To the question of the pathogenesis of endometrial hyperplasia

Abstract

Traditional attitude towards the role of hyperestrogenia in endometrial hyperplasia pathogenesis can be considered cogent only in case of simple endometrial hyperplasia (SEH). In case of complex endometrial hyperplasia (CEH) and atypical endometrial hyperplasia (AEH) excessive proliferation occurs only in endometrial glands not diffusely but as pockets. The signs of atrophy are often registered outside these pockets that reflects the state of estrogens.The aim: is to study the structure of pathological endometrial changes that patients with abnormal uterine bleeding (AUB) have and natural combination of various forms of pathological endometrial changes.Material. The results of histological examination of endometrium collected from 668 patients have been studied.Results. The structure of pathological changes that occur in case of AUB has been identified. Various endometrial changes outside CEH and AEH pockets against the background of SEH, polyposis, atrophic endometrium have been detected without any regularity; the fact that does not confirm the role of hyperestrogenia in CEH and AEH pathogenesis.Conclusion. SEH being the result of estrogen and progesterone imbalance is subjected to cyclic progestin hormone therapy to prevent acyclic bleeding. Observation with regular control is acceptable in the absence of AUB after the curettage in case of SEH and CEH without atypia. In case of AEH surgical treatment is required.

Keywords

• endometrial hyperplasia
• pathogenesis
• treatment strategy