyp tend to have a different shape and act above the mucous membrane of the uterus.
Polyps are very dangerous, as they not only cause some discomfort in a woman, but unpleasant consequences.
Polyps in turn can be classified:
- Polyp, which develops due to the stroma and glands (glandular).
- Develops due to connective tissue (fibrous).
- Combined glandular and fibrous
A common endometrial polyp in the uterus does not cause clinical symptoms. Often it may be found during the examination by the gynecologist at ultrasound, but also when looking for the causes of infertility.
The effects of polyps
- Violations in the menstrual cycle of women.
Since a polyp on the mucous membrane of the uterus can be triggered by hormonal disruption, this can not but affect the menstrual cycle. If a polyp exists for a long time, it causes:
- menstrual cycle is not regular,
- massive bleeding without cycle
- large volume of blood secreted during menstruation, hyperpolymenorrhea,
Such hemorrhages in soybeans turn into anemia, which cannot but affect the general well-being of the woman.
If a polyp is not diagnosed or treated, then its presence in the uterus may trigger anovulation. As a result, the egg is not able to mature, and as a result a woman cannot become pregnant. But if the egg came out, and fertilization took place, miscarriages are possible in the first weeks. Because pathological changes in the endometrium do not allow the egg to normally attach to the walls of the uterus.
Among other things, if a woman managed to get pregnant, if there is a polyp, then this also has its own risks, and this should not be forgotten.
How to diagnose?
It is possible to confirm or deny whether there are any changes in the mucous membrane of the uterus by means of visual inspection of the cavity. Hysteroscopy is the method that gives this opportunity. You can also use such a method as curettage for the purpose of diagnosis, but it is worth noting that there is a chance of not completely getting rid of pathological changes in the endometrium of the uterus, which can later lead to the late diagnosis of malignant tumors.
If a patient has a postmenopause, the doctor suspects endometrial pathology, then hysteroscopy is a mandatory diagnostic method.
This method of diagnosis greatly enhances the effect of treatment, since it is possible to know exactly what changes occurred in the endometrium. Ultrasound scanning, which is performed both transvaginally and abdominally, should also be included in the examination complex.
What is the treatment method?
Scraping for diagnostic purposes is also one of the treatment methods. Because during curettage, the gynecologist receives not only material for further histology, but also removes the pathologically changed mucous membrane. The results that the doctor will receive after hysteroscopy will enable him to correctly prescribe treatment.
Treatment activities include both conservative therapy and surgery. Therapeutic treatment is to restore the desired level of hormones in the body of a woman, for this purpose prescribed hormones. But it should be borne in mind that such drugs are attributed, not only taking into account changes in the endometrium, but also age, other diseases of a woman and much more.
Since a significant number of diseases of the reproductive system of women have become malignant, doctors have become more radical in their treatment.
Surgical intervention is carried out in order to reduce the likelihood of neoplasms. For women who are postmenopausal, active tactics are chosen. This is due to the fact that at such an age, the pathology of the mucous membrane can become a ground for the development of oncology, therefore, promptly applied surgery can be considered the prevention of the development of oncology of the uterus.
Women who are still young and want to have children in the future are prescribed conservative therapy. In such cases, hormone drugs are attributed, for a long time, with frequent examination of the uterus.
Endometrial pathology: causes, diagnosis, treatment
Endometrium is the inner mucous membrane of the uterus, which has two layers: functional and basal. The basal layer has a constant thickness and structure. The stem cells that make up it are responsible for restoring (regenerating) the layers of the endometrium. The functional layer has a different dynamics, responsive to the concentration of female hormones. Due to changes in the functional layer, menstruation comes every month. That it is an indicator of women's health. If there is any endometrial pathology, there are often failures in the menstrual cycle.
If it is expressed figuratively, the endometrium can be compared to a cradle, which in a certain period is ready to receive a fertilized egg. If this does not happen, then there is a rejection of the functional layer, which is reborn after menstruation.
