Should endometrial hyperplasia be treated after menopause?

Postmenopausal endometrial hyperplasia needs to be treated based on the specific situation, but in most cases, evaluation and intervention are needed to prevent malignant changes. The causes may involve hormone imbalance, metabolic abnormalities, and external stimuli. Treatments include medication, surgery, or lifestyle adjustments.

1) Imbalance of hormone levels

After menopause, due to the decline of ovarian function, the imbalance of estrogen and progesterone levels may lead to abnormal proliferation of the endometrium. Especially for some women who still have high estrogen levels in their bodies, the lack of progesterone for a long time may increase the risk of endometrial hyperplasia. Doctors may confirm the cause by testing hormone levels. For simple hyperplasia, you can consider taking progesterone drugs such as dydrogesterone tablets, progesterone or long-acting contraceptives to restore hormone balance and reduce the risk of hyperplasia.

2) Metabolic abnormalities

Metabolic problems such as obesity, diabetes, polycystic ovary syndrome, and hypertension are closely related to postmenopausal endometrial hyperplasia. These diseases may increase the level of estrogen in the body or extend its duration of action. For example, enzymes in the adipose tissue of obese women can convert androgens into estrogen, thereby inducing endometrial hyperplasia. For such patients, reducing weight, improving diet structure (such as consuming more fiber-rich vegetables, fruits, and whole grains, and eating less high-fat and high-sugar foods), combined with regular exercise (such as at least 150 minutes of moderate-intensity aerobic exercise per week) are important means to control metabolic abnormalities.

3) Pathological factors

Certain disease factors may also cause endometrial hyperplasia, such as uterine fibroids or endometritis. If the hyperplasia is complex, atypical, or suspected of precancerous lesions, surgical treatment may be required, such as uterine curettage or even hysterectomy. For postmenopausal women, especially those with abnormal vaginal bleeding or persistent pelvic discomfort, they should seek medical attention and undergo pathological examination as soon as possible to rule out malignant lesions.

4) Influence of external factors

Improper use of hormone replacement therapy or long-term use of drugs that affect endocrine function may lead to postmenopausal endometrial hyperplasia. If hormone therapy is indeed necessary, women are advised to choose combined hormone replacement therapy and monitor changes in endometrial thickness after medication to reduce the risk of hyperplasia.

For postmenopausal endometrial hyperplasia, regardless of whether symptoms occur, it is necessary to pay great attention and have regular physical examinations, including ultrasound examination of endometrial thickness, hormone level testing, and necessary endometrial biopsy. If hyperplasia is confirmed, a personalized treatment plan should be developed under the guidance of a doctor to prevent further deterioration.