Endometrial Hyperplasia Research Paper

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Introduction:. Endometrial hyperplasia is one of the most common cause of abnormal menstrual bleeding. It is defined as a condition of excessive proliferation of endometrial glands relative to the stroma, resulting in increased gland to stroma ratio. It is a noninvasive uterine wall proliferation but patients with endometrial hyperplasia have an increased risk of developing endometrial cancer.
Endometrium is the innermost layer of the uterine wall and is composed of a outer functional layer and a inner basal layer. The endometrium is lined by ciliated columnar epithelial cells and its lamina propria contains simple tubular types of endometrial glands.
Pathogenesis: Normally, following a menstrual period, Pituitary hormones and ovarian estrogen stimulates the proliferative phase of the endometrium. This proliferative phase is halted by rising levels of progesterone at about 10 to 14 days following the menstruation.Estrogen causes proliferation of the uterine lining and progesterone controls and maintains the uterine growth. If the balance between estrogen and progesterone is disturbed, there could be absolute or relative increase in the level of estrogen. Continuous estrogen stimulation unopposed by progesterone causes hyperplasia of the endometrium. Mutations of the PTEN tumor suppressor gene have been found in more than 20% of hyperplasias. Most of the endometrial hyperplasias are reversible with appropriate therapy ,however if the hyperestrogenic stimulation persists, hyperplasia
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The most common risk factors include exogenous estrogen , the polycystic ovarian syndrome, ovarian neoplasm, obesity, infertility and late menopause. The two other risk factors, diabetes mellitus and hypertension are considered as a consequence of obesity and not a direct cause of endometrial

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