Endometrium, the norm of the thickness of which is different, by day of the cycle has different indicators:
- 5-7 days. During the early proliferation phase, the endometrial thickness does not exceed 5 mm.
- 8-10 day. Endometrium thickens to 8 mm.
- 11-14 days. In the late proliferation phase, the thickness reaches 11 mm.
After this, the secretion phase begins. During this period, if there is no endometrial pathology, the layer becomes more friable, thickens.
- 15-18 days. Thickness reaches 11-12 mm.
- 19-23 day. The maximum thickness of the endometrium. The average is 14 mm, but can reach a maximum of 18 mm. The layer becomes more loose, "fluffy."
- 24-27 day. Thickness begins to decrease slightly, it becomes from 10 to 17 mm.
Such here are the phases of the endometrium. During menstruation, the thickness of the endometrium decreases, reaching only 0.3-0.9 mm.
If a woman has menopause, what should be the endometrium? The normal layer thickness is 5 mm. The slightest deviation of 1.5 or 2 mm should cause alertness. In this case, it is better to watch a gynecologist.
Very often, thin endometrium causes female infertility. To heal this is quite possible, you only need to persistently go towards your goal. Treatment can be carried out in several alternative ways: hormonal drugs, herbal decoctions, pseudo-hormones.
Some women do not want to resort to medical treatment of the thin endometrium and use folk remedies in this case.
Thin endometrium is well restored with the help of sage. Drink it in the first phase of the cycle. 1 teaspoon to brew in 200 g of water, taken during the day.
Borovaya uterus is transformed as a pseudo-hormone in the body of a woman. In addition, it has anti-inflammatory effect.
Drops "Tazalok" from a series of homeopathy help in the normalization of the menstrual cycle, are a regulator of the synthesis of endogenous gonadotropic hormones.
Capacity thin endometrium with medication
How to increase thin endometrium, the thickness of which varies in different phases of the cycle? In the first phase of the cycle, doctors will prescribe the drug “Proginova”, “Femoston”, etc. For the second phase of the cycle, “Duphaston” will do. This drug contributes to the formation of the structure of the endometrium, it acts as a synthetic progesterone.
Before using all these synthetic drugs, you should definitely consult a gynecologist and assess the risk yourself, since they all have some contraindications.
There are cases when a thin endometrium is detected after taking oral contraceptives. Rejection of them and the use of Regulon tablets for two months often gives a positive result and contributes to the restoration of thin endometrium.
A healthy endometrium is the key to a successful onset and development of pregnancy. Currently, many women experience any endometrial disease and, as a result, suffer from infertility. What does the term "endometrial pathology" mean, what are the consequences of this phenomenon, how to overcome this problem? First things first.
The main function of the endometrium in the female body is successful, successful embryo implantation. In order for a pregnancy to occur, it must attach itself to the wall of the endometrium. That is why infertility can occur in various endometrial pathologies, the successful attachment of the embryo becomes simply impossible. But there are different pathologies, there are several endometrial diseases. What exactly, in each case should be determined by a specialist.
From the nature of the occurrence of the disease, gynecologists and endocrinologists distinguish two benign disorders. Pathology of the endometrium of the uterus is inflammatory in nature, this includes endometritis. Non-inflammatory - these are hyperplastic processes. These include endometrial polyps, hyperplasia, and endometriosis.
It happens that in the female body combines several pathologies. What is the reason for this? Primarily a disruption of the endocrine system or a genetic propensity. In many cases, after successful treatment, pregnancy becomes possible.
Inflammatory disease of the mucous (endometrium) of the uterus. What is the cause of the disease? Penetration into the mucous membrane of the uterus of various pathogens. There are several basic factors contributing to the disease:
- Any infectious processes that exist in the body.
- Perfect sexual intercourse without protection.
- Erosion of the uterus.
- Examination of the uterus, tubes using hysterosalpinography.
- Chronic gynecological diseases.
- Non-sterile instrument during gynecological examination.
- Cesarean section.
- Endometrial curettage.
Typical symptoms in endometritis:
- Irregular menstruation.
