The choice of options for treating endometrial hyperplasia depends on many factors. However, since the disease is causing a hormonal imbalance in the body, the main method of treatment of the endometrium hyperplasia is hormonal.
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Medical treatment of endometrial hyperplasia
The endometrial hyperplasia treatment strategy depends on many factors: this is the age of the patient, the cause and nature of hyperplasia, clinical manifestations of the disease, the presence of contraindications to a particular treatment method, the tolerance of therapeutic drugs and much more.
It goes without saying that since the main cause of endometrial hyperplasia is hormonal imbalance, the main method of treating endometrial hyperplasia - hormonal.
The effect of hormonal drugs that are used to treat endometrial hyperplasia may be local to brake and suppress the processes of endometrial growth, and the central, overwhelming hypophysome of gonadotropic hormones. The central action is most strongly expressed in combined estrogen-gestagenic drugs, local action - in Gestagennes. The choice of certain drugs depends on many criteria, in particular, from the age of the patient.
Young girls aged 13 to 20 years, suffering from juvenile bleeding caused by the endometrium hyperplasia, most often recommended the six-month cyclic administration of combined oral contraceptives: estrogen with progestin.
If after a six-month course the patient's condition is not normalized and ovulation is not restored, then to stabilize the state of the endometrium and the prevention of possible bleeding, the reception of estrogen with progestins continues. Reception of oral contraceptives can continue until planning a girl desired pregnancy.
Patients of reproductive age, as a rule, are prescribed three courses of cyclic reception of estrogen with progestins with subsequent re-biopsy endometrial. It is known that even high doses of progestins are usually carried well to patients.
However, in patients of childbearing tactics of the treatment of hyperplasia, endometrial depends on whether the occurrence of pregnancy is desirable or undesirable at the moment.
Since one of the main symptoms of the endometrium hyperplasia is anointulation, and, consequently, infertility, women who are trying, but can not get pregnant to the doctor about endometrial hyperplasia.
If a woman wants to get pregnant, the doctor may, first of all, restore ovulation.
If the pregnancy is not yet desirable, and the woman appealed to the gynecologist about bleeding, then the reason for annovation and the treatment is revealed by cyclic reception of estrogen with progestins.
It should be remembered that even the recovery of ovulation and the normal menstrual cycle does not save a woman from the need to pass a re-examination, most often - the endometry biopsy, which is carried out in about 3 to 6 months after the end of treatment.
This is due to the fact that endometrial hyperplasia, preserved after treatment with gestagenic drugs, increases the risk of endometrial cancer. This is approximately 3% of patients after treatment.
As for the patients during the period of perimopause and postmenopause, they are shown mainly by drug treatment, after six months after which the biopsy of the endometrium is also conducted.
If the risk of developing complications, including the transition of endometrial hyperplasia to oncological diseases, is high, then patients who do not have reason to leave the uterus, the doctor can recommend hysterectomy, that is, the removal of the uterus.
When prescribing hormone therapy, compliance with certain conditions and strict consideration of contraindications. Of course, the treatment of hypeometrical hyperplasia using hormones is possible not always - in cases of contraindications to hormone therapy as an alternative, surgical methods of treatment of endometrial hyperplasia are used as an alternative.
Surgical treatment methods
Surgical methods of treatment of endometrial hyperplasia include amputation and extirpation of uterus. They are shown, in particular, with a recurrent iron-cystic hyperplasia, developed against the background of diseases of the internal secretion glands (diabetes, prediabet, etc.), obesity, hypertensive disease, liver and veins diseases.
In addition, surgical treatment is preferably under the prejudition states of endometrial - adenomatosis, adenomatous polyps, especially in the case of their combination with adenomyosis and uterine, pathological processes in the ovaries.
In general, it can be said that the conservative therapy of progestins in the treatment of endometrial hyperplasia is acceptable, first of all, girls and young women who want to keep their reproductive function. Such treatment is carried out under careful medical control and before, and after therapy.
For women in the period of Klimaks, the final method of treatment remains hysterectomy.
After the end of the treatment of endometrial hyperplasia, much attention is paid to the prevention of relapses and development of endometrial cancer.
Prevention of the disease
Prevention is primarily in regular medical examinations of the patient, during which a careful study of endometrial tissues is carried out.
In addition, the patients of young age, the doctor may prescribe a preventive reception of hormonal drugs, which significantly reduces the risk of hyperplasia and endometrial cancer.
From the very patient, the timeliness of appeal to the gynecologist in many ways, at the very first symptoms of the disease - especially in the event of uterine bleeding or bleeding between menstruation.
