Treatment of postmenopausal endometrial thickness

Every woman's body will become more fragile after the age of 45, because at this age the hormone levels and functions in all aspects have undergone great changes, and the person has slowly transformed. Yes, some symptoms of menopause after menopause will cause many people to become bad-tempered and suffer from insomnia. So what is the situation of endometrial thickening after menopause? Let's take a look.

1. Surgery

(1) In stage I, total extrafascial hysterectomy and bilateral salpingo-oophorectomy are performed. Patients with any of the following conditions should undergo selective pelvic lymph node and para-aortic lymph node resection and/or dissection: ① The pathological type is clear cell carcinoma, serous carcinoma, squamous cell carcinoma, undifferentiated carcinoma, or endometrioid adenocarcinoma. ②The depth of myometrial invasion is ≥1/2. ③ Cancer involves more than 50% of the uterine cavity or serum CA125 is significantly elevated.

(2) In stage II, extensive total hysterectomy and bilateral salpingo-oophorectomy, pelvic and para-aortic lymph node dissection are performed. After entering the abdominal cavity, ascites or peritoneal washings should be collected for cytological examination. A comprehensive exploration should be performed during the operation. After the uterine appendages are removed, the uterus should be dissected immediately to understand the extent of the cancer and the depth of infiltration into the myometrium, and the tissue should be sent for frozen specimen examination to determine whether there are any lesions outside the uterus. Cancer tissue should be routinely tested for estrogen and progesterone receptors as a basis for selecting adjuvant therapy after surgery.

2. Radiation therapy

(1) Preoperative radiotherapy can shrink the lesion, create conditions for surgery, or eliminate hidden metastatic lesions. For patients with stage II and III lesions and poorly differentiated cells, intracavitary irradiation or extracorporeal irradiation can be added before surgery. Surgery is performed within 1 to 2 weeks after the completion of intracavitary radiotherapy and 4 weeks after the completion of external beam irradiation.

(2) Postoperative radiotherapy is used for lesions that could not be completely removed during surgery, or for areas suspected of metastatic cancer. Adding radiotherapy after surgery can supplement the insufficient scope of surgery and reduce postoperative recurrence. If cancer cells are found in the ascites of stage II patients or cancer has infiltrated the deep muscle layer and lymph nodes have metastasized, they will need radiotherapy after surgery, either 60Co or linear accelerator external beam radiation.

(3) Although adenocarcinoma is not sensitive to radiation, radiotherapy is still effective for the elderly or patients with severe comorbidities who cannot tolerate surgery, as well as for patients in stages III and IV who are not suitable for surgery.

3. Medication

(1) Progestin therapy is mostly used for patients with advanced or recurrent cancer who cannot be surgically removed. It is more effective for well-differentiated endometrial cancer that is estrogen and progesterone receptor positive. Intramuscular injection of progesterone acts on cancer cells and combines with progesterone receptors to form a complex that enters the cancer cell nucleus, delaying the release of DNA and RNA and inhibiting the growth of cancer cells.

(2) Anti-estrogen treatment

(3) Chemotherapy is one of the comprehensive treatment measures for advanced or recurrent cancer. It is also used to treat patients with high risk factors for postoperative recurrence in order to reduce extrapelvic recurrence. It can be used alone, or in combination with several drugs, or combined with progesterone.

The above contents are about some situations of endometrial thickening after menopause. If these phenomena occur after menopause, they may be caused by some diseases, so we must be vigilant. The female group is originally a vulnerable group, and menopause will cause changes in all aspects of our lives. We must pay attention to our health so that we can enjoy life better. Hope everyone is healthy and happy.