Wednesday, 11 July 2018

Alert: Excessive Menstrual Bleeding May Be an Early Sign of Cancer

"Endometrial hyperplasia is a thickening of the inner lining of the womb (uterus). Most often it is caused by an excess of the hormone estrogen, which is not balanced by the hormone progesterone. Endometrial hyperplasia is often found in a woman who does not ovulate, the egg is not released from the ovary," said dr. Budi Wiweko, Sp.OG (K), Research and Community Services Manager, an OB/GYN at FKUI/RSCM.

During the first part of the cycle, the hormone estrogen causes the lining to grow and thicken to prepare the uterus for pregnancy. The embryo needs the lining to implant and grow. In most cases, if the egg is fertilized, estrogen works with another hormone, progesterone, to stop ovulation. Progesterone will help control the growth of the lining. When the lining is too thick, the embryo will be difficult to reach it.

In endometrial hyperplasia, the growth of the uterine lining becomes uncontrolled because progesterone is not made during post-ovulation.

In fact, endometrial hyperplasia is different from other uterine disorders such as cysts and uterine fibroids (myomas). "They have different symptoms. Cysts is a benign tumor in the ovary, while uterine myoma is a benign tumor in the uterus. So, they are different. Meanwhile, endometrial hyperplasia is the abnormal thickening of the lining of the uterus. Thus, they are completely different. Symptoms of an ovarian cyst include pain during menstrual periods. Whereas, the most common symptoms of uterine fibroids include heavy menstrual bleeding. In some cases, fibroids found in the lining of the uterus may also lead to endometrial hyperplasia," dr. Budi explained.

The abnormalities may cause menstrual disorders. However, these disorders are benign and may not cause death.

"The thickening of the uterine lining due to the excess of the hormone estrogen can lead to malignancy. It also increases the risk of developing endometrial cancer. The cancer will develop if the hormone progesterone is not made to control the overgrowth of the lining, or simply known as precancerous lesions," dr. Budi emphasized.

"Women over 40 have a higher risk of experiencing endometrial hyperplasia which can develop into endometrial cancer. Women with ovulation disorders, obesity, hypertension, diabetes mellitus are also prone to endometrial cancer. The disorders may lead to precancerous condition in the uterus," he added.