- During the period of heavy bleeding.
- The "spotting" in the middle of the cycle.
- Painful periods.
- Pain during intercourse.
- Drawing pain in the abdomen.
- Increased pain during the development of the disease.
If endometritis is found during pregnancy, it requires immediate treatment. The disease can affect the fetal membranes of the embryo and lead to its death.
If on certain days of the cycle the thickness of the endometrium is underestimated, hypoplasia is diagnosed by gynecologists. The cause of the disease are hormonal disorders, poor blood supply, inflammatory processes. This endometrial pathology may occur as a result of frequent abortions, infectious diseases, prolonged use of the intrauterine device. The main task in the treatment of hypoplasia is the thickening of the endometrium.
The cause of the disease most often are hormonal disruptions in the body or hereditary factors. With hyperplasia, the endometrial layers change their structure.
There are several types of hyperplasia:
- Glandular hyperplasia.
- Fibrous hyperplasia atypical (precancerous condition).
- Glandular cystic hyperplasia.
Glandular endometrium is often found in diseases of the adrenal glands, ovaries, thyroid gland. Most often, women with diabetes, polyps in the uterus, myoma, and arterial hypertension suffer from hyperplasia.
What is dangerous hyperplasia? Uncontrolled cell growth, which can lead to terrible consequences - endometrial cancer. Hyperplasia is treated with both medication and surgery.
Benign proliferation of endometrial cells. Polyps are capable of being deployed not only in the uterus itself, but also on its neck. The reasons for their formation are hormonal disorders, the consequences of surgical interventions, abortions, and infections of the urogenital area. Polyps are most often formed in the endometrium. There are several types of polyps:
- Ferruginous. They are formed in the tissues of the glands, usually diagnosed at a young age.
- Fibrous. Formed in connective tissue. More commonly seen in older women.
- Glandular fibrous. Consists of connective and glandular tissue.
It is possible to get rid of polyps only with the help of surgical intervention. This should be done as soon as possible, since the cells are able to degenerate into malignant ones. Modern equipment allows you to perform operations quickly, efficiently, painlessly.
A female disease in which nodes are formed outside the uterus, similar in structure to the endometrial layer. Nodes can appear on nearby organs. It happens that during the rejection of uterine tissues, they are not completely removed with menstruation, penetrate into the tubes and begin to grow there. Endometriosis develops.
The main causes of the disease are:
- Excess weight.
- Frequent stress.
- Bad habits.
- Failures in the menstrual cycle.
- Inflammation in the genitals.
- Surgery on the uterus.
- Hormonal disruptions.
- Problems with thyroid.
Symptomatic indicators of endometriosis include:
- Painful urination and bowel movements.
- The "spotting" in the middle of the cycle.
- Pain before menstruation.
- Pain during sexual intercourse.
Currently, an increasing percentage of women suffer from various endometrial pathologies. They suffer from long, heavy, painful menstruation, hyperplastic processes, polyposis. Unfortunately, it is not always possible to achieve effective treatment with hormone therapy or curettage of the uterus. An alternative in this case is ablation, or removal of the endometrium. This is a minimally invasive procedure during which the destruction or complete removal of the uterine lining (endometrium) is performed.
Indications for surgery:
- Massive, repeated, prolonged bleeding. At the same time there is no efficacy from the treatment. The presence of malignant processes in the sexual sphere in women over 35 years old.
- Рецидивы гиперплатических процессов в период пременопаузы или постменопаузы.
- The impossibility of hormonal treatment of proliferative processes in the postmenopausal period.
What factors should be considered when performing ablation?
- The inability to completely remove the uterus or the rejection of this type of surgery.
- Reluctance to save childbearing function.
- The size of the uterus.
