In the structure of gynecological pathologies, endometrial hyperplastic processes make up a fairly large percentage. These pathological processes are diagnosed in a large number of women of reproductive and older age. Hyperplastic processes of the endometrium include endometrial hyperplasia, endometrial polyps, and precancerous conditions. The danger of hyperplastic processes lies in the fact that all of them can become malignant over time, which is why it is so important to detect and effectively treat endometrial hyperplastic processes in a timely manner.
Clinical picture of endometrial hyperplastic processes
Hyperplastic processes of the endometrium are pathological focal or diffuse proliferation of the glandular and stromal components of the uterine mucosa. With this pathology, it is the glandular structures that are predominantly affected. Hyperplastic processes of the endometrium can occur in women of any age, but most often they are diagnosed in the perimenopausal period. All three types of hyperplastic processes have both similar and distinctive features. At the same time, the clinical picture of pathological processes is almost the same, so it is important to use the most informative diagnostic methods.
Hyperplastic processes of the endometrium:
- etiological factors of endometrial hyperplastic processes;
- characteristic symptoms of endometrial hyperplastic processes;
- methods for diagnosing endometrial hyperplastic processes.
Etiological factors of endometrial hyperplastic processes
Pathological transformation of the endometrium is a complex biological process that affects almost all parts of the neurohumoral regulation of a woman's body. The leading place in the development of hyperplastic processes of the endometrium is given to hormonal disorders, namely absolute or relative hyperestrogenism against the background of insufficient ability of progesterone to suppress estrogen. The causes of hyperestrogenism are as follows:
- anovulation with persistence or atresia of follicles;
- hormone-producing ovarian formations;
- disorders of the pituitary or adrenal glands;
- irrational use of hormonal drugs.
An important role in the development of endometrial hyperplastic processes is played by metabolic and endocrine disorders of the body. Among non-hormonal factors, the development of the pathological process can be influenced by inflammatory processes of the endometrium, disturbances in tissue reception, as well as disturbances in the functioning of the body's immune system.
Characteristic symptoms of endometrial hyperplastic processes
The clinical picture of endometrial hyperplastic processes is not pronounced. In 10% of patients of reproductive age and 40% of postmenopausal women, endometrial hyperplastic processes are asymptomatic.
The main clinical manifestations of endometrial hyperplastic processes are acyclic uterine bleeding, mainly metrorrhagia, less often menorrhagia.
Endometrial polyps can also be manifested by pain syndrome: patients complain of cramping pains in the lower abdomen. But polyps often do not give any clinical picture, especially in postmenopausal women. Since the hyperplastic processes of the endometrium in patients of reproductive age are based on anovulation, infertility is also one of the symptoms of the pathology.
Methods for diagnosing endometrial hyperplastic processes
Diagnosis of endometrial hyperplastic processes is carried out using the following methods:
- transvaginal ultrasound is one of the most informative methods for diagnosing endometrial hyperplastic processes. With endometrial hyperplasia, an increase in the median uterine echo in the anterior size with a non-uniform acoustic density is detected, with polyps - ovoid or rounded inclusions in the uterine cavity with increased echo density;
- Hysteroscopy - the method makes it possible to study in detail the condition of the uterine mucosa. With hyperplasia, the endometrium is thickened, edematous, a large number of glands are determined in it. With endometrial polyps, the uterine cavity is filled with polypoid growths throughout;
- Histological examination of scrapings of the uterine mucosa is a method that allows you to finally confirm the diagnosis of endometrial hyperplastic processes.
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