From the very beginning of the gestation process, the endometrium plays a fundamental role in ensuring success. This is because its function as a receptor is to allow the embryo to implant. When there is an alteration in endometrial receptivity, it often leads to repeated implantation failures and can even result in female infertility.
Among the conditions that directly affect the endometrium, hyperplasia stands out, which we will develop further in this blog.
What is endometrial hyperplasia?
Endometrial hyperplasia refers to the excessive increase in the cells that make up the endometrium, which the body normally regulates. This proliferation of the cells surrounding the uterus stems from a hormonal imbalance, specifically in estrogen and progesterone levels.
Both hormones influence the menstrual cycle. Hence, one of the symptoms of endometrial hyperplasia may be abnormal vaginal bleeding, although we will see different ways to diagnose it with certainty.
Possible causes of hyperplasia
Hyperplasia has risk factors that increase the likelihood of this condition proliferating and causing different problems. Among the possible causes —and to understand their origin— the following stand out:
- Diabetes
- Obesity
- Chronic anovulation
- Polycystic ovary syndrome
- Lynch syndrome
- Hormone replacement therapy (HRT)
It should be noted that endometrial hyperplasia mainly affects women over the age of 45. However, its onset will depend on the previously mentioned hormone levels.
Common symptoms
Although several symptoms may appear, it is mainly during menstruation that specialists can foresee the existence of a hormonal imbalance. It should also be emphasized that there are cases where women with hyperplasia experience no symptoms at all and are therefore asymptomatic.
- Heavy menstrual bleeding: quantity and duration
- Short menstrual cycles
- Intermenstrual bleeding
- Uterine bleeding after menopause
How is hyperplasia diagnosed? What treatment is available?
Detecting and diagnosing endometrial hyperplasia is important not only because it can impair gestation, but also due to its potential to develop into cancer.
These are the three medical tests used to diagnose this condition:
- Ultrasound: with this test, the gynecologist can precisely measure the size and thickness of the endometrium. Excessive thickness is associated with a high likelihood of hyperplasia.
- Endometrial biopsy: a small sample of the endometrium is taken to study its histology in the laboratory and obtain a result.
- Hysteroscopy: this procedure allows visualization of the uterine cavity and mucous membranes. It also serves as a complement to the biopsy.
Thanks to scientific advances, there are treatments available to stop the proliferation of cells that cause endometrial hyperplasia. Depending on the type of hyperplasia —as we will see below— different treatments will be applied.
Treatment also depends on the woman’s desire to conceive: in this case, contraceptive pills or progesterone may be prescribed. However, if the patient does not wish to become pregnant, the most common option is to remove the uterus to prevent the hyperplasia from progressing to an cancerous state.
What types of hyperplasia exist?
To evaluate hyperplasia and make an accurate diagnosis, the following types are currently recognized:
- Endometrial hyperplasia without atypia, simple: a benign proliferation without cytological atypia.
- Endometrial hyperplasia without atypia, complex: carries a risk of progressing to endometrial cancer, although the probability is low.
- Atypical endometrial hyperplasia, simple: may develop into endometrial carcinoma if not detected in time or not treated properly.
- Atypical endometrial hyperplasia, complex: tends to progress more quickly to endometrial cancer. Accurate diagnosis and proper treatment can prevent progression to cancer.
Can I get pregnant with endometrial hyperplasia?
The answer is yes, you can, although the chances are much lower. When hyperplasia occurs, the result is a variation in the shape and size of the endometrium, where the growth is excessively large. This may compromise pregnancy and embryo implantation, although there are also cases of successful pregnancy in women with hyperplasia.
The best recommendation, without a doubt, is to consult a specialist professional who can evaluate the situation. Although this condition cannot currently be prevented, monitoring your menstruation and reducing risk factors such as smoking or obesity are essential to lower the chances of its development.
