Hyperplastic processes of the endometrium is one of the most common pathological processes in gynecology that can develop in women of reproductive and older age. Hyperplastic processes include directly hyperplasia, polyps and precancer of the endometrium. The main reason for the development of pathology is a hormonal imbalance with an increase in the level of estrogen in the blood of a woman. On this basis, excessive proliferation of the endometrium occurs, the main danger of which is the likelihood of malignant degeneration. Effective and timely treatment of endometrial hyperplastic processes will help to avoid such consequences.

Peculiarities of treatment of endometrial hyperplastic processes

Treatment of endometrial hyperplastic processes depends primarily on the age at which the pathology arose in a woman. Therapy is aimed at stopping emerging bleeding, restoring menstrual function in women of reproductive age or achieving subatrophy or atrophy of the endometrium at an older age, as well as preventing the occurrence of relapses of the pathology. In a small percentage of cases, endometrial hyperplastic processes can become malignant, which is why it is so important to apply effective methods of treating these diseases in a timely manner.

Treatment of endometrial hyperplastic processes:

  • treatment of endometrial hyperplastic processes in reproductive age;
  • treatment of endometrial hyperplastic processes in perimenopause;
  • treatment of endometrial hyperplastic processes in postmenopausal women.

Treatment of endometrial hyperplastic processes in reproductive age

Treatment of endometrial hyperplastic processes in patients of reproductive age is performed as follows:

  • First of all, patients undergo hysteroscopy, separate diagnostic curettage and histological examination, after which a hormone therapy regimen is prescribed;
  • in case of recurrence of the hyperplastic process of the endometrium, it is necessary to conduct additional diagnostics in order to exclude a hormonally active process in the ovaries, after which hormonal therapy can be continued with higher doses of drugs;
  • in case of ineffectiveness of hormonal therapy and recurrence of atypical hyperplasia or adenomatous polyps, it is necessary to carry out surgical intervention, the volume of which is determined individually for each patient;
  • if hormonal therapy is ineffective in women who do not want to preserve reproductive function, endometrial resection is an effective treatment.
To reduce the risks of hormone therapy at any age with  in the treatment of endometrial hyperplastic processes, patients are simultaneously prescribed hepatoprotectors, antiplatelet agents and anticoagulants.

Treatment of endometrial hyperplastic processes in perimenopause

The treatment of endometrial hyperplastic processes in perimenopausal patients also includes, first of all, hysteroscopy with separate diagnostic curettage. After that, depending on the structure of the endometrium and the presence of concomitant pathologies, a further treatment regimen for the patient is selected. If a woman wishes to maintain her menstrual function – She is individually selected hormone therapy regimen. In the presence of recurrent hyperplasia without atypia, endometrial ablation is performed. If the disease is combined with uterine fibroids or internal endometriosis – hysterectomy recommended.

Treatment of endometrial hyperplastic processes in postmenopausal women

For newly diagnosed endometrial hyperplasia in postmenopausal patients, hormonal therapy should be recommended. The recurrence of the disease at this age is an indication for extirpation of the uterus with appendages. If the patient has absolute contraindications to hysterectomy – it is permissible to prescribe hormonal therapy with gestagens up to 12 months or to perform endometrial ablation. With atypical hyperplasia of the endometrium in postmenopausal women, it is necessary to perform a panhysterectomy. If there are also contraindications for this operation – treatment of endometrial hyperplastic processes should be based on the long-term use of gestagens. To reduce the risks of hormone therapy at any age with  

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