Complex endometrial hyperplasia is a condition characterized by the abnormal growth and thickening of the inner lining of the uterus, known as the endometrium. It is considered a precursor to endometrial cancer, though not all cases progress to cancer. Complex endometrial hyperplasia is distinguished from simple endometrial hyperplasia by the presence of certain structural changes and increased cell abnormalities within the endometrial tissue.
The complex form of endometrial hyperplasia involves an overgrowth of glandular and stromal cells in the endometrium. These cells can appear crowded and may display features that indicate a higher potential for developing into cancerous cells. Risk factors for complex endometrial hyperplasia include hormonal imbalances, obesity, polycystic ovary syndrome (PCOS), and certain medications like tamoxifen.
Diagnosis is typically made through a biopsy of the endometrial tissue, which is obtained either through an outpatient procedure called dilation and curettage (D&C) or by performing an office-based endometrial biopsy. Once diagnosed, treatment options depend on factors such as the patient's age, desire for future fertility, and the extent of cell abnormalities. Treatment may involve hormonal therapies, such as progestin therapy, to promote a more normal endometrial lining, or surgical interventions like D&C to remove the abnormal tissue. In some cases, a hysterectomy (removal of the uterus) may be recommended, especially if the patient is not planning to have children in the future or if the condition is severe or recurrent.
In summary, complex endometrial hyperplasia is a condition characterized by abnormal growth and structural changes in the endometrial lining of the uterus. It is considered a precursor to endometrial cancer and is more advanced than simple endometrial hyperplasia. Prompt diagnosis and appropriate treatment are essential to manage the condition and reduce the risk of progression to cancer. Women experiencing symptoms like irregular or heavy bleeding should seek medical attention for proper evaluation and guidance.