How Is Hyperplasia Treated?
Print PageEmergency Treatment
If you need your period stanched right away because of hemorrhaging, then you will be offered tranexamic acid (Cyklokapron®). Your problem is likely an ovulatory hormonal imbalance. Your body produces too much plasminogen activator before your period begins. Taking one gram of Cyklokapron® every 6 hours for 4 days when the heavy bleeding starts will quickly reduce your blood flow by 40%. Cyklokapron® is also used as an anti-stroke medication, and can cause complications, such as: Dizziness from low blood pressure; visual disturbances, especially color changes and loss of visual acuity; and damage to the retinas in your eyes. If visual disturbances occur, you must stop taking Cyklokapron®.
Anemia
If the lab finds you have iron deficiency anemia, then your doctor will advise you to take iron supplement pills daily. 300 mg ferrous gluconate (or iron equivalent) is easier for your stomach to tolerate than ferrous sulphate, but is a little more expensive.
Increase your intake of iron-rich foods, like: Eggs; spinach and other dark green, leafy vegetables; liver; iron-fortified cereal and pasta; beans; nuts; legumes (lentils); dried fruit; and prune juice. Iron requires Vitamin C so that it can be adequately absorbed, so eating these foods also will help: Orange juice; strawberries; broccoli; grapefruits; lemons; kiwi; mangoes; apricots; peppers; tomatoes; cabbage; potatoes; romaine lettuce; turnip greens. Buy a stool softener because iron is constipating. If your anemia does not resolve with the iron supplements and dietary changes, you may receive iron injections, blood transfusions, and in-patient care in a hospital.
Do not take iron supplements without first verifying with an accredited lab that you truly have iron deficiency anemia. There are other forms of anemia and conditions that cause fatigue. Taking iron supplements when you do not have iron deficiency anemia causes iron overload and damages your liver. Your further treatment options depend on the type of hyperplasia you have:
Simple
Simple hyperplasia with no atypical cells in the smear responds very well to progesterone/progestin treatment. You can receive the progesterone via a skin cream or a vaginal gel or alternatively as a synthetic progestin.
Pure progesterone has fewer side-effects compared with synthetic progestins in the form of an IUD or pills. About 86.5% of patients with simple hyperplasia find it regresses successfully with progesterone or progestin treatment. Progesterone instigates regular and predictable periods. When you stop taking progesterone/progestin each month, your entire endometrium will shed at once, and you will not have prolonged bleeding. There will be no dangerous build-up lining your uterus because your period has been hormonally induced and your natural estrogen production is balanced with progesterone. You require a follow-up examination after three months to verify that your hyperplasia has cleared. If your hyperplasia is resistant to the initial treatment doses then your doctor will likely step up the daily dose without a break for six months. If you initially use pure progesterone and the hyperplasia does not clear they will usually switch to a progestin.
Complex
Your doctor may offer you triptorelin (Trelstar®, Diphereline®) for 6 months. It is a gonadotrophin-releasing hormone analogue (GnRHa) that regresses complex hyperplasia for 85.7% of patients, but 7.1% have persistent hyperplasia, and another 7.1% progress on to atypical complex hyperplasia (precancer). Side effects can be bothersome.
Simple atypical
Megace® (megestrol acetate) for six months is the first line defense for atypia. If unsuccessful, then your doctor will probably offer you endometrial ablation (burning off the lining of the womb) or transcervical resection of the endometrium (TCRE).
Complex atypical
Usually, your doctor will advise a complete hysterectomy (removal of the womb, fallopian tubes and ovaries, or TAHBSO) for complex atypical hyperplasia because there is a 29% to 30% chance it could develop into cancer of the uterus. Your doctor may also wish to dissect your pelvic lymph nodes if he or she suspects cancer has spread (metastasized). Your doctor may want to thin out your endometrium before the surgery, to make your uterus easier to remove through your vagina, so you may be offered male hormones, which will send you into menopause. (see www.hysterectomy-hormone-support.com) Removal of the ovaries (oopherectomy) will require hormonal therapy support to address the resultant deficiencies of estrogen and testosterone (see www.oopherectomy.info).