What are the early symptoms of endometrial thickening?

There are many early symptoms of endometrial thickening. Have you ever known about them? As women, it is very necessary for us to understand this knowledge. Some people do not take care of their bodies and often catch colds and stay up late, which causes many problems in their bodies, especially the uterus. This is very troublesome. Now the editor will explain it to you. I hope you can get something from it. I also hope that you will not encounter this problem.

Clinical manifestations

1. Age

Atypical endometrial hyperplasia occurs in younger women. It can also occur in perimenopausal or postmenopausal women.

2. Menstrual status

Abnormal menstruation is one of the prominent symptoms of this disease. It is often manifested as irregular vaginal bleeding, infrequent menstruation or amenorrhea for a period of time followed by long-term heavy vaginal bleeding.

3. Fertility status

Long-term anovulation due to endocrine abnormalities reduces the fertility of such patients. The infertility rate in patients under 40 years old can reach 90%.

The diagnosis relies on endometrial histology. The sampling methods include: endometrial biopsy, dilation and curettage, vacuum aspiration, and hysteroscopy. Since atypical endometrial hyperplasia often presents as scattered or single focal lesions, the entire endometrium may have various degrees of hyperplasia at the same time, and taking only a few tissue biopsies cannot reflect all changes in the endometrium. For perimenopausal women with atypical endometrial hyperplasia found during hysterectomy, 30%-50% of them also have well-differentiated adenocarcinoma. Therefore, it is very important to obtain comprehensive endometrial tissue from the uterine cavity for pathological examination. Compared with simply taking a few pieces of endometrial tissue, dilation and curettage can scrape more comprehensive tissue, but some areas may still be missed because the curette does not reach, especially the two uterine horns and the uterine fundus. Negative pressure suction can make the endometrium shed more completely, and the diagnosis will be more comprehensive and reliable. Hysteroscopy can not only observe the condition of the endometrium from its appearance, but also perform curettage or negative pressure aspiration under direct vision, making the examination and diagnosis more detailed and comprehensive.

Treatment of atypical endometrial hyperplasia requires a clear diagnosis and identification of the cause. If accompanied by polycystic ovaries, functional ovarian tumors, or other endocrine disorders, targeted treatment should be performed. At the same time, symptomatic treatment should be started immediately for those diagnosed with atypical endometrial hyperplasia, using medication or surgical treatment. The choice of plan should be determined based on the patient's age, fertility requirements, and physical health condition. For those under 40 years old, their tendency to cancer is low and drug treatment can be considered first. Young people who hope to have children should try drug treatment first, because after drug treatment, about 30% of patients may still become pregnant and give birth to a full-term baby. For women before and after menopause, the potential for cancer is higher than that of younger people, so hysterectomy is often performed directly.

1. The principle of drug treatment is

Standardized medication, long-term examinations, regular testing, and timely assisted pregnancy. Types of medication: ① The ovulation-inducing drug clomiphene is taken once a day on the 5th to 9th day of the cycle. If necessary, the medication period can be extended by 2 to 3 days. ② Progestin drugs: They vary according to the degree of endometrial atypicality. Mild atypical hyperplasia can be treated with intramuscular injection of progesterone, starting on the 18th or 20th day of the cycle, and taken for 5-7 days. Patients with moderate and severe atypical hyperplasia should use medroxyprogesterone continuously for a course of 3 months. After each course of treatment, a curettage or removal of endometrial tissue should be performed for histological examination. Depending on the response to the drug, the patient can choose to stop treatment or increase or decrease the dosage of the drug as appropriate. An intrauterine ring can also be placed.

2. Surgery

Curettage and aspiration is not only an important diagnostic method, but also one of the treatment methods. Because local lesions can also be removed through curettage. Patients with atypical endometrial hyperplasia who are over 40 years old and have no fertility requirements can undergo hysterectomy once diagnosed. However, for patients with hypertension, diabetes, obesity or advanced age who have poor tolerance to surgery, drug treatment may be considered under close follow-up monitoring. Young patients who have not responded to drug treatment, whose endometrial hyperplasia continues or worsens or is suspected of having developed cancer, whose vaginal bleeding cannot be controlled by curettage and drug treatment, and whose condition recurs after delivery, may all consider surgical removal of the hysterectomy.

After reading these introductions to the early symptoms of endometrial thickening, do you understand more? Hehe, the editor will introduce more relevant knowledge in the next article. If you are interested, you can continue to watch and read my article. Finally, the editor still advises female readers to maintain normal living habits and not to always stay up late and skip meals, which will affect their health.