Endometrial Hyperplasia: Symptoms, Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Thajammul Samrin , Gynecologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Endometrial hyperplasia is a condition where the lining of the uterus, called the endometrium, becomes thicker than usual. This abnormal thickening can be caused by an imbalance of hormones, particularly estrogen and progesterone. When these hormones are not in the right balance, the endometrium can grow too much, leading to hyperplasia.

In some cases, certain risk factors such as obesity, diabetes, or polycystic ovary syndrome (PCOS) can contribute to the development of endometrial hyperplasia. Additionally, women who are postmenopausal or have never been pregnant may also be at a higher risk.

What are the Types of Endometrial Hyperplasia?

Endometrial hyperplasia comprises various types, including simple hyperplasia, complex hyperplasia, and atypical hyperplasia. The types of hyperplasia are differentiated based on the degree of glandular complexity and cellular atypia, with atypical hyperplasia posing the highest risk for malignant transformation.

Simple Hyperplasia: Characterized by an overgrowth of endometrial glands without atypical cells.
Complex Hyperplasia: Involves an abnormal growth pattern of endometrial glands and may have atypical cells present.
Atypical Hyperplasia: Shows distorted glandular architecture and abnormal cell features, posing a higher risk for developing endometrial cancer.
Hyperplasia without Atypia: Indicates increased glandular growth but lacks abnormal cellular changes seen in atypical hyperplasia.
Hyperplasia with Atypia: Refers to a condition where there is both excessive glandular proliferation and the presence of atypical cells.

What are the Symptoms of Endometrial Hyperplasia?

Endometrial hyperplasia can cause various symptoms that may include abnormal uterine bleeding, such as heavier or longer periods than usual, bleeding between periods, or postmenopausal bleeding.

Additionally, changes in menstrual cycles, such as irregular periods, can be a sign of this condition. It is essential to consult a healthcare provider if you are experiencing any of these symptoms for proper evaluation and management.

Abnormal uterine bleeding, such as heavy periods or bleeding between periods, is a common symptom of endometrial hyperplasia.
Pelvic pain or discomfort, particularly during menstruation or intercourse, can be experienced by individuals with endometrial hyperplasia.
Changes in menstrual patterns, including irregular periods or shorter/longer cycles, may indicate the presence of endometrial hyperplasia.
Unexplained weight gain or bloating that is not related to diet or exercise could be a symptom of endometrial hyperplasia.
Some individuals with endometrial hyperplasia may experience pain or pressure in the lower abdomen or back.

What are the Causes of Endometrial Hyperplasia?

One primary cause is an imbalance of estrogen and progesterone hormones, with excess estrogen relative to progesterone leading to unopposed estrogen stimulation of the endometrium. Additionally, factors like diabetes, certain medications, and genetic predisposition can also play a role in the development of endometrial hyperplasia.

Hormonal imbalance, particularly excess estrogen relative to progesterone, can lead to endometrial hyperplasia by stimulating abnormal growth of the uterine lining.
Obesity is a risk factor for endometrial hyperplasia as excess fat tissue can increase estrogen production, contributing to the thickening of the endometrium.
Prolonged use of estrogen-only hormone replacement therapy without progesterone can cause endometrial hyperplasia due to unopposed estrogen stimulation of the endometrial cells.
Polycystic ovary syndrome (PCOS) is associated with endometrial hyperplasia as it often leads to irregular menstrual cycles and anovulation, resulting in prolonged exposure to estrogen.

When to See a Doctor for Endometrial Hyperplasia?

Women with abnormal uterine bleeding, bleeding after menopause, prolonged menstrual periods, or unexplained pelvic discomfort should consult a Gynecologist. A Gynecologic Oncologist may be involved if atypical hyperplasia is diagnosed.

