This article will help you read and understand your pathology report for disordered proliferative endometrium.
by Adnan Karavelic, MD FRCPC, updated December 16, 2020
The uterus is a pear-shaped hollow organ that is in the female pelvis between the rectum and the urinary bladder. The upper part of the uterus (fundus) is attached to the fallopian tubes while the lower part is connected to the vagina through the uterine cervix.
The walls of the uterus are made up of three layers:
The endometrium is hormone-responsive and goes through regular menstrual cycles during a women’s reproductive years. Each menstrual cycle is controlled by a complex orchestra of hormones. During the menstrual cycle, the endometrium is preparing itself for the possible pregnancy by becoming thicker and richer in blood vessels.
In the first part of the menstrual cycle, the endometrium is growing under the influence of estrogen (a hormone produced by the ovaries) and is known as the proliferative phase (growing phase).
After ovulation (ovulation is when an egg is released from the ovary, pushed down the fallopian tube, and is made available to be fertilized), the endometrial changes are under control of progesterone (another hormone released by the ovaries). If pregnancy does not occur (the egg is not fertilized), the thickened endometrial lining is shed, accompanied by bleeding (menses), and the cycle repeats.
In some situations, however, the endometrium is exposed to a prolonged influence of estrogen. That results in increased growth and crowding of the endometrial glands, and can lead to endometrial hyperplasia. Some common situations that can result in prolonged estrogen exposure include polycystic ovary syndrome, obesity, eating disorders, thyroid disorders, and estrogen-only birth control pills. Women nearing menopause (perimenopause) may also experience prolonged estrogen exposure.
The diagnosis of disordered proliferative endometrium is a descriptive diagnosis. It means that after examining your tissue sample under the microscope, your pathologist saw irregular and dilated endometrial glands in the proliferative phase (growing phase).
The diagnosis of disordered proliferative endometrium is just one piece of the answer and the diagnosis needs to be considered together with your medical history, physical examination, and any other tests that were performed (blood work, imaging tests, etc.). Your doctor will use all of this information in order to determine the final diagnosis and reason for this condition.
There are many causes for disordered proliferative endometrium. Your treatment options will depend on your medical history and the results of other tests performed. Talk to your doctor about what this diagnosis means to you.