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Endometrial Hyperplasia

Endometrial Hyperplasia is a disorder characterized by excessive thickening of the uterus lining. This happens due to abnormal proliferation of the endometrial cells mainly due to presence of high levels of estrogen in the body.

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However, this stage is not cancerous but it’s a warning sign of uterus cancer. Depending upon the risk posed by this progression to cancer, there are two main categories of endometrial hyperplasia:

Simple and Complex hyperplasia without atypia:

In the simple  type, there’s dilation, outpouching and cystic expansion of glands while the complex pattern is marked by budding and crowding of the glands.

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Simple and Complex atypical hyperplasia:

Several worrisome changes are observed. The glands show increased mitotic activity with enlarged cell nuclei. Scientifically it’s defined as cytologic atypia.

Health Complications of Endometrial Hyperplasia

As said above, those without atypical changes carry no or very minor risk of developing cancer but those with atypical symptoms are more likely to get endometrial carcinoma.

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The risk of developing cancer is definitely higher in menopausal women.

It can also hamper your chances of getting pregnant.

Symptoms of Endometrial Hyperplasia

  • Pain during sexual intercourse
  • Hot  flashes with rapid heart rate
  • Vaginal bleeding between after menopause
  • Vaginal bleeding between two consecutive menstrual cycle
  • Long phase of periods accompanied by heavy bleeding
  • absence of menstrual periods
  • Menstrual cycles without ovulation- Anovulatory periods

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Causes of Endometrial Hyperplasia

The primary reason behind this problem is - the sensitivity of the endometrium towards estrogen. Estrogen levels increase in the body due to many factors which further triggers growth of the uterus lining.

The following conditions are responsible for endometrial hyperplasia

  • Lack of ovulation in women, especially after menopause, halts secretion of progesterone in women, thereby increasing the levels of estrogen.
  • It can also occur during perimenopause on account to irregular ovulation
  • Obesity along with diabetes
  • Prolonged intake of estrogen like medications or high doses of estrogen
  • polycystic ovary syndrome
  • Oestrogen-secreting ovarian tumour
  • It could be also hereditary
  • Use of anti breast cancer drugs like tamoxifen

Diagnosis of endometrial hyperplasia

The symptoms form the basis for diagnosis of endometrial hyperplasia.

The tests for diagnosing hyperplasia, polyps or fibroids are almost same which includes the following:

  • The abnormality inside the uterine lining is viewed by conducting a transvaginal ultrasound. Thickness of the endometrium can be measured by this technique.
  • Secondly, doctor may also insist to perform these tests, viz. hysteroscopy, endometrial biopsy and dilation and curettage to rule out any probability of cancer.

Treatment for endometrial hyperplasia

The treatment depends on the severity of the symptoms, the nature of hyperplasia, age and general health of the patient.

  • Common cases of endometrial hyperplasia, i.e. without atypia can be easily overcome with specific progesterone doses. It could be in the form of oral pills, birth control patches or IUDs.
  • Surgery is usually performed on menopausal women or those with atypia endometrial hyperplasia. This includes hysterectomy (surgical removal of the uterus) and endometrial ablation (removal of the endometrium).

When to see a doctor?

See your doctor if you are experiencing any of those aforementioned symptoms. Never delay or wait for the symptoms to deteriorate. Secondly, express to your doctor if you are planning to have a baby.

Preventing Endometrial hyperplasia

Preventive measures are directed towards leading a healthy lifestyle which reduces the risk of developing this abnormality

  • Exercises regularly to avoid becoming obese
  • Eat lot of fruits and fibers. Cut down of unhealthy fats and carbohydrates.
  • Observe your menstrual cycles
  • Avoid estrogen replacement therapy and other types of estrogen supplements until it’s needed absolutely

Dealing with any health complication definitely becomes a challenge and especially when it related to your reproductive system. Nevertheless, we suggest you to seek the best treatment and your doctor will no doubt support you for a speedy recovery.

Written by: Saptakee sengupta
Date last updated: January 11, 2015