What is endometrial hyperplasia? Is it a problem if it is not treated?

Endometrial hyperplasia is a precancerous lesion of endometrial cancer, a common gynecological tumor. It is a non-physiological lesion of endometrial hyperplasia. Women aged 50-54 are considered a high-risk group for the disease. The probability of endometrial hyperplasia increases with age. Every year, 133 out of 100,000 people suffer from it.

How many types of endometrial hyperplasia are there?

Advances in genetics have led to new insights into its pathogenesis, including endometrial hyperplasia without atypical endometrial hyperplasia; endometrial atypical hyperplasia or endometrial intraepithelial neoplasia (EIN). Endometrial dysplasia is considered a precursor to type I endometrial cancer, and both have the same risk factors. Endometrial hyperplasia without atypical endometrial hyperplasia rarely develops into endometrial cancer (1-3%).

Related risk factors

1. Menstrual abnormalities (such as old age or postmenopause, infertility, early menarche or late menopause, anovulation, menopausal transition and polycystic ovary syndrome);

2. Iatrogenic factors (estrogen therapy without progestin antagonism, tamoxifen);

3. Comorbidities (such as obesity, diabetes, hypertension or Lynch syndrome, etc.).

Diagnosis and monitoring of endometrial hyperplasia

The diagnosis of endometrial hyperplasia and endometrial cancer depends on endometrial biopsy. Diagnostic hysteroscopy is more helpful in obtaining specimens than normal endometrial biopsy. Especially in common endometrial biopsy specimens, endometrial hyperplasia or endometrial cancer are highly suspected, persistent vaginal bleeding, and specimens cannot be obtained. Its advantages are more prominent. Without atypical endometrial hyperplasia, the risk of progression to endometrial cancer within 20 years is less than 5%. It has been reported that 75% to 100% of cases can automatically return to normal during follow-up.

Drug treatment

Compared with oral progesterone, LNG-IUS can achieve higher prognosis rates of 67%-72% and 81%-94%, respectively.

In addition, medroxyprogesterone acetate injection can be used as an alternative to LNGIUS, with a 6-month recovery rate of 92%.

Due to its efficacy and fewer side effects, LNG-IUS is more easily accepted, making it the recommended drug for patients with atypical endometrial hyperplasia.