Polyps of the endometrium: symptoms, causes and treatment
What is it - the endometrial polyp is a local form of hyperplastic processes of the inner layer of the uterus.
This is a condition in which the endometrial overgrowth occurs in one place, which leads to the formation of a plus-tissue having various sizes.
Symptoms of the disease may be absent for a long time or manifest immediately in the form of profuse menstruation or intermenstrual bleeding.
Therefore, it is necessary to diagnose this condition as soon as possible, for which a woman should regularly visit a gynecologist and follow all the recommendations given to them.
The causes of the development of endometrial polyps may be different. However, in all cases, there is an increased estrogen content in the body, mainly monoform( estrone).
It can be either relative, when the synthesis of gestagens is reduced, and absolute, at which gestagens are normal, and estrogens are produced in minimal amounts. The main causative factors that lead to hyperestrogenemia are:
Symptoms of the endometrial polyp depend on its location in the uterine cavity and size. Small polyps, located high from the cervical canal and far from the tube corners, do not appear for a long time. Therefore, they can be accidentally detected during an ultrasound examination.
In other cases, this pathological condition may be manifested by such symptoms as:
The diagnosis of polyps using vaginal examination is not always possible. Usually, when viewed in mirrors, only those polyps that penetrate the cervical canal and the lumen of the vagina can be detected.
However, they are easily confused with cervical polyps, since it is not possible to visualize the leg. Therefore, the main method of diagnosis is ultrasound.
With its help it is possible to evaluate:
Late diagnostics and, as a consequence, untimely treatment, can lead to the development of a number of complications of endometrial polyps.
These include:
Treatment of endometrial polyps is combined. This means that in the beginning their removal is shown, and then - conservative therapy.
Removal of polyps is made with a differential diagnostic and therapeutic purpose, this procedure can be carried out in a blind( scraping the uterine cavity) or hysteroscopy in conjunction with hysteresisectoscopy. The latter method is most preferable, since it allows to remove the foot of the polyp, which can underlie the recurrence of this pathological process.
The removed biological material must necessarily be sent for histological examination. This is necessary to exclude signs of cancer( endometrial cancer or precancerous processes).
Only after this, the nature of conservative therapy can be determined, since it is based on the appointment of hormonal drugs for a long time. And as you know, tumors of the genital organs in most cases are estrogen dependent, therefore, in the absence of histological examination, it is possible to provoke the progression of the oncological process.
The choice of a hormonal drug depends on the age of the woman. The main goal with which he is appointed is a correction of the existing relative or absolute hyperestrogenemia underlying the hyperplastic processes of the endometrium. In the early, middle reproductive age and the juvenile period, the use of combined estrogen-progestational drugs is indicated.
The younger the woman, the lower the dose of estrogen in the drug can be. Therefore, girls under the age of 18 should prefer low-dose combined oral contraceptives. The rest should take medications. In the late reproductive age, gestagenic preparations are commonly used( they do not contain estrogens).In the perimenopausal period, both gestagens and estrogen-yeast preparations for hormone replacement therapy can be prescribed( doses of hormones in them are several times lower than in contraceptives).
The duration of hormonal therapy is from 3 months to 12. Conservative therapy demonstrates dynamic ultrasound monitoring to assess the state of the endometrium, which allows to judge its effectiveness.
Recurrent polyps, histologically confirmed, with ineffective hormonal treatment being performed, are an indication for the removal of the uterus in women who have reproductive functions( gave birth to children and do not want any more).This is due to the fact that the risk of malignancy( malignancy) in this case is great.
Prophylaxis for endometrial polyps is:
This is a condition in which the endometrial overgrowth occurs in one place, which leads to the formation of a plus-tissue having various sizes.
Symptoms of the disease may be absent for a long time or manifest immediately in the form of profuse menstruation or intermenstrual bleeding.
Therefore, it is necessary to diagnose this condition as soon as possible, for which a woman should regularly visit a gynecologist and follow all the recommendations given to them.
Causes of the endometrial polyps
The causes of the development of endometrial polyps may be different. However, in all cases, there is an increased estrogen content in the body, mainly monoform( estrone).
