Endometrial hyperplasia is a pathological abnormal proliferation of the endometrium in the uterus, a common and frequently occurring condition in women. It is usually caused by hormonal imbalance, resulting in anovulatory menstrual cycles, primarily occurring during adolescence and menopausal transition.
Endometrial hyperplasia is classified into simple, complex, and atypical hyperplasia:
1. Simple hyperplasia is a physiological response of the endometrium to elevated estrogen levels in the body, often caused by anovulatory menstrual cycles, commonly seen in females approaching menarche or menopause.
2. Complex hyperplasia is characterized by glandular epithelial hyperplasia leading to the formation of papillary or budding growth within the glandular lumens, with about 3% progressing to adenocarcinoma.
3. Atypical hyperplasia involves increased layers of glandular epithelial cells, significant cellular disarray, and one-third of patients may progress to adenocarcinoma.
Normal endometrium undergoes proliferative and secretory phases. However, in simple endometrial hyperplasia, there is no secretory phase, indicating lack of hormonal influence for transformation. This condition can lead to clinical symptoms such as excessive menstrual bleeding, prolonged menstruation, or incomplete menstrual shedding based on the regular menstrual cycle. Simple endometrial hyperplasia is a common gynecological disorder, classified as the mildest form of endometrial hyperplasia. It primarily occurs due to continuous estrogen stimulation thickening the endometrium without shedding, leading to hyperplasia. Apart from irregular vaginal bleeding, women with simple endometrial hyperplasia exhibit few other symptoms.
Does endometrial hyperplasia affect pregnancy?
Whether endometrial hyperplasia affects pregnancy depends on the severity of the condition. Generally, simple hyperplasia is a benign lesion and does not pose a problem for pregnancy. The endometrium serves as the nurturing site for the fertilized egg, and variations in endometrial thickness can impact conception. Embryonic implantation and fetal development can only occur smoothly in a normal endometrium. When endometrial hyperplasia occurs, causing an increase in endometrial thickness, receptivity decreases, thereby reducing the likelihood of pregnancy to an extent.
However, in cases where endometrial thickening is due to anovulatory menstrual cycles, it can hinder pregnancy by preventing ovulation. Moreover, excessive thickening of the endometrium can lead to difficulty in embryo implantation or increase the risk of miscarriage after implantation. While pregnancy is possible with simple endometrial hyperplasia, the chances are reduced. Under medical guidance, hormone therapy can be used to treat this condition with timely and appropriate dosage. Hormone therapy is usually administered in the latter half of the menstrual cycle for about three months for regulation. Therefore, for young patients with fertility aspirations, proactive management should be adopted before conception, seeking assistance from fertility specialists post-recovery to formulate an optimal preconception plan.
