General Information About Endometrial Hyperplasia
Disease Details and Frequently Asked Questions
It is the abnormal thickening of the spongy tissue (endometrium) lining the inner surface of the uterus (where the baby attaches or what is shed as menstruation) due to an increase in the number of cells caused by improper hormonal stimulation.
The thickening itself is not cancer, but there are two types:
1. Hyperplasia Without Atypia: Cells are normal, just increased in number. The risk of cancer is very low, around 1-3%.
2. Atypical Hyperplasia: The shape and nucleus structure of the cells are also distorted. If left untreated, it is a 'precancerous' disease carrying a 30% risk of transforming into Uterine Cancer.
The endometrial lining thickens with 'Estrogen' and thins out to be shed as menstruation with 'Progesterone'. If a woman does not ovulate (has PCOS), is transitioning to menopause, or has Obesity (excess weight/fat tissue constantly produces estrogen), progesterone cannot be produced. Unopposed estrogen constantly stimulates the wall, causing it to thicken.
The most important symptom is Abnormal Vaginal Bleeding. Menstrual periods that are much longer, heavier, and clottier than normal (unable to manage with pads), cycles shorter than 21 days, and especially any spotting or bleeding after Menopause are the biggest warning signs of endometrial hyperplasia (and cancer).
The gynecologist measures the thickness of the uterine lining using vaginal ultrasound (in a menopausal woman, it should not exceed 4-5 mm). If the thickness is suspicious, it is MANDATORY to perform an Endometrial Biopsy (Pipelle/Curettage) from the inside of the uterus to understand whether it is a simple benign overgrowth or an 'Atypical' precancer. The procedure is performed painlessly within seconds using a thin cannula under anesthesia or in an outpatient setting.
Treatment is based on the pathology biopsy results.
If there is NO cellular abnormality (Atypia): The missing 'Progesterone' hormone is administered via pills or a Hormonal IUD (Mirena) to thin the lining, and the patient is monitored at 3-6 month intervals.
If there IS cellular abnormality (Atypia): Because the cancer risk is very high, if the woman has completed her childbearing, the Gold Standard treatment is a Hysterectomy (complete removal of the uterus and ovaries via minimally invasive surgery). In young women who desire children, high-dose hormone therapy and strict biopsy monitoring are used to preserve the uterus.
Our health library contents are prepared for informational purposes only and with scientific data available at the time of recording. For all your questions, concerns, diagnosis, or treatment regarding your health, please consult your doctor or a healthcare institution.
