What to do if the endometrium is thick? Treatment based on the cause

The uterus is a very important organ for women. If women have uterine problems, it will have a great impact on their reproductive health, and in severe cases, infertility may occur. Thickening of the endometrium is called endometrial hyperplasia. Endometrial hyperplasia is also called precancerous lesions, which have a certain tendency to become cancerous.

1: Young patients are treated with ovulation induction: Young patients mostly suffer from anovulatory functional uterine bleeding, and their basal body temperature should be measured. If they are confirmed to have monophasic anovulation, ovulation induction treatment can be used. Ovulation-inducing drugs include clomiphene and chorionic gonadotropin, which are generally used for patients with mild atypical endometrial hyperplasia. The dosage of clomiphene is 50-100 mg, once a day, taken on the 5th to 9th day of the cycle. If necessary, the medication period can be extended by 2 to 3 days.

2: Curettage and dilation for women in the reproductive period: Generally, one curettage can control bleeding. If bleeding still occurs after curettage, hysteroscopy and B-ultrasound should be performed to rule out submucosal fibroids or other organic lesions. Women in the reproductive period may also be infertile and clinically manifest as polycystic ovary syndrome with anovulation, which should be treated as polycystic ovary syndrome.

3: Menopausal transition period: It is often anovulatory functional uterine bleeding. If menstruation is infrequent and the amount of blood is heavy or the bleeding time is long after curettage and hemostasis, progesterone treatment should be given every two months, and follow-up observation should be conducted after 3 cycles.

4: Late menopause: You should ask whether to use estrogen replacement therapy alone. After curettage, the replacement therapy can be suspended or progesterone can be added. Progestogens can inhibit the proliferation of the endometrium caused by estrogen.

1: Hysterectomy during the menopausal transition or postmenopause: Since age is the main risk factor for malignant transformation of endometrial hyperplasia, hysterectomy is appropriate for patients in this age group.

2: Young people or those who want to have children can use drug treatment: Atypical hyperplasia is a potentially malignant precancerous lesion. If not treated, 20% will develop into cancer. However, cancer is rare in young patients. Moreover, drug treatment is effective for young and reproductive patients, so drug treatment can be chosen to preserve fertility.

All are normal. Thick endometrium is thought to be caused by high estrogen levels, so it is best to conduct a six-item hormone test and provide symptomatic treatment based on the results.