Endometrial Hyperplasia

Endometrial hyperplasia occurs as the lining of the uterus (endometrium) thickens to an unnatural degree. This occurs because of an increased number of endometrial glands. Women at puberty or menopause are at a heightened risk.

Postmenopausal women are at risk for endometrial hyperplasia when undergoing unopposed estrogen replacement therapy. In this type of therapy, progesterone is not administered. Women receiving this type of hormone treatment tend to experience a higher incidence of endometrial hyperplasia.

During a normal menstrual cycle, estrogen causes the endometrium to thicken, preparing the uterus for pregnancy. Then, during ovulation, the ovary releases an egg. Finally, after ovulation, progesterone increases to prepare the endometrium to receive a fertilized egg. When pregnancy does not occur, levels of both estrogen and progesterone decrease and menstruation begins, which sheds the lining of the endometrium.

The endometrial lining fails to shed when there is an absence of progesterone. In these cases, there is a hormonal imbalance where there is too much estrogen and not enough progesterone.

Some of the most common symptoms of endometrial hyperplasia include:

• Abnormal vaginal bleeding between menstrual periods or post-menopause
• Abnormally heavy menstrual bleeding
• Painful intercourse
• The absence of a menstrual period (amenorrhea)
• Menstrual cycles wherein ovulation does not occur (anovulatory periods)

To accurately diagnose endometrial hyperplasia, a tissue biopsy provides the most conclusive answers. This can be done by endometrial biopsy, dilation and curettage (D&C), or hysteroscopy. A preliminary screening may include a transvaginal ultrasound which can measure the thickness of the endometrium. D&C may also help to treat hyperplasia by removing some of the excess endometrial tissue.

One available treatment for endometrial hyperplasia is progestin, which is available as an oral medication, vaginal cream, intravenously or as an intrauterine device.

Hysterectomy may be recommended in some cases where hyperplasia is treatment-resistant or in cases of recurring endometrial hyperplasia after successful treatment or the development of atypical (premalignant) endometrial hyperplasia.

Because endometrial hyperplasia can lead to a premalignant condition called “atypical endometrial hyperplasia,” it is important to see a doctor if you’re currently experiencing symptoms.

Our board-certified team of specialists and surgeons is here for you and can diagnose endometrial hyperplasia and work to find the best treatment plan for you.

 For more information, schedule an appointment today or call us to speak with one of our patient coordinators.