Endometrial hyperplasia is a condition which occurs when the lining (endometrium) of the uterus (womb) becomes too thick. In some cases it can also lead to uterine cancer. Throughout the menstrual cycle of a woman, the endometrium changes as a response to the hormones. During the first phase of the cycle, estrogen in a woman’s body is mainly made by the ovaries. The estrogen makes the uterine wall a bit thick for the body to prepare itself for pregnancy. If the walls get too thick without the presence of progesterone level to control the estrogen level, endometrial hyperplasia occurs. If a woman doesn’t go through ovulation at any menstrual cycle, the progesterone doesn’t get made and this in turn avoids the lining to be shed. The endometrium can grow as a response to the excessive estrogen, this can make the cells inside the uterine lining crowded, thus forming an abnormal growth.
Endometrial hyperplasia can occur after menopause when progesterone is no longer made by the uterus because ovulation stops naturally. In most cases, it also occurs during perimenopause (ovulation doesn’t occur naturally). Other causes of endometrial hyperplasia include, use of estrogen boosting medicines, long term use of estrogen in women who have already gone through menopause, irregular periods, polycystic ovary syndrome (PCOS) and obesity. However, it can be treated effectively by a gynaecologist. Consuming progestin orally or using it as a vaginal cream can make the progesterone level balanced with the estrogen content, hence treating endometrial hyperplasia.
In many cases, progestin can also be given as a shot inside an intrauterine device. However, the doctor decides what quantity of progestin should be given to you depending upon the severity of the condition and your age. Excessive progestin can be fatal so it is advisable to seek advice from a doctor before getting this treatment. Sometimes, if endometrial hyperplasia is diagnosed too late and it has already developed into complex atypical hyperplasia, the risk of cancer rises. In such cases, a doctor usually prescribes surgery like hysterectomy.
Symptoms of endometrial hyperplasia include, bleeding during menses which is heavier than usual and lasts long, menstrual cycles which are shorter than twenty-one days and vaginal bleeding after menopause. You should get diagnosis as soon as you experience these symptoms. Diagnostic tests will be performed by your doctor for signs of uterine cancer or endometrial hyperplasia. A transvaginal ultrasound test can be done to calculate the thickness of the uterine wall (endometrium). Sometimes, a small tissue can also be extracted from your vagina and studied under a microscope. This can also be done along with hysteroscopy, curettage, dilation and endometrial biopsy.
Women who don’t have regular menstruation and have signs of amenorrhea can also consume progestins. It can also be consumed along with OHT (Ovarian hormone therapy) or ERT (Estrogen replacement therapy). Endometriosis causes a lot of pain, so progestin can be given to reduce the pain.
If you do not have enough estrogen in your body, progestin should be only consumed after a doctor’s advice.
Progestin can have a number of side effects such as irregular menstrual cycles, bleeding or spotting between periods, sore breasts, headache, nausea, dizziness, weight gain, bloating or complete ceasing of menstrual periods. Most of the times, these side effect are temporary and will disappear as soon as you quit progestin medications.
After the treatment, it is vital to take care of your health properly and maintain a good diet so that endometrial hyperplasia doesn’t reoccur in future. Smoking and being obese can increase the chances of this disorder, so it is recommended to quit smoking completely and exercise regularly to control weight gain. Smoking also results to female infertility, so it should not be continued if you aim for a healthy lifestyle.
Recovery usually depends on your own capacity and metabolism rate, but if you are on progestin medications, endometrial hyperplasia can become completely treated in a period of a few months. However, progestin should be continued as recommended by your doctor and should not be consumed in excess or the results can be fatal.
The price of progestin in India ranges from Rs. 70 to Rs. 2,000.
The results of the treatment are only permanent if proper prevention measures and care is taken after the treatment. However, there is still a possibility of the relapse of endometrial hyperplasia.
Women who have atypical hyperplasia can go through a surgery known as hysterectomy. This surgery should be considered keeping in mind, that she will not be able to conceive children after undergoing hysterectomy. Women with endometrial hyperplasia without atypia should consider using an IUS (Intrauterine system). This device releases progestogen in the lining of the uterus and reduces the symptoms of endometrial hyperplasia.