The following is a summary of some of the problems that are commonly encountered during the treatment of endometrial hyperplasia, which I hope will be helpful to you. However, it should be noted that these answers are the usual treatment, and if some unsolvable problems arise during the treatment process, it is still important to seek medical advice in a timely manner and not to be negligent.
What medication for what condition? There are many different types of endometrial hyperplasia, and the medication used varies from case to case. The following is a list of medications for some common conditions.
Endometrial hyperplasia disorder: It belongs to the earliest stage of endometrial hyperplastic lesions and is usually treated with oral contraceptives or progestin after half cycle to adjust the menstrual cycle.
Simple hyperplasia of the endometrium and complex hyperplasia of the endometrium: these are benign lesions and are usually treated with low-dose progestin post- and half-cycle therapy, such as progesterone.
Endometrial atypical hyperplasia: It is a precancerous lesion of endometrial cancer. If there is no fertility requirement or contraindication for fertility preservation treatment, the preferred treatment option is surgical removal of the uterus. If the indications for fertility preserving treatment are met, treatment with high dose progestin, such as megestrol acetate (160mg) or medroxyprogesterone acetate (500mg), is used. Treatment with the mannophore ring is also available.
Endometrial cancer: The preferred treatment is surgical removal of the uterus and bilateral fallopian tubes and ovaries. Patients with a strong desire to preserve their reproductive function can be treated with high-dose progestin with the same treatment regimen as endometrial atypia, after rigorous screening and if they meet the indications for treatment to preserve reproductive function.
How do I take these medications?
Please note that medication use should be taken strictly in accordance with medical advice, and the following is the usual method of administration
Oral contraceptive pills: the most commonly used are Mafron, Ursine, and Daimler-35. Take them on the 3rd-5th day of menstruation (note that they are taken on the 3rd-5th day of menstruation, i.e. bleeding, not 3-5 days after menstruation). Take 1 capsule per day, regularly, for 21 days. Note that these drugs are hormonal and need to be taken on a daily basis. Missing a dose may cause irregular bleeding. Oral contraceptive pills are contraceptively effective when taken regularly and no other contraceptive measures are required during the period of use.
Progesterone: Start taking it on the 10th-15th day of menstruation according to the doctor’s prescription, once a day, 10mg each time, for 10-15 days. Again, you need to take it every day on time and not to miss it.
Medroxyprogesterone acetate or medroxyprogesterone acetate: Take the medication every day according to the doctor’s prescription, for continuous use without stopping.
What should I do if I encounter these problems while taking the medication?
Bleeding during medication: If bleeding occurs in drops while taking the above medication, it is not necessary to pay attention to it and continue to use the medication. If the amount of bleeding increases, such as the normal amount of menstruation, you should stop taking the medication and seek medical advice.
How long does it take for your period to come after stopping the medication: If you are taking progesterone or oral contraceptives, your period will come within 1-2 weeks after stopping the medication as prescribed by your doctor. If you stop taking the pill for more than two weeks and still do not have a period, you need to see your doctor.
Too much menstrual bleeding after stopping the pill: Generally, when menstruation comes after stopping the progesterone or oral contraceptive pill, there may be more bleeding within 1-2 cycles after starting the treatment. If the bleeding is heavy and continues for 1-2 days, you can ignore it and continue to take the next cycle of medication as prescribed by your doctor. If the bleeding is heavy and does not stop, you need to see a doctor.
Can I continue to take the next cycle of medication if my menstruation is not clear: Because of the lesions in the endometrium, the bleeding may be irregular and incomplete during the first few cycles of progestogen or oral contraceptive treatment. If the menstrual flow does not finish within 1-2 cycles after starting the medication, it does not affect the medication, just take the medication according to the doctor’s prescription and start the next cycle of treatment.