For diagnostic purposes, small volumes of tissue are taken from the body using special methods. In order to make a correct diagnosis based on the results of a biopsy, the doctor must follow a number of necessary conditions during the procedure. Histopathologist according to the results of the scraping study gives an assessment of the functional and morphological state of the endometrium. The results of the study are directly dependent on how the endometrial biopsy was performed, what material was received. If for the study, highly fragmented pieces of tissue were obtained, then it is difficult for a specialist, sometimes it is impossible to restore the structure. It is very important during the scraping to try to get undigested, larger strips of the endometrium.
What are the ways to produce endometrial biopsy?
- As a complete diagnostic curettage of the uterus when the cervical canal is dilated. Begin the procedure with the cervical canal, then scrape the uterine cavity. For curettage bleeding, a small curette should be performed, special attention should be paid to the corners of the uterus, where polypous growths are often formed. If, at the first curettage of the curette from the cervical canal, tiny tissue appears, then the procedure is stopped due to suspicion of carcinoma.
- Line scrapings (method of trains). The goal is to determine the causes of infertility, control the results of hormone therapy. This technique can not be used for bleeding.
- Aspiration biopsy. Suction of endometrial mucosal tissue pieces. The method is most often used for mass screening, the goal is to identify cancer cells.
If any endometrial pathology is detected in a woman's body, treatment should be started immediately. The time to start the treatment process gives the most promising forecasts. Even a sentence such as infertility may not be terrible if you consult a gynecologist in time, undergo a full examination and treatment. Watch your health!
Postmenopausal endometrial pathology
Hormonal changes associated with the onset of postmenopausal women may trigger the development of pathological changes in the uterine lining, which is commonly called endometrial hyperplasia, or adenomyosis in the scientific community. You can learn more information about this ailment from the material below.
Features evolved changes in the mucous membrane of the uterus
The endometrium, or the single-layer epithelium lining the female genital organ, is very sensitive to hormonal fluctuations. Against the background of neuroendocrine disorders, the central regions of the brain no longer properly control the functioning of target organs, ovaries, uterus, which ultimately leads to an unreasonable growth of the epithelium. Pathology of the endometrium in postmenopause can have the following forms:
- Glandular - characterized by simple growth of the epithelium.
- Glandular cystic - involves an increase in glandular tissue with the appearance of multiple nodules.
- Focal - implies hyperplasia of the connective tissue, in which the formation of polyps.
- Adenomatous, in which atypical cells are found.
It should be borne in mind that involutive changes in the reproductive organs in women fall at the age when the main immune organ, thymus, decreases the intensity of T-lymphocyte production. As a result, the malignancy of overgrown endometrium cells becomes possible. Cancer is considered the main and most dangerous consequence of the pathology of a single-layer epithelium of the uterine cavity.
Why endometrial hyperplasia occurs in menopause
Today, doctors do not have a clear understanding of the causes of hyperplastic changes in the uterine lining. Nevertheless, it is considered that endometrial pathology in postmenopause and menopause results from dysregulation of the hormonal regulation of the menstrual cycle. It is important to note that epithelium thickening is often diagnosed during the onset of menopause. This phenomenon is considered quite normal for menopause.
Over time, enlarged areas of the mucous are rejected and the endometrium becomes normal thickness. In a situation when adenomyosis is found in postmenopausal women, doctors recommend that patients undergo a full examination for the presence of comorbidities of the reproductive organs. Among the provoking factors of pathology can be identified:
- hereditary predisposition
- hormone therapy
- Complications after scraping.
How is postmenopausal endometrial hyperplasia
The danger of proliferation of the uterine mucosa is the almost complete absence of symptoms of the development of this disease. The only sign of a thickening of the endometrium during postmenopausal is a sudden abundant discharge, often turning into uterine bleeding. As a rule, women go to the doctor when symptoms of background pathology appear. Patients may experience:
- fatigue and irritability,
- pulling pains in the abdomen,
Reliable information about the state of the uterine mucosa can be obtained by visual inspection of the organ, which became possible after the hysteroscopy method was introduced into gynecological practice. In contrast to the usual cure, this procedure allows you to completely remove the endometrium that was changed due to the hormonal imbalance.
