What is uterine thickening (endometrial hyperplasia)?

Endometrial hyperplasia is more commonly known as uterine thickening. It is a condition that needs to be treated because it can turn into cancer of the uterine lining.

Who is more common?

Endometrial hyperplasia is more common in women who are obese or overweight, who have a history of polycystic ovaries, who have been treated for infertility, who are hypertensive, diabetic, who have been given estrogen for a long time without progesterone, and who are being treated for breast cancer. The risk is high in patients who do not menstruate for several months and this condition recurs. It should be considered in bleeding that persists despite medication.

What are the symptoms and how is it diagnosed?

Endometrial hyperplasia is characterized by heavy bleeding after long intermenstrual periods. In some patients, ultrasound examination reveals a thick uterine lining with irregular cavities. Conditions such as fibroids, polyps and adenomyosis that cause irregular menstrual bleeding should be excluded. In the presence of additional factors listed above, endometrial biopsy should be performed in women under the age of 45 or over the age of 45 who have irregular bleeding but have no risk factors. In other words, a biopsy should be performed from inside the uterus. Biopsy is a painless diagnostic method that can be performed under office conditions and takes less than a minute.

How is it treated?

Endometrial hyperplasia (thickening of the uterine lining) is treated with medication and surgery. If the hyperplasia consists of cells with a high probability of cancer, continuous medication is applied, if not (simple) intermittent medication is applied. Surgical removal of the uterus should be recommended in women over the age of forty if there is no desire for children. It is known that 30% of patients have concomitant cancer at the time of diagnosis in thickenings consisting of cells with a high probability of cancer (atypia). Therefore, if the patient does not want to have children, atypical hyperplasia should be treated as uterine lining cancer.

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