Some adverse reactions that often occur during the use of the drug: many patients will experience breast pain when taking oral contraceptives, especially Da-Ying-35, it is recommended to go to the mammary department first to exclude breast disease, if there is no abnormality can continue to take, if the pain is unbearable, it is recommended to seek medical advice, the doctor will switch to other drugs according to the situation. It should be especially noted that the progestin used for treatment may cause an increase in the incidence of breast cancer, so it is recommended to have a breast examination before starting treatment and to consult a doctor promptly if the breast does not adapt during the treatment.
Weight gain: Weight gain usually occurs when taking high doses of progestins. This is because high doses of progestins can cause water and sodium storage or appetite to increase, so weight gain occurs. If edema is obvious, it is recommended to consult a doctor, who will treat the symptoms appropriately.
Appetite: You may experience an increase in appetite while taking oral contraceptives. It is advisable to keep your mouth shut, exercise and control your diet.
Nausea and vomiting: If the symptoms are mild, you can ignore them. If severe, you need to seek medical attention and change medication if necessary. For patients taking metformin, the drug itself can cause nausea and vomiting and abdominal distension, it is recommended that if the symptoms are severe, you can switch to metformin extended-release tablets, or the drug is reduced or temporarily discontinued, and when the symptoms are relieved, it is appropriate to gradually increase the dosage.
Allergic reactions: A small number of oral contraceptives can cause allergic reactions, if they occur, you should seek medical advice as soon as possible and change the medication under the guidance of a doctor.
How long does it take to treat and can this problem be cured?
The duration of treatment and the effectiveness of treatment vary between endometrial hyperplastic lesions.
Endometrial hyperplasia disorders are usually adjusted for three months.
Simple endometrial hyperplasia is usually treated for three months with a follow-up ultrasound on the fifth day of menstruation, and the doctor will recommend whether endometrial pathology is needed to determine the effectiveness of treatment. The vast majority of cases of simple hyperplasia have satisfactory results.
Complex endometrial hyperplasia is also treated on the fifth day of menstruation after three months of treatment. Since the efficiency of treatment for complex hyperplasia is about 80%, endometrial pathology is required after three months of treatment to determine the effectiveness of treatment. Usually the treatment lasts for 3-6 months.
The duration of drug treatment for endometrial atypical hyperplasia and endometrial cancer is usually 6-9 months, and the treatment efficiency is usually about 70-80%. Since there is a possibility of treatment failure or disease progression, endometrial pathology examination is required every three months during treatment to determine the effectiveness of treatment.
Does it mean that everything is fine after treatment?
It must not be so! It must be prevented! It must be prevented! Prevention is essential! It is important to say it three times.
As most of the endometrial hyperplasia is caused by ovarian ovulation dysfunction, resulting in the lack of progesterone protection of the endometrium. Although progesterone is used during treatment to reverse the diseased endometrium. However, the ovarian problem persists and there is no good way to get the ovaries to resume ovulation voluntarily and consciously. Therefore, if the endometriosis is left untreated after treatment, it will not take long for the endometriosis to return and even worsen. Therefore, after treatment of endometriosis, it is necessary to take oral contraceptives, the Mannedel ring, and post-progestin semi-cycle to protect the endometrium and allow regular menstruation.
What should I do if I want to have a baby after treatment?
Since most endometrial lesions have ovarian ovulatory dysfunction, you need to seek the help of a reproductive endocrinologist if your endometrium is reversed to have a baby. After evaluating the endometrium, ovarian function and the patency of the fallopian tubes, the reproductive endocrinologist will give a reasonable assisted reproduction plan. However, it is important to note that if you are not pregnant during the examination and treatment period, you must apply progesterone to ensure regular menstruation and protect the lining. Since there is a possibility of pregnancy, the progestin of choice at this time is natural progesterone or dydrogesterone. These progestogens can protect the lining and allow menstruation if you are not pregnant, and if you are pregnant, you will be fine.
What about after having a baby?
As before, it must be prevented, it’s a lasting project, we won’t stop until menopause! Of course, for patients with atypical hyperplasia and endometrial cancer, we also recommend prophylactic surgery to remove the uterus after completing childbirth because of the possibility of progression.