The biomaterial obtained at the end of hysteroscopy is usually sent for research. In a situation where the thickness of the endometrium during postmenopause reaches 10-15 mm, curettage with subsequent histology of the removed tissue samples is indicated. In addition to visual inspection, patients with symptoms of pathology of the uterine mucosa undergo abdominal and transvaginal ultrasound.
Treatment of postmenopausal endometrial hyperplasia
Disease therapy depends on the form of the pathology and the duration of its course. Do not try to treat hyperplasia on their own. The choice of therapeutic agents should be carried out by a doctor taking into account the results of tests. Folk remedies can be used as an additional treatment for the disease. It is also important to understand that quite often after medical treatment, pathology recurs. In such a situation, the operation becomes inevitable.
The use of drugs is allowed only in the absence of a focal form of pathology with its characteristic polypous formations. In this case, drug therapy involves the use of the patient for 3-6 months of hormones in order to reduce the negative impact on the endometrium of estrogens. Often, medications are prescribed before surgery. The mucosa reduced due to the use of medications is removed in a less traumatic way. Endometrial pathology in the postmenopausal period is treated with the following drugs:
Operational resolution of the problem is carried out with a high proportion of the probability of pathology transformation into a malignant process or with multiple complex relapses of the disease. It is worth noting that the combination of diagnostic and operative hysteroscopy helps to more effectively eliminate the modified endometrium in the background of a relatively small trauma. In addition, the surgical treatment of mucosal pathology can be carried out by:
- curettage - curettage of single-layer epithelium,
- cautery - laser processing of polyps,
- cryodestruction - exposure to low temperatures,
- hysterectomy - removal of the uterus.
Nontraditional therapies are often more effective against postmenopausal hyperplasia than medications. It happens that after the end of the course of taking the pills, the disease returns. In this situation, many patients prefer to treat herbal hyperplasia with herbal medicine. Particularly effective means against the pathology of the endometrium are:
- Golden mustache and burdock root. Plants need to rinse thoroughly, squeeze the juice out of them. Next, the liquid ingredients must be mixed in equal shares and taken 2 times a day and 1 tbsp. l
- Nettle tincture. About 200 g of grass should be poured 500 ml of diluted alcohol, then leave the product in a dark place for 3 weeks. Endometrial hyperplasia can be cured by tincture, using it by 1 tsp. twice a day.
Every woman should take care of the health of her urogenital system, since such deviations cause a lot of adverse feelings and can become provocateurs of irreversible consequences. Most women, unfortunately, do not know what the pathology of the endometrium of the uterus is, so they can ignore the obvious symptoms of diseases, which will lead to disruption in the functioning of the reproductive system.
Endometrial pathology often occurs due to:
- infectious diseases
- endocrine disruption,
- polypous growths
- effects of estrogen
- hereditary factor.
Inflammatory processes can occur due to:
- sexually transmitted diseases
- childbirth with complications.
When a woman outgrows a certain age line, she is faced with changes in the functioning of the sexual, hormonal systems. Changes in the menstrual cycle, lead to changes in the work of hormonal levels. The first signs of deterioration of the reproductive system are:
- general weakness
- excessive irritability,
- weight gain.
The development of endometrial pathology aggravates these symptoms and a woman has gynecological complaints. Among these symptoms can be observed blood discharge of a dark color, thick consistency, turning into bleeding. Such bleeding has a spontaneous nature and can be abundant, with secretions of pieces, clots of the mucous membrane.
These bleedings are accompanied by strong pulling pain in the uterus. The woman feels worse, in particular appear:
- irresistible thirst
- profuse bleeding for a long time
- degradation of performance
If a woman ignores the symptoms, she develops:
- blood pressure surges,
- weight gain due to accumulations of excess fluid.
Timely diagnosis of the disease allows the specialist to prescribe competent treatment.
- At the first stage, the patient undergoes an ultrasound examination using a vaginal sensor. At the same time it is necessary to pass a complete blood count. A local or even consolidation of the endometrium, viewed on the ultrasound, indicates the presence of pathology.
