Guide to Advanced Surgery for Women's Health
Why Choose Cedars-Sinai Marina del Rey Hospital for Endometrial Hyperplasia Treatment?
The well trained gynecological surgeons at Cedars-Sinai Marina del Rey Hospital review patients with hyperplasia of the uterus and provide the best treatment advice for each patient. The patients can choose from the various non-surgical and surgical treatment options available. The treatment that is best for the symptoms and severity of endometrial hyperplasia will be considered.
The endometrium is the inner lining of the uterus. Excessive growth or thickening of this lining in the uterus is called endometrial hyperplasia. This condition occurs due to the increase in the number of endometrial glands in the uterus.
When an egg reaches the uterus from the ovary through the fallopian tubes, the inner layer of the uterus thickens to prepare for the pregnancy and growth of the baby. If fertilization does not happen, the lining of the uterus is discarded during the menstrual periods every month. The menstrual cycle is managed by two hormones called estrogen and progesterone. Maintenance of correct balance between these two hormones is very crucial for the good health of your uterus. In the case of imbalances in the hormone levels or if the hormones are not produced in proper amounts, then excessive growth or thickening of the cells in the inner layer of the uterus takes place resulting in endometrial hyperplasia.
Surgical Procedures for Endometrial Hyperplasia Performed at Cedars-Sinai Marina del Rey Hospital
Dilatation and Curettage (D&C): This procedure removes tissues of the uterus lining. In this procedure, an instrument is inserted into the vagina through the cervix, the inner portion of the uterus is viewed on a display and with the help of other surgical instruments, the defective uterine tissues are cut and removed.
Transcervical resection of the endometrium (TCRE): With the help of a hysteroscope, the lining of the uterus is removed. This procedure is also called hysteroscopic resection.
Total hysterectomy: If other treatments do not respond well and if the disorder reoccurs, your doctor may consider the removal of the uterus and other reproductive organs around it. This procedure is ideal for patients who have attained menopause.
Drugs and Other Treatment Needed for Endometrial Hyperplasia
Endometrial hyperplasia is broadly classified into the following types:
Simple hyperplasia »
Complex hyperplasia »
Atypical hyperplasia »
Symptoms of Endometrial Hyperplasia
- Heavy bleeding during the menstrual period
- Menstrual bleeding lasting for more than the usual five days
- Shorter menstrual cycles, less than 21 days
- Bleeding even after menopause
- Lower abdominal pain
- Abnormal mood swings
- Severe cramping type of pain
- Hot flushes
Diagnosis of Endometrial Hyperplasia
Transvaginal ultrasound: With this technique, the thickness of the endometrial lining of the uterus can be identified. This test involves the insertion of a small device called a transducer into the vagina. The sound waves, which come from this device are converted into images of your pelvic organs.
Laboratory test: For further diagnosis, a sample of the tissue from the inner lining of the uterus is taken and examined under a microscope to find out the presence of any cancer cells.
- A straw shaped device called a pipette is used to suck a small portion of the uterine lining
- Aspirating the uterine tissue through an electronic suction device called Vabra aspiration
- The liquid jet is sprayed on the uterine wall to wash off some of the tissues
- With a help of a brush, some tissues can be brushed out
Dilation and Curettage: A long spoon-shaped instrument called a curette will be inserted through the vagina to scrape a sample tissue of the uterus for examination.
Hysteroscopy: A device called a hysteroscope is inserted into the vagina and the inner part of the uterus is visualized on a monitor. A sample of the tissue may also be taken with the help of other surgical instruments.
Risk Factors for Endometrial Hyperplasia
Here are some factors that may increase your risk of developing endometrial hyperplasia:
- Smoking cigarettes
- Never bearing children
- Age above 35
- Early-onset of menstruation
- Conditions such as diabetes, gallbladder and thyroid disease, and cysts in the ovary
- Family history of ovarian, uterine cancer or cancer of the colon
Causes of Endometrial Hyperplasia
The main cause of endometrial hyperplasia is the presence of excessive levels of estrogen and limited progesterone in the body. Lack of progesterone occurs when ovulation does not happen. The cells of the endometrium grow in the presence of estrogen, gather together, and grow abnormally resulting in endometrial hyperplasia.
Herbs: According to Chinese medicine, a combination of herbs that help relieve pain, improve blood circulation, body metabolism, ease emotional and mental stress is recommended. Blood circulation herbs include semen persica, salvia root, and bupleurum. Pollen typha is one of the analgesic herbs used to relieve pain. Tonic herbs such as ginseng, codonopsis, and rehmannia are used to control the basal temperature and aid the balancing of hormones. Oyster shell and prunella can be used to dissolve cysts. Spicy herbs such as dry ginger, fennel, and cinnamon bark are given to warm up the body, and the blood circulating herbs such as tang-kuei, red peony, cnidium, bulrush, pteropus, myrrh, and corydalis may also be used. The appropriate recipe has to be taken from a doctor specialized in herbal medicine. Vitex (chaste berry) taken in the form of tincture and evening primrose oil help increase the hormone level of progesterone and control excess estrogen.
Acupuncture: Acupuncture along with herbal medication has helped to relieve pain, improve blood circulation, and regulate menstrual and hormonal flow in the body, thus resolving many disorders of the uterus.
Endometrial hyperplasia cannot be prevented. The below measures may be taken to reduce the risk of endometrial hyperplasia:
Frequent check-ups: Women must undergo a periodical examination of their pelvic region so that any abnormalities in the uterus may be identified at an early stage to take up immediate treatment.
Avoid being overweight: Obese women must try to shed excess weight and maintain a healthy weight.
Regular exercise: Exercising daily will reduce the risk of endometrial hyperplasia.
Diet: Eating healthy food containing fewer amounts of fat will be helpful.
Are you suffering from irregular and prolonged periods, heavy menstrual bleeding, pelvic discomfort, mood swings, or spotting? For any information, questions, or guidance related to endometrial hyperplasia, feel free to consult our specialty-trained and skilled gynecologist at Cedars-Sinai Marina del Rey Hospital.