A disease in which there is overgrowth of tissue in a limited area, always requires observation and exclusion of cancer. It is in this disease is focal hyperplasia of the endometrium of the uterus, which apparently substitutes one or more polyps.

Why start focal hyperplasia of the endometrium

Hormonal support menstrual always lead to changes in the uterine cavity. Thus, the secretion of follicle large amounts of estrogen leads to the fact that the mature egg is retained in the ovary, as for its release (ovulation) need the hormones of the second half of the menstrual cycle (luteinizing hormone, the pituitary gland and the female sex hormone progesterone), but not enough, which leads to long-term the first phase of the menstrual cycle, lack of ovulation Ovulation - How to determine as accurately as possible?   and the widening of the mucous membrane of the uterus. With the onset of the second phase with a lack of progesterone Progesterone - norm and pathology   pachymenia hardly reduced in volume and then, by the end of the menstrual cycle is rejected, usually with severe bleeding. Thus the walls of the uterine cavity may be residual mucosa that will support intermenstrual bleeding period and then become the basis of focal overgrowth of tissue, and possibly in the formation of uterine polyps.

Maybe another "scenario": estrogen produced little, and as the egg is not matured, produced them is long, wavy, with the result that the egg never ripens not released from the ovary and menstrual bleeding continues long, wavy. Bleeding is not too strong, but eventually loses blood a lot. In this case, the mucous membrane of the uterus is gradually torn away and some of its parts can not be removed.

Such non-remote areas of mucous membrane lesions may be initially proliferating mucosa and then form the basis for polyps, which can be glandular, fibrous or adenomatous (benign tumor of glandular tissue). The thickness of the mucous membrane of the uterus (the endometrium) at focal hyperplasia can reach 5-6 cm.

Contribute to the formation of polyps, inflammatory diseases of the uterus, injuries (including severe birth abortion), endocrine disorders, including those of a general nature (diabetes, thyroid disease Thyroid disease - women at risk , Obesity, etc.), stress, genetic predisposition and so on.

Focal may be atypical endometrial hyperplasia, in which tissue cells change their appearance. This kind of focal hyperplasia often turns into a malignant tumor.

How does the uterus at the focal endometrial hyperplasia

Polyps of the glandular or glandular-fibrous tissue typically have a rounded body or slightly elongated shape and leg. Polyp growths formed by all layers of the mucous membrane of the uterus along with the underlying tissue. Its base is made up of fibrous and glandular cells. A polyp can be one, several, or multiple polyps are found. In most polyps located in the upper part of the uterus (the bottom) and in the place where the body of the uterus fallopian tubes depart.

Top polyps are smooth, pink surface. But in some cases, the polyp is ulcerated because of circulatory disorders, which always accompany cyclical rejection of the endometrium. Under the microscope, it is seen that in the polyp tissue includes cancer of various sizes, partially penetrating into the middle muscular layer of the uterus. In addition, it has many components of connective tissue and blood vessels dilated sclerosed.

Focal atypical endometrial hyperplasia is a hotbed of altered mucosal tissue in which there are cells with more or less severe atypia. When these foci appear in the polyp, a polyp called adenomatous.

Diagnosis and treatment

Diagnosis can be made based on the typical occurrences of the disease (cyclic and acyclic heavy or prolonged bleeding), as well as additional testing. We investigate the hormonal status of blood occasion ultrasound of the pelvic organs and the uterus using a vaginal probe, endoscopy (hysteroscopy) with taking a piece of tissue for analysis, X-ray examination of the uterus (hysterography), if necessary, the radioisotope research and cancer.

Lobular hyperplasia, including polyps removed by scraping the uterine cavity in the process of therapeutic hysteroscopy. While the patient is on the operating table, conducted histological examination of the removed tissue. Upon detection of atypical cells specific to a malignant tumor, the uterus was removed.

