Endometrial hyperplasia history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Swathi Venkatesan, M.B.B.S.[2]
Overview
A positive history of irregular menstrual cycles (PCOD) may be present.[1] A detailed drug history may be helpful in the assessment of possible risk factors for endometrial hyperplasia. A history of inappropriate hormone replacement therapy in post menopausal women and history of tamoxifen use in breast cancer patients may be present.[2][3][4]
History
- Bleeding during the menstrual period that is heavier or lasts longer than usual
- Menstrual cycles that are shorter than 21 days (counting from the first day of the menstrual period to the first day of the next menstrual period)
- Any bleeding after menopause
- A detailed drug history may be helpful in the assessment of possible risk factors for endometrial hyperplasia.
- Inappropriate hormone replacement therapy in post menopausal women (with insufficient progesterone component)[2][3]
- History of tamoxifen use[4]
- Tamoxifen is a non-steroidal anti-estrogen that binds to the estrogen receptor and is used primarily for adjuvant therapy in breast cancer
- Tamoxifen may also act as an estrogen agonist in a low estradiol environment
- Up to 50% of breast cancer patients who are treated with tamoxifen may develop an endometrial lesion within 6-36 months
- Any patient who develops bleeding while on tamoxifen needs evaluation
- A positive history of irregular menstrual cycles (PCOD) may be present.[1]
We observed an association between EH/EC and a history of gestational diabetes specific to younger women. Future studies focusing on the relationships between gestational diabetes, obesity, and EC, including age at diagnosis, are warranted.[5]
Symptoms
- The majority of patients with endometrial hyperplasia present with abnormal uterine bleeding.[1]
- Any postmenopausal bleeding should raise suspicion for malignancy.
References
- ↑ 1.0 1.1 1.2 Endometrial hyperplasia. Radiopedia. http://radiopaedia.org/articles/endometrial-hyperplasia-1 Accessed on March 10, 2016.
- ↑ 2.0 2.1 Emons G, Beckmann MW, Schmidt D, Mallmann P, Uterus commission of the Gynecological Oncology Working Group (AGO) (2015). "New WHO Classification of Endometrial Hyperplasias". Geburtshilfe Frauenheilkd. 75 (2): 135–136. doi:10.1055/s-0034-1396256. PMC 4361167. PMID 25797956.
- ↑ 3.0 3.1 Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K; et al. (2009). "Incidence of endometrial hyperplasia". Am J Obstet Gynecol. 200 (6): 678.e1–6. doi:10.1016/j.ajog.2009.02.032. PMC 2692753. PMID 19393600.
- ↑ 4.0 4.1 Tamoxifen associated endometrial changes. Radiopedia. http://radiopaedia.org/articles/tamoxifen-associated-endometrial-changes Accessed on March 10, 2016
- ↑ Wartko PD, Beck TL, Reed SD, Mueller BA, Hawes SE (August 2017). "Association of endometrial hyperplasia and cancer with a history of gestational diabetes". Cancer Causes Control. 28 (8): 819–828. doi:10.1007/s10552-017-0908-9. PMID 28577154.