It can be either relative, when the synthesis of gestagens is reduced, and absolute, at which gestagens are normal, and estrogens are produced in minimal amounts. The main causative factors that lead to hyperestrogenemia are:
- 1) Follicular ovarian cysts
- 2) Obesity( according to the latest scientific data, adipose tissue takes an active part in the synthesis of estrone, resulting in an increase in the thickness of the endometrium)
- 3) Neuroendocrine syndromes.
Clinical manifestations of
Symptoms of the endometrial polyp depend on its location in the uterine cavity and size. Small polyps, located high from the cervical canal and far from the tube corners, do not appear for a long time. Therefore, they can be accidentally detected during an ultrasound examination.
In other cases, this pathological condition may be manifested by such symptoms as:
- cramping pains in the abdomen, especially when the polyp is infringed either in the tube corners or in the cervical channel
- aching pain in the lower abdominal part of the
- intermenstrual bloody discharge
- contact bleeding if the polypvyguhaet in the lumen of the vagina
- profuse menstruation, as against the background of the polyp does not occur a complete rejection of the endometrium.
Diagnosis of the endometrial polyp
The diagnosis of polyps using vaginal examination is not always possible. Usually, when viewed in mirrors, only those polyps that penetrate the cervical canal and the lumen of the vagina can be detected.
However, they are easily confused with cervical polyps, since it is not possible to visualize the leg. Therefore, the main method of diagnosis is ultrasound.
With its help it is possible to evaluate:
- the size of the polyp
- its location
- obtain indirect data on the histological structure of the
- with a certain probability of distinguishing a benign process from a malignant
- development of complications.
Complications of
Late diagnostics and, as a consequence, untimely treatment, can lead to the development of a number of complications of endometrial polyps.
These include:
- uterine bleeding that can endanger the life of a woman
- posthemorrhagic anemia, which is very often severe, due to the recurrence of bleeding
- frequent combination with uterine myoma, which also develops against the background of a relative or absolute increase in the body estrogen
- development of precancerous processes in violationcell division
- endometrial cancer
- infringement of the polyp in the cervical canal or difficult corners
- ischemic changes with the development of necrosis polyp endometry, against which there is an inflammatory reaction of the body
- the birth of a large polyp.
Treatment of endometrial polyps
Treatment of endometrial polyps is combined. This means that in the beginning their removal is shown, and then - conservative therapy.
Removal of polyps is made with a differential diagnostic and therapeutic purpose, this procedure can be carried out in a blind( scraping the uterine cavity) or hysteroscopy in conjunction with hysteresisectoscopy. The latter method is most preferable, since it allows to remove the foot of the polyp, which can underlie the recurrence of this pathological process.
The removed biological material must necessarily be sent for histological examination. This is necessary to exclude signs of cancer( endometrial cancer or precancerous processes).
Only after this, the nature of conservative therapy can be determined, since it is based on the appointment of hormonal drugs for a long time. And as you know, tumors of the genital organs in most cases are estrogen dependent, therefore, in the absence of histological examination, it is possible to provoke the progression of the oncological process.
The choice of a hormonal drug depends on the age of the woman. The main goal with which he is appointed is a correction of the existing relative or absolute hyperestrogenemia underlying the hyperplastic processes of the endometrium. In the early, middle reproductive age and the juvenile period, the use of combined estrogen-progestational drugs is indicated.
The younger the woman, the lower the dose of estrogen in the drug can be. Therefore, girls under the age of 18 should prefer low-dose combined oral contraceptives. The rest should take medications. In the late reproductive age, gestagenic preparations are commonly used( they do not contain estrogens).In the perimenopausal period, both gestagens and estrogen-yeast preparations for hormone replacement therapy can be prescribed( doses of hormones in them are several times lower than in contraceptives).
The duration of hormonal therapy is from 3 months to 12. Conservative therapy demonstrates dynamic ultrasound monitoring to assess the state of the endometrium, which allows to judge its effectiveness.
Recurrent polyps, histologically confirmed, with ineffective hormonal treatment being performed, are an indication for the removal of the uterus in women who have reproductive functions( gave birth to children and do not want any more).This is due to the fact that the risk of malignancy( malignancy) in this case is great.
Prevention of
Prophylaxis for endometrial polyps is:
- normalization of the ovarian-menstrual cycle
- regular medical examinations at the gynecologist( once a year)
- a decrease in body weight with its excess, since fat tissue is the site of the synthesis of estrogens.