On this page, you will find everything you need to know about endometrial hyperplasia.
What Is Endometrial Hyperplasia?
Endometrial hyperplasia occurs when the lining of the uterus (endometrium) becomes abnormally thick. The endometrium is the tissue that is shed during menstruation and also the layer where a fertilized egg implants during pregnancy. In advanced cases, endometrial hyperplasia may lead to endometrial cancer, a type of uterine cancer.
What Are the Symptoms of Endometrial Hyperplasia?
- Abnormal menstrual bleeding or bleeding between periods.
- Short menstrual cycles (less than 21 days).
- Heavy menstrual bleeding.
- Vaginal bleeding after menopause.
What Causes Endometrial Hyperplasia?
People with endometrial hyperplasia produce excessive estrogen and insufficient progesterone. These two hormones play essential roles in menstruation and pregnancy. During ovulation, estrogen thickens the uterine lining, while progesterone prepares the uterus for a possible pregnancy. If pregnancy does not occur, progesterone levels drop, and the lining is shed during menstruation.
Risk factors for endometrial hyperplasia include:
- Certain breast cancer treatments (e.g., tamoxifen).
- Diabetes
- Early onset of menstruation or late menopause.
- Family history of ovarian, uterine, or colon cancer.
- Gallbladder disease.
- Estrogen-only hormone therapy in women with an intact uterus.
- Obesity
- Polycystic ovary syndrome (PCOS).
- Smoking
- Thyroid disease.
- Long-standing irregular or absent menstrual periods.
How Is Endometrial Hyperplasia Diagnosed?
The doctor will take a medical history and perform a physical examination. Additional tests may be requested as needed, such as:
- Ultrasound
- Endometrial biopsy.
- Hysteroscopy
What Are the Treatment Options for Endometrial Hyperplasia?
Treatment varies based on the condition and may include:
Progestin-based therapies:
- Oral progesterone (e.g., birth control pills).
- Hormonal intrauterine device (IUD) containing progesterone.
- Injections
- Vaginal creams or gels.
Hysterectomy may be recommended in advanced cases when:
- The condition worsens or cancerous changes develop.
- Progestin therapy fails to improve the condition.
Can Endometrial Hyperplasia Be Prevented?
- Use progesterone along with estrogen if undergoing hormone replacement therapy after menopause.
- Take combined oral contraceptives (estrogen + progestin) if experiencing irregular periods.
- Quit smoking.
- Maintain a healthy weight.
What Are the Complications of Endometrial Hyperplasia?
- Anemia
- Untreated atypical endometrial hyperplasia may progress to cancer.
When Should You See a Doctor?
- Heavy or abnormal bleeding.
- Vaginal bleeding after menopause.
- Painful intercourse.
- Pelvic pain.
- Unusual vaginal discharge.
- Frequently missed periods.
Frequently Asked Questions:
My periods stopped for three months and then came back. Is this normal?
As women approach menopause, often after the age of 45, menstrual cycles may become irregular, sometimes stopping for a while and then returning sporadically. This is considered normal. A woman is not considered postmenopausal until she has gone a full year without any menstrual bleeding.
I haven’t had a period for over a year, and now I’m experiencing vaginal bleeding. Is this normal?
Vaginal bleeding after going more than a year without a period is usually abnormal. You should consult your doctor to determine the cause and rule out any serious conditions.
