Hyperplastic processes of an endometria
Contents:
Description:
Hyperplastic processes of an endometria – benign pathology of a mucous membrane of a uterus which develops against the background of an absolute or relative giperestrogeniya.
Great scientific and clinical interest to this problem is attracted as the high frequency of the uterine bleedings caused by this pathology, and a possibility of a malignancy. About 70% of endometrial cancer in a climacteric develop against the background of an endometria hyperplasia.
Symptoms of Hyperplastic processes of an endometria:
Clinically the hyperplasia of an endometria is shown by disturbance of menstrual function. At development of a disease it is possible to observe sudden bleeding at which blood loss reaches considerable degree and leads to anemia. In other cases bleeding not plentiful, but long, lasts several weeks, and sometimes and months, and also leads to secondary anemia. On the nature of bleeding at patients of a hyperplasia of an endometria can be both acyclic, and cyclic.
Acyclic bleedings arise after a long absence of periods of different duration more often (of 6-8 weeks to several months). Sometimes they arise already in 2-3 weeks after the termination of the previous periods or bleeding.
Cyclic bleedings come the next periods in time, proceed a long time and are followed by symptoms of anemia, the general weakness, an indisposition, dizziness.
At patients with an endometria hyperplasia the late approach of a menopause which is followed by lengthening of the period of effect of hormones of ovaries, as a rule, takes place.
Thus, at most of patients with a hyperplasia of an endometria observe constancy of clinical manifestations of anovulation in the form of dysfunctional uterine bleedings, endocrine and exchange disturbances (obesity, reduced tolerance to glucose), pathological changes of function of a liver, an idiopathic hypertensia. However it is necessary to consider that in 10-30% of cases the asymptomatic course of a disease is noted.
Reasons of Hyperplastic processes of an endometria:
Carry to risk factors of development of a hyperplasia of an endometria:
• disturbances of MTs as anovulation;
• infertility in the anamnesis;
• obesity;
• SD;
• insulin resistance;
• hereditary tendency (new growths of ovaries, uterus, MZh, large intestine).
Treatment of Hyperplastic processes of an endometria:
Pharmacotherapy.
Treatment begins with a separate medical and diagnostic scraping of walls of a cavity of the uterus and the cervical channel.
Basis of treatment of a hyperplasia of an endometria is hormonal therapy.
Hormonal therapy is carried out in combination with other methods of pathogenetic therapy which include:
• sedative drugs;
• vitamins;
• antioxidants;
• psychotherapy.
Surgical treatment
Indications to operational treatment of patients with an endometria hyperplasia
At reproductive age:
• a complex atypical hyperplasia in the absence of effect of conservative therapy in 3 months;
• a simple atypical and complex not atypical hyperplasia in the absence of effect of conservative therapy in 6 months.
In a climacteric:
• a complex atypical hyperplasia – at establishment of the diagnosis;
• a simple atypical and complex not atypical hyperplasia – in the absence of effect of conservative therapy in 3 months.
At not atypical forms of a hyperplasia of an endometria, especially at women of reproductive age, use of a gisteroskopichesky resection or ablation of an endometria is reasonable, and at atypical – preference is given to a hysterectomy.
