Endometrial hyperplasia history and symptoms: Difference between revisions
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{{Endometrial hyperplasia}} | {{Endometrial hyperplasia}} | ||
{{CMG}}{{ | {{CMG}}{{Swathi}} | ||
==Overview== | ==Overview== | ||
A positive history of irregular [[menstrual cycle]]s ([[PCOD]]) may be present.<ref name=qw>Endometrial hyperplasia. Radiopedia. http://radiopaedia.org/articles/endometrial-hyperplasia-1 Accessed on March 10, 2016.</ref> 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.<ref name="pmid25797956">{{cite journal| author=Emons G, Beckmann MW, Schmidt D, Mallmann P, Uterus commission of the Gynecological Oncology Working Group (AGO)| title=New WHO Classification of Endometrial Hyperplasias. | journal=Geburtshilfe Frauenheilkd | year= 2015 | volume= 75 | issue= 2 | pages= 135-136 | pmid=25797956 | doi=10.1055/s-0034-1396256 | pmc=PMC4361167 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25797956 }} </ref><ref name="pmid19393600">{{cite journal| author=Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K et al.| title=Incidence of endometrial hyperplasia. | journal=Am J Obstet Gynecol | year= 2009 | volume= 200 | issue= 6 | pages= 678.e1-6 | pmid=19393600 | doi=10.1016/j.ajog.2009.02.032 | pmc=PMC2692753 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19393600 }} </ref><ref name=mn>Tamoxifen associated endometrial changes. Radiopedia. http://radiopaedia.org/articles/tamoxifen-associated-endometrial-changes Accessed on March 10, 2016</ref> | A positive [[History and Physical examination|history]] of irregular [[menstrual cycle]]s ([[PCOD]]) may be [[Presenting symptoms|present]].<ref name="qw">Endometrial hyperplasia. Radiopedia. http://radiopaedia.org/articles/endometrial-hyperplasia-1 Accessed on March 10, 2016.</ref> 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 [[Postmenopausal|post menopausal]] [[women]] and [[History and Physical examination|history]] of [[tamoxifen]] use in [[breast cancer]] [[patients]] may be present.<ref name="pmid25797956">{{cite journal| author=Emons G, Beckmann MW, Schmidt D, Mallmann P, Uterus commission of the Gynecological Oncology Working Group (AGO)| title=New WHO Classification of Endometrial Hyperplasias. | journal=Geburtshilfe Frauenheilkd | year= 2015 | volume= 75 | issue= 2 | pages= 135-136 | pmid=25797956 | doi=10.1055/s-0034-1396256 | pmc=PMC4361167 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25797956 }} </ref><ref name="pmid19393600">{{cite journal| author=Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K et al.| title=Incidence of endometrial hyperplasia. | journal=Am J Obstet Gynecol | year= 2009 | volume= 200 | issue= 6 | pages= 678.e1-6 | pmid=19393600 | doi=10.1016/j.ajog.2009.02.032 | pmc=PMC2692753 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19393600 }} </ref><ref name="mn">Tamoxifen associated endometrial changes. Radiopedia. http://radiopaedia.org/articles/tamoxifen-associated-endometrial-changes Accessed on March 10, 2016</ref> | ||
==History== | ==History== | ||
*A detailed drug history may be helpful in the assessment of possible risk factors for endometrial hyperplasia. | *Bleeding during the menstrual period that is heavier or lasts longer than usual | ||
**Inappropriate [[hormone replacement therapy]] in post menopausal women (with insufficient [[progesterone]] component)<ref name="pmid25797956">{{cite journal| author=Emons G, Beckmann MW, Schmidt D, Mallmann P, Uterus commission of the Gynecological Oncology Working Group (AGO)| title=New WHO Classification of Endometrial Hyperplasias. | journal=Geburtshilfe Frauenheilkd | year= 2015 | volume= 75 | issue= 2 | pages= 135-136 | pmid=25797956 | doi=10.1055/s-0034-1396256 | pmc=PMC4361167 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25797956 }} </ref><ref name="pmid19393600">{{cite journal| author=Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K et al.