- A histological examination of the uterus is also required. Under anesthesia, the patient is scraping the contents of the uterus, is sent for analysis. The results of the study will show the presence or absence of atypical cells. They will indicate which type of hyperplasia is found in the patient.
- The third diagnostic method is hysteroscopy. In the process, the uterus cavity itself is examined, if necessary, polyps are removed, the existing extra layer of the endometrium.
A woman should be aware of what endometrial pathologies are, because it is the state of this layer of the uterus that largely determines her health and ability to bear children.
- Hyperplasia is a pathology in which mucous membrane cells begin to actively divide under the influence of internal factors, as a result of which the endometrium thickens. Anomaly appears when there is an insufficient amount of progesterone in the body, an overabundance of estrogen. The patient is prescribed hormone therapy.
- Hypoplasia - thinning of the endometrial layer, accompanied by severe pain during menstruation, reducing the likelihood of fertilization, possible infertility. Treatment is carried out by hormonal drugs, often they are the same as in the treatment of hyperplasia.
- Endometritis of the uterus - an infectious lesion of the uterus due to ingestion of infection, fungus, virus. Drug therapy is prescribed, combining antibiotics and anti-inflammatory drugs. Read more in the article ""
- Hypertrophy - a thickening of the entire mucous membrane of the uterus.
- Hypotrophy - endometrial failure. Pathology is treated hormonally.
- Focal fibrosis of the stroma - the appearance on the stroma of a hollow formation filled with fluid. Perhaps drug, surgical treatment.
- Endometriosis - endometrial thickening by dividing unchanged cells. If atypical cells are present in the scraping, one should speak of the precancerous condition.
Treatment of endometrial pathology can be surgical and conservative. It all depends on the individual development of the disease. Conservative therapy includes the appointment of hormonal drugs. It is necessarily accompanied by antibacterial and detoxification therapy.
Treat pathology need a complex. So you can achieve the desired result without fear of relapse.
Endometrial pathology can be treated by surgery. There are three common methods:
- therapeutic and diagnostic curettage, used for uterine bleeding. His goal is to stop bleeding, get a biomaterial for research,
- hysteroresectoscopy, in the course of which the polyps are removed, the pathological layer of the endometrium,
- removal of the uterus, which is carried out when a large number of atypical cells are detected during hysteroresectoscopy.
During menopause, the normal thickness of the uterus should not exceed 5 mm. If its thickness increases by 2 mm, it is necessary to undergo regular examinations. In cases where there are deviations from the norm of more than 3 mm, the woman needs full therapy, because endometrial hyperplasia develops.
Pathology of the endometrium in menopause in a woman quite often develops in the form of uterine dysplasia. In the normal state, the basal layer consists of rounded cells containing a single nucleus. As it ripens, moving to the surface layer, the nucleus decreases. In case of violation (dysplasia), a large number of atypical cells are formed, gradually replacing healthy cells with sick ones. Dysplasia can be of three forms:
Reviews of patients who are faced with endometrial abnormalities show that timely and correct diagnosis of the disease gives a high chance of getting rid of it.
Irina 40 l, Omsk
After the research - hysteroscopy and diagnostic curettage, the specialist diagnosed adenomyosis, chronic endometritis. Assigned after hormonal treatment, which is an improvement. Thanks to timely treatment competent, the uterus was saved.
Tatyana 30 l, Ekaterinburg
Last winter, endometrial hyperplasia was diagnosed. Hormone treatment was prescribed for 3 months. Followed the recommendations of the doctor, saw pills. Repeated ultrasound after 3 months showed that the extra endometrium was gone.
Antonina 32 g, Perm
After the diagnosis of hysteroscopy, the doctor prescribed the Janine course for 4 months without a break. The treatment was successful, after it almost immediately became pregnant. Complications have arisen.
Treatment of endometriosis pathologies should be comprehensive, timely. Regular examinations at the gynecologist, attentive attitude to your own well-being will help prevent the development of the disease or detect it in the initial stages.