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OVERVIEW

What is endometrial hyperplasia?

Endometrial hyperplasia is a condition in which the endometrium (lining of the uterus) is abnormally thick. There are four types of endometrial hyperplasia. The types vary by the amount of abnormal cells and the presence of cell changes. These types are: simple endometrial hyperplasia, complex endometrial hyperplasia, simple atypical endometrial hyperplasia, and complex atypical endometrial hyperplasia.

SYMPTOMS

The primary symptom of endometrial hyperplasia is abnormal menstrual bleeding. Contact your healthcare provider if you experience:

• Menstrual bleeding that is heavier or longer lasting than usual.
• Menstrual cycles (amount of time between periods) that are shorter than 21 days.
• Menstrual bleeding between menstrual periods.
• Not having a period (pre-menopause).
• Post-menopause uterine bleeding.

CAUSES

What causes endometrial hyperplasia?

Endometrial hyperplasia is caused by too much estrogen or not enough progesterone. Both of these hormones play roles in the menstrual cycle. Estrogen makes the cells grow, while progesterone signals the shedding of the cells. A hormonal imbalance can produce too many cells or abnormal cells.

DIAGNOSIS

How is endometrial hyperplasia diagnosed?

Abnormal uterine bleeding can be a symptom for many things. Your healthcare provider can perform an exam and tests to diagnose the main condition. A transvaginal ultrasound measures your endometrium. It uses sound waves to see if the layer is average or too thick. A thick layer can indicate endometrial hyperplasia. Your healthcare provider may take a biopsy of your endometrium cells to determine if cancer is present.

PREVENTION

Can endometrial hyperplasia be prevented or avoided?

You are more likely to have endometrial hyperplasia if you have gone through menopause. This is because your body’s hormones and menstrual cycles change. Other risk factors for this condition are:

• Long-term use of medicines that contain high levels of estrogen or chemicals that act like estrogen.
• Irregular menstrual cycles, which can be caused by infertility or polycystic ovary syndrome (PCOS).
• Obesity.
• Use of tobacco.
• First menstrual cycle at an early age.
• Going through menopause at an older age.
• Never having been pregnant.
• Family history of uterine, ovarian, or colon cancer.

You cannot prevent endometrial hyperplasia, but you can help lower your risk by:

• Losing weight, if you are obese.
• Taking a medicine with progestin (synthetic progesterone), if you already are taking estrogen, due to menopause or another condition.
• Taking birth control or another medicine to regulate your hormones and menstrual cycle.

TREATMENT

Treatment options for endometrial hyperplasia depend on what type you have. The most common treatment is progestin. This can be taken in several forms, including pill, shot, vaginal cream, or intrauterine device.

Atypical types of endometrial hyperplasia, especially complex, increase your risk of getting cancer. If you have these types, you might consider a hysterectomy. This is a surgery to remove your uterus. Healthcare providers may recommend this if you no longer want to become pregnant.

There are also a number of more conservative treatments for younger women who do not wish to have a hysterectomy. Your healthcare provider will help you decide which treatment option is best for you.

Living with endometrial hyperplasia

In most cases, endometrial hyperplasia is very treatable. Work with your healthcare provider to create a treatment plan. If you have a severe type or if the condition is ongoing, you might need to see your healthcare provider more often to monitor any changes.