Endometrial hyperplasia is a condition where the cells in the endometrium (that is, the lining of the uterus) grow faster than normal. Hence, the endometrium becomes too thick. 

Endometrial hyperplasia is of two types: typical and atypical. While endometrial hyperplasia is not in itself cancer, atypical endometrial hyperplasia is a risk factor for endometrial and uterine cancer.

Types of endometrial hyperplasia

There are two types of endometrial hyperplasia. They include:

• Endometrial hyperplasia without atypia (typical endometrial hyperplasia). In this type of endometrial hyperplasia, the cells look normal; hence a lower risk for cancer. 

• Atypical endometrial hyperplasia. In this type of endometrial hyperplasia, there is an overgrowth of unusual cells – a precancerous condition. This type of endometrial hyperplasia increases your risk of developing endometrial cancer if left undiagnosed and untreated.

Symptoms of endometrial hyperplasia

The most common symptom of endometrial hyperplasia is abnormal bleeding. They could be in the form of:

• Heavy and/or prolonged menstrual bleeding

• Short menstrual cycles (<21 days)

• Any bleeding after menopause

Causes of Endometrial hyperplasia

Endometrial hyperplasia occurs when there are higher levels of oestrogen and not enough progesterone. Usually, this is seen in menopausal women, where ovulation does not occur. The endometrial cells respond to oestrogen by thickening the lining of the uterus. However, due to the little or no progesterone, the lining of the uterus does not shed, resulting in abnormal, persistent thickening of the endometrium.

The risk factors associated with endometrial hyperplasia include:

• Older age (>35) 

• Race, seen more in whites

• Early age of menstruation and late onset of menopause

• Nulliparity (never been pregnant)

• Long history of oligomenorrhea (irregular menstruation) or amenorrhea (absent menstruation)

• Obesity

• Family history of ovarian, colon, or uterine cancer

• Smoking cigarette 

• Taking tamoxifen, a  medication used to treat breast cancer

• Having underlying medical conditions like diabetes, PCOS (polycystic ovarian syndrome, thyroid disease, or gallbladder disease

• Being on hormone therapy

Treatment of Endometrial hyperplasia

• Medications. Progestin is given as a hormone therapy to treat the condition. It is made available as oral pills, injections, an intrauterine device (IUD) or Mirena IUD, or as a vagina cream.

• Surgery. Hysterectomy is often suggested if there is an increased risk for cancer (atypical endometrial hyperplasia).

You can make an appointment with Dr Kenny on 07 3188 5000.

This article is written to be informative and does not substitute seeking a professional consultation from a medical professional.