Definition

What is endometrial hyperplasia?

The endometrium which is the lining of the uterus becomes too thick because of excess cell growth, it is called endometrial hyperplasia. Although it is not cancer, it can lead to cancer of the uterus in some cases.

The endometrium has ability to change throughout the menstrual cycle in response to hormones. During the first part of the cycle, the hormone estrogen is made by the ovaries. Estrogen help the lining grow and thicken to prepare the uterus for pregnancy. Next, in the middle of the cycle, an egg is released from one of the ovaries (ovulation).

Following ovulation, the amounts of another hormone called progesterone begin to develop. Progesterone prepares the endometrium to receive and nourish a fertilized egg. If pregnancy does not happen, estrogen and progesterone levels will decrease steadily. When progesterone starts to decrease, it will trigger menstruation, or shedding of the lining. Since the lining is completely shed, a new menstrual cycle begins.

Endometrial hyperplasia most often is caused by the excessive estrogen but lack of progesterone. If ovulation does not occur, progesterone is not made, and the lining is not shed. The endometrium may keep growing in response to estrogen. The cells that create the lining may crowd together and may become abnormal. It may persist and if left untreated can progress to true cancer though it is not clear to determine when it will happen

How common is endometrial hyperplasia?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of endometrial hyperplasia?

The common symptoms of endometrial hyperplasia are:

  • Bleeding during the menstrual period that is heavier or lasts longer than usual
  • Menstrual cycles that are shorter than 21 days (counting from the first day of the menstrual period to the first day of the next menstrual period)
  • Any bleeding after menopause

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above orhave any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes endometrial hyperplasia?

  • Some evidences showed that it result from an excessive presence of the hormone estrogen. As this hormone imbalance is also linked to cancer of the uterus, it is for this reason that hyperplasia is sometimes considered a precancerous condition.
  • Women who are exposed less regularly to the hormone progesterone are at increased risk of hyperplasia.
  • Women nearing menopause (when ovulation is erratic) or postmenopause women (when ovulation has stopped) are more at risk.
  • Some teenagers, just past menarche who have not yet established a regular pattern of ovulation are also at risk.
  • Women who have used estrogen replacement therapy (ERT) without supplementing it with progestins
  • The breast cancer treatment drug tamoxifen.

 

Risk factors

What increases my risk for endometrial hyperplasia?

There are many risk factors for endometrial hyperplasia, such as:

  • Age older than 35 years
  • White race
  • Never having been pregnant
  • Older age at menopause
  • Early age when menstruation started
  • Personal history of certain conditions, such as diabetes mellitus, polycystic ovary syndrome, gallbladder disease, or thyroid disease
  • Obesity
  • Cigarette smoking
  • Family history of ovarian, colon, or uterine cancer

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

 

How is endometrial hyperplasia diagnosed?

There are many causes of abnormal uterine bleeding. If you have abnormal bleeding and you are 35 years or older, or if you are younger than 35 years and your abnormal bleeding has not been helped by medication, your health care provider may perform diagnostic tests for endometrial hyperplasia and cancer.

Transvaginal ultrasound may be required to measure the thickness of the endometrium. For this test, a small device is placed in your vagina. Sound waves from the device are converted into images of the pelvic organs.

The only way to tell for certain that cancer is present is to take a small sample of tissue from the endometrium and study it under a microscope. This can be done with an endometrial biopsy, dilation and curettage, or hysteroscopy.

How is endometrial hyperplasia treated?

A full workup need to be done if endometrial hyperplasia is diagnosed because hyperplasia and cancer cells can be present at the same time. The treatment options will be different according to the woman’s age and type of hyperplasia present.

In many cases, endometrial hyperplasia can be treated with progestin. Progestin is given orally, in a shot, in an intrauterine device, or as a vaginal cream. How much and how long you take it depends on your age and the type of hyperplasia. Treatment with progestin may cause vaginal bleeding like a menstrual period.

If you have atypical hyperplasia, especially complex atypical hyperplasia, the risk of cancer is increased. Hysterectomy usually is the best treatment option if you do not want to have any more children.

Lifestyle changes & home remedies

What are some lifestyle changes or home remediesthat can help me manage endometrial hyperplasia?

The following lifestyles and home remedies might help you cope with endometrial hyperplasia:

  • If you take estrogen after menopause, you also need to take progestin or progesterone.
  • If your menstrual periods are irregular, birth control pills (oral contraceptives) may be recommended. They contain estrogen along with progestin. Other forms of progestin also may be taken.
  • If you are overweight, losing weight may help. The risk of endometrial cancer increases with the degree of obesity.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 15, 2017 | Last Modified: August 15, 2017

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