What causes endometrial hyperplasia?

Generally, endometrial hyperplasia may be caused by factors such as hormonal imbalance during puberty, hormonal disturbances around menopause, anovulatory dysfunctional uterine bleeding, polycystic ovary syndrome (PCOS), and endometrial polyps. It is recommended to seek timely medical consultation to identify the underlying cause and receive appropriate treatment under a physician's guidance. Detailed explanations are as follows:

1. Hormonal Imbalance During Puberty: During puberty, ovarian function is not yet mature, leading to fluctuating estrogen levels, irregular ovulation, and insufficient progesterone. The endometrium proliferates due to continuous estrogen stimulation alone. No special treatment is required, as hormone levels will stabilize as ovarian function gradually matures.

2. Hormonal Disturbances Around Menopause: During the perimenopausal period, ovarian function declines, resulting in reduced and irregular estrogen secretion and insufficient progesterone production. The endometrium continuously thickens due to lack of antagonism. Regular monitoring of endometrial thickness and hormone levels is necessary. It is advisable to appropriately increase intake of soy products in the diet to supplement phytoestrogens and maintain emotional stability.

3. Anovulatory Dysfunctional Uterine Bleeding: Long-term anovulation prevents normal progesterone secretion, leading to continuous estrogen-induced endometrial proliferation, often accompanied by heavy menstrual bleeding and prolonged menstrual periods. Patients should follow medical advice to use medications such as dydrogesterone tablets, progesterone capsules, or norethisterone tablets to regulate hormone levels.

4. Polycystic Ovary Syndrome: Cystic changes in the ovaries lead to elevated androgen levels and ovulatory dysfunction, with relative estrogen excess stimulating abnormal endometrial hyperplasia. This is often accompanied by infrequent menstruation and hirsutism. Patients should follow medical advice to use medications such as ethinyl estradiol cyproterone tablets, drospirenone ethinyl estradiol tablets, or spironolactone tablets to regulate hormones, reduce androgen levels, and improve ovulatory function.

5. Endometrial Polyps: Localized excessive endometrial proliferation forms polyps, causing overall endometrial thickening. When abnormal uterine bleeding is significant or symptoms are severe, hysteroscopic endometrial polypectomy is required to remove the polyps and restore normal endometrial morphology.

Maintaining healthy lifestyle habits is important in daily life, including avoiding excessive fatigue and reducing consumption of spicy or cold foods. Regular gynecological examinations should also be conducted to promptly detect and address endometrial abnormalities, thus maintaining reproductive health.