After surgery, curettage of the uterus Curettage - how dangerous it is?   woman appointed hormonal therapy, which aims - preventing proliferation (proliferation) of the mucous membrane of the uterus.

Galina Romanenko

Uterine fibroids after birth may behave differently. But more often it is reduced in size, especially if the woman for a long time breastfeeding. At the same time, fibroids can cause bleeding in the early postpartum period, as well as the connection of infection slow recovery of the normal state of the uterus in the late postpartum period.

How does the early postpartum period in women with uterine fibroids

During pregnancy a woman's body is undergoing significant hormonal changes. This may significantly increase the number of female sex hormones, including estrogen, cause the fibroids can be increased. The increase also contributes to the increase of uterine muscle layer of the uterus, stretching muscle fibers and improving blood circulation in the uterus. But at the end of pregnancy, this process stops and fibroids may even decrease in size.

Immediately after birth, during the early postpartum period starts to separate pituitary hormone prolactin stimulates the secretion of breast milk. Under the action of prolactin Prolactin - effect on the body is not fully known   uterus contracts in volume, including fibroids decreases. At the same time in the early postpartum period may cause uterine bleeding.

The postpartum period - the time from the date of delivery of the placenta before the completion of the reverse changes in the woman's body during pregnancy. The duration of the period of six weeks postpartum.

After delivery of the placenta uterus begins to decline rapidly, contributing to compression of blood vessels and prevent gaping bleeding. When uterine fibroids can occur violation of the contractile ability of the uterus, and this in turn can cause bleeding. Bleeding can be caused by an increment or incomplete separation of the placenta. Knowing that a woman has fibroids, the doctor receiving the delivery, can be prepared in advance for the development of such a complication and consider emergency response tactics.

How is the late postpartum period in women with uterine fibroids

In most cases, after the first two weeks of the woman's condition improves, the uterus begins to actively decline in the amount recovered its internal mucosa. But if during labor were problems with the separation of the placenta or the uterine cavity was a small piece of the placenta, it can cause delays restore normal uterine volume, recovery of the epithelium at the site of the placenta, uterine bleeding Uterine bleeding outside of menstruation - a sign of a serious breach   and infection of the uterus in the late postpartum period.

All of these complications in the postpartum period are developing not all women, but the risk is always present their development. To avoid such complications in the last weeks of pregnancy the woman is held closely monitored, including regularly held ultrasound for monitoring the condition of the placenta and the size of fibroids. If you suspect a violation of the placenta and the first signs of an eating disorder of the placenta immediately assigned a treatment to prevent complications.

As the "behaves" uterine fibroids after childbirth

Breast-feeding for six months contributes to the stable release of prolactin, which in turn contributes to partially reverse fibroids. But sometimes immediately after birth may increase in uterine volume. This occurs due to swelling of the injured tissue during childbirth. But then, when the swelling subsides, you'll notice that the fibroids decreased in volume (unless, of course, continued breastfeeding).

But most of all postpartum uterine returns to its initial (before pregnancy) size. Sometimes after the birth amid recovery state of the uterus is gradually changing the location of the fibroids.

Sometimes postpartum degeneration of fibroids. As a result of this process, fibroid tissue necrosis. This in turn leads to the release of large amounts of toxic substances that enter the blood and cause poisoning organism. Evolved wherein the biologically active substance can cause severe hemorrhage and lead to infection of the uterus.

A sign of the degeneration of uterine fibroids is the emergence of severe pain in the abdomen Abdominal pain: when to sound the alarm? , Fever, signs of inflammation in the peripheral blood (high white blood cell count and high ESR). Confirm the diagnosis using ultrasound.

If you suspect a degeneration of uterine fibroids women usually are hospitalized and spend conservative therapy in the hospital.

After delivery, women with uterine fibroids Uterine fibroids - when surgery is needed?   must undergo regular preventive examination by a gynecologist. This will allow them to continue to give birth to a healthy baby without compromising their health.

Galina Romanenko