| title=Incidence of endometrial hyperplasia. | journal=Am J Obstet Gynecol | year= 2009 | volume= 200 | issue= 6 | pages= 678.e1-6 | pmid=19393600 | doi=10.1016/j.ajog.2009.02.032 | pmc=PMC2692753 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19393600 }} </ref> | *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) | ||
**History of tamoxifen use<ref name=mn>Tamoxifen associated endometrial changes. Radiopedia. http://radiopaedia.org/articles/tamoxifen-associated-endometrial-changes Accessed on March 10, 2016</ref> | *Any bleeding after menopause | ||
***[[Tamoxifen]] is a non-steroidal anti-estrogen that binds to the [[estrogen]] receptor and is used primarily for adjuvant therapy in breast cancer | *A detailed [[drug]] [[History and Physical examination|history]] may be helpful in the [[Assessment and Plan|assessment]] of possible [[risk factors]] for [[endometrial hyperplasia]]. | ||
***Tamoxifen may also act as an estrogen agonist in a low estradiol environment | **Inappropriate [[hormone replacement therapy]] in post [[menopausal]] [[women]] (with insufficient [[progesterone]] component)<ref name="pmid25797956">{{cite journal| author=Emons G, Beckmann MW, Schmidt D, Mallmann P, Uterus commission of the Gynecological Oncology Working Group (AGO)| title=New WHO Classification of Endometrial Hyperplasias. | journal=Geburtshilfe Frauenheilkd | year= 2015 | volume= 75 | issue= 2 | pages= 135-136 | pmid=25797956 | doi=10.1055/s-0034-1396256 | pmc=PMC4361167 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25797956 }} </ref><ref name="pmid19393600">{{cite journal| author=Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K et al.| title=Incidence of endometrial hyperplasia. | journal=Am J Obstet Gynecol | year= 2009 | volume= 200 | issue= 6 | pages= 678.e1-6 | pmid=19393600 | doi=10.1016/j.ajog.2009.02.032 | pmc=PMC2692753 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19393600 }} </ref> | ||
***Up to 50% of breast cancer patients who are treated with [[tamoxifen]] may develop an endometrial lesion within 6-36 months | **History of [[tamoxifen]] use<ref name="mn">Tamoxifen associated endometrial changes. Radiopedia. http://radiopaedia.org/articles/tamoxifen-associated-endometrial-changes Accessed on March 10, 2016</ref> | ||
***Any patient who develops bleeding while on [[tamoxifen]] needs evaluation | ***[[Tamoxifen]] is a [[non-steroidal]] [[Anti-estrogen therapy|anti-estrogen]] that binds to the [[estrogen]] [[receptor]] and is used primarily for [[adjuvant therapy]] in [[breast cancer]] | ||
*A positive history of irregular [[menstrual cycle]]s (PCOD) may be present.<ref name=qw>Endometrial hyperplasia. Radiopedia. http://radiopaedia.org/articles/endometrial-hyperplasia-1 Accessed on March 10, 2016.</ref> | ***[[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]] [[Lesions|lesion]] within 6-36 months | |||
***Any [[patient]] who [[Development|develops]] [[bleeding]] while on [[tamoxifen]] needs evaluation | |||
*A positive [[History and Physical examination|history]] of irregular [[menstrual cycle]]s ([[PCOD]]) may be present.<ref name="qw">Endometrial hyperplasia. Radiopedia. http://radiopaedia.org/articles/endometrial-hyperplasia-1 Accessed on March 10, 2016.</ref> | |||
We observed an association between [[Endometrial hyperplasia|EH]]/[[Endometrial cancer|EC]] and a [[History and Physical examination|history]] of [[gestational diabetes]] specific to younger [[women]]. Future studies focusing on the relationships between [[gestational diabetes]], [[obesity]], and [[Endometrial cancer|EC]], including [[age]] at [[diagnosis]], are warranted.<ref name="pmid28577154">{{cite journal |vauthors=Wartko PD, Beck TL, Reed SD, Mueller BA, Hawes SE |title=Association of endometrial hyperplasia and cancer with a history of gestational diabetes |journal=Cancer Causes Control |volume=28 |issue=8 |pages=819–828 |date=August 2017 |pmid=28577154 |doi=10.1007/s10552-017-0908-9 |url=}}</ref> | |||
==Symptoms== | ==Symptoms== | ||
*The majority of patients with endometrial hyperplasia present with abnormal uterine bleeding.<ref name=qw>Endometrial hyperplasia. Radiopedia. http://radiopaedia.org/articles/endometrial-hyperplasia-1 Accessed on March 10, 2016.</ref> | *The majority of [[patients]] with [[endometrial hyperplasia]] present with [[abnormal uterine bleeding]].<ref name="qw">Endometrial hyperplasia. Radiopedia. http://radiopaedia.org/articles/endometrial-hyperplasia-1 Accessed on March 10, 2016.</ref> | ||
*Any postmenopausal bleeding should raise | *Any [[postmenopausal]] [[bleeding]] should raise suspicion for [[malignancy]]. | ||
==References== | ==References== | ||
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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.