Should I have a hysterectomy for endometrial hyperplasia?

If you have atypical endometrial hyperplasia, your specialist will probably recommend you have a hysterectomy. This is an operation to remove the womb. This is to prevent you developing a cancer of the lining of the womb.

Do you need a hysterectomy for thickened endometrium?

How is endometrial hyperplasia managed or treated? If you're at increased risk of cancer due to atypical endometrial hyperplasia, your healthcare provider may recommend a hysterectomy to remove the uterus. After a hysterectomy, you won't be able to get pregnant.

What is the best treatment for endometrial hyperplasia?

In many cases, endometrial hyperplasia can be treated with progestin. Progestin is given orally, in a shot, in an intrauterine device (IUD), or as a vaginal cream. How much and how long you take it depends on your age and the type of hyperplasia. Treatment with progestin may cause vaginal bleeding like a period.

What type of hysterectomy is best for endometrial hyperplasia?

Partial hysterectomy (removal of the uterus and cervix) is the treatment of choice for hyperplasia with atypia in patients who have completed childbearing. Supracervical hysterectomy should not be performed because the abnormal uterine cells can be present in the cervix.

How long does it take for atypical endometrial hyperplasia to turn into cancer?

In one study, hyperplasia without atypia progressed to endometrial carcinoma in fewer than 5% of women; in comparison, atypical hyperplasia progressed to endometrial carcinoma in one in eight women within 10 years, and in one in three women within 20 years.

RCOG GUIDELINE MANAGEMENT OF ENDOMETRIAL HYPERPLASIA

How often does endometrial hyperplasia become cancer?

Complex atypical hyperplasia (CAH) has a risk of becoming cancer in up to 29% of cases if it's not treated, and the risk of having an undetected endometrial cancer is even higher.

Can endometrial cancer be seen during hysteroscopy?

Hysteroscopy is a useful method that can be used to detect endometrial cancer lesions. In addition, office hysteroscopy is easy to be scheduled and does not require anesthesia.

What is the most common age to get endometrial hyperplasia?

In our study, among women 18–90 years the overall incidence of endometrial hyperplasia was 133 per 100,000 woman-years, was most common in women ages 50–54, and was rarely observed in women under 30. Simple and complex hyperplasia incidences peaked in women ages 50–54.

Should I get a hysterectomy if I have precancerous cells?

If the precancerous disease is more extensive or involves adenocarcinoma in situ (AIS), and the woman has completed childbearing, a total hysterectomy may be recommended. 1 During a total hysterectomy, the entire uterus (including the cervix) is removed.

Why did I get endometrial hyperplasia?

Endometrial hyperplasia is caused by too much estrogen or not enough progesterone. Both of these hormones play roles in the menstrual cycle. Estrogen makes the cells grow, while progesterone signals the shedding of the cells. A hormonal imbalance can produce too many cells or abnormal cells.

When should I worry about endometrial thickness?

If an endometrial thickness of ≥ 8 mm is considered abnormal, 0.9% of women without cancer and without bleeding and 12% of women without cancer and with bleeding will have endometrial measurements above this threshold, and 95% of women with cancer will have endometrial measurements above this threshold.

What is the most common cause of endometrial thickening?

The most common cause of endometrial hyperplasia is having too much estrogen and not enough progesterone. That leads to cell overgrowth. There are several reasons you might have a hormonal imbalance: You've reached menopause.

Does endometrial hyperplasia cause weight gain?

Endometriosis is an estrogen-dependent disease, which means that its symptoms may worsen when estrogen levels are higher. However, there is no evidence that this can cause weight gain.

Can endometrial hyperplasia go away on its own?

Endometrial hyperplasia is an increased growth of the endometrium. Unlike a cancer, mild or simple hyperplasia can go away on its own or with hormonal treatment. The most common type of hyperplasia, simple hyperplasia, has a very small risk of becoming cancerous.

How thick is endometrial hyperplasia?

At this phase, the endometrium begins to thicken and may measure between 5–7 mm. As the cycle progresses and moves towards ovulation, the endometrium grows thicker, up to about 11 mm. About 14 days into a person's cycle, hormones trigger the release of an egg.

What percentage of endometrial biopsies are cancerous?

Patients with endometrial specimens that show atypia have about a 25 percent likelihood of progressing to carcinoma, compared with less than 2 percent in patients without atypia.

Why do doctors not want to do hysterectomy?

In interviews with people seeking hysterectomies, doctors justify their refusal to their patients using a mix of these motherhood assumptions as well as more “medically-sounding” reasons: it's too invasive, too extreme, too risky, etc.

What are the signs of needing a hysterectomy?

Why would I not want a hysterectomy?

For many women, the biggest drawback to a hysterectomy is loss of fertility. Once you have a hysterectomy, you cannot conceive, and for many women of childbearing age, this is a significant loss. Women who feel pushed into a hysterectomy may also have a negative reaction to it.

Is endometrial hyperplasia painful?

Some of the most common symptoms of endometrial hyperplasia include: Abnormal vaginal bleeding between menstrual periods or post-menopause. Abnormally heavy menstrual bleeding. Painful intercourse.

Is endometrial hyperplasia rare?

Endometrial hyperplasia is a condition in which the lining of your womb becomes too thick. In some women, this can lead to cancer of the uterus. Endometrial hyperplasia is rare. It affects about 133 out of 100,000 women.

What happens if your endometrial biopsy is positive?

Biopsy results may show cell changes linked to hormone levels, or abnormal tissues, such as fibroids or polyps. These can lead to abnormal bleeding. Your provider can also use endometrial biopsy to check for uterine infections, such as endometritis.

Is hysteroscopy major surgery?

Hysteroscopy is considered minor surgery and usually does not require an overnight stay in the hospital. However, in certain circumstances, such as if your doctor is concerned about your reaction to anesthesia, an overnight stay may be required.

Can a Dr see cancer during a hysterectomy?

Laparoscopic hysterectomy: Laparoscopic surgery is done with a tiny camera and special instruments. The surgeon puts these tools through several small incisions (cuts) in the belly. In a laparoscopic hysterectomy, the surgeon usually is able to see the organs well enough to find out the extent of the cancer.

Is it normal to have a CT scan before a hysterectomy?

Many patients undergo CT or MRI imaging prior to hysterectomy for uterine malignancy. Preoperative CT or MRI is unlikely to alter surgical planning. Preoperative imaging for uterine cancer patients should be identified as a low value service.