You should see a doctor if you experience:

Bleeding after menopause
Heavy or irregular menstrual bleeding
Persistent bleeding between periods

Seek immediate medical attention if you:

Develop heavy vaginal bleeding causing dizziness or fainting
Experience severe pelvic pain with excessive bleeding
Notice rapidly worsening symptoms or signs of severe anemia

These symptoms may indicate significant blood loss or a serious uterine condition requiring urgent medical evaluation.

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How Is Endometrial Hyperplasia Diagnosed?

During the medical history review, the healthcare provider will inquire about symptoms like abnormal uterine bleeding and risk factors such as obesity or hormonal imbalances. Transvaginal ultrasound helps visualize the thickness of the endometrium, while an endometrial biopsy provides a definitive diagnosis by examining a sample of the uterine lining. These methods together help healthcare providers accurately diagnose endometrial hyperplasia and determine appropriate treatment options.

Endometrial hyperplasia is diagnosed through endometrial biopsy, transvaginal ultrasound, hysteroscopy, and dilation and curettage (D and C).
Endometrial biopsy involves taking a sample of the endometrial tissue for microscopic examination to detect hyperplasia.
Hysteroscopy involves inserting a thin, lighted tube through the cervix to directly view the inside of the uterus for abnormalities.
Dilation and curettage (D and C) is a procedure where the lining of the uterus is scraped and examined for hyperplasia.

What are the Treatment for Endometrial Hyperplasia?

Treatment options for endometrial hyperplasia depend on the type and severity of the condition. In cases of simple hyperplasia without atypia, hormone therapy with progestin is often recommended to help regulate the menstrual cycle and reduce the thickening of the endometrium.

In cases of simple or complex endometrial hyperplasia without atypia, hormone therapy using. Surgical procedures such as dilation and curettage (D and C) may be performed to remove the excess endometrial tissue and reduce the risk of developing endometrial cancer.

For complex hyperplasia with atypia or when hyperplasia progresses to precancerous or cancerous stages, more aggressive approaches such as hysterectomy or minimally invasive procedures like endometrial ablation may be considered. Regular monitoring and follow-up are crucial in managing endometrial hyperplasia to prevent complications and ensure optimal treatment outcomes.

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What are the Risk Factors Of Endometrial Hyperplasia?

Endometrial hyperplasia, a condition characterized by the abnormal thickening of the lining of the uterus, can be influenced by various risk factors. Hormonal imbalances, such as estrogen dominance relative to progesterone, can also contribute to the condition. Women undergoing hormone replacement therapy without progestin, those with polycystic ovary syndrome (PCOS), and individuals with a history of certain cancers or diabetes are also at higher risk.

Obesity, especially when accompanied by high levels of estrogen, is a significant risk factor for developing endometrial hyperplasia.
Prolonged use of estrogen-only hormone replacement therapy without progesterone can increase the risk of endometrial hyperplasia.
Diabetes, particularly uncontrolled diabetes, is a risk factor for endometrial hyperplasia as high insulin levels can affect estrogen levels.

What is the Recovery Process for Endometrial Hyperplasia?

Recovery depends on treatment type and severity of the condition.

Regular follow-up and monitoring
Hormonal balance management
Healthy lifestyle and weight control
Early detection of recurrence

Frequently Asked Questions

1. How do I recognize the signs of endometrial hyperplasia?

Look for abnormal uterine bleeding, changes in menstrual cycle, pelvic pain, and frequent urination as signs of endometrial hyperplasia.

2. What precautions should be taken for endometrial hyperplasia?

Regular follow-ups with your healthcare provider and appropriate hormone therapy can help manage endometrial hyperplasia.

3. How can endometrial hyperplasia affect the body in the long term?

Endometrial hyperplasia can increase the risk of endometrial cancer if left untreated in the long term.

4. What treatment options are available for endometrial hyperplasia?

Treatment options for endometrial hyperplasia include hormonal therapy, dilation and curettage (D&C), hysteroscopy with removal of abnormal tissue, and in severe cases, a hysterectomy.