Learning About Endometrial Hyperplasia

What is it?

Endometrial hyperplasia is a problem with the uterus. The lining (endometrium) of the uterus gets too thick. This often causes abnormal uterine bleeding.

The uterus is where a fetus grows during pregnancy. It's a pear-shaped organ in your lower belly.

Bleeding is abnormal if:

• You bleed more than usual.
• You bleed more often.
• You bleed at a time that isn't normal for you.
• You bleed after menopause.

This condition can lead to cancer in some cases. The risk of cancer is higher if the doctor sees certain kinds of cell changes.

Your doctor might suggest treatments such as hormone therapy or surgery. Treatment will depend on the kind of hyperplasia you have.

What causes it?

Hormones control the lining of the uterus. If you have too much of the hormone estrogen compared to progesterone, the lining can start to thicken. This can affect your menstrual cycle. (A regular cycle often helps keep the lining of the uterus thin.)

This condition is more common around menopause. And your risk may be higher if you have:

• Polycystic ovary syndrome.
• Obesity, diabetes, or late menopause.
• Never given birth.
• Tamoxifen treatment for breast cancer.

How is it diagnosed?

If you have abnormal uterine bleeding, your doctor may do some tests. The tests check the lining of your uterus.

You may have a transvaginal, or pelvic, ultrasound. This test uses sound waves to make a picture of the uterus. It can measure the thickness of the lining.

You will also have a biopsy. Your doctor will take a small sample of the lining of the uterus. The sample will be checked under a microscope.

The doctor will look for certain changes in the cells that could lead to cancer. If changes are found, this is called endometrial hyperplasia with atypia. Or it may be called atypical endometrial hyperplasia.

How is it treated?

Treatment may include:

• Watching for changes in the lining of the uterus over time.
• Progestin therapy.
• Having surgery to remove the uterus (hysterectomy). In some cases, the ovaries and fallopian tubes may also be removed.

Your treatment will depend on whether the cells that line the uterus have changes that could lead to cancer. It also depends on whether you want to get pregnant in the future.