When the lining of the uterus, called the endometrium, grows too thick, the condition is known as endometrial hyperplasia. It’s most often caused by excess estrogen without progesterone. Near the onset of menopause, women who are experiencing irregular menstrual cycles because they no longer ovulate monthly, are more likely to experience this benign condition. Endometrial hyperplasia is also more common in women who take estrogen without progesterone or other medications that act like estrogen. Women who are obese convert other hormones to estrogen in their fat cells, which can also make them prone to endometrial hyperplasia.
Other conditions that are risk factors for endometrial hyperplasia include:
- Gallbladder disease
- Thyroid disease
- Polycystic ovary syndrome
Women who have never been pregnant, as well as those who started their period at an early age or started menopause at an older age are also at higher risk.
Endometrial hyperplasia can be a precursor to cancer. It is often diagnosed based on tissue obtained by an endometrial biopsy, a simple procedure done in the office. Endometrial biopsy may cause mild cramping.
Providers recommend different treatments, depending on the type of endometrial hyperplasia present. If atypical cells are seen, it is more concerning.
The most common symptoms of endometrial hyperplasia include:
- Postmenopausal bleeding or spotting
- Heavy or prolonged menstrual periods
- Bleeding between menstrual periods
- Abnormal vaginal discharge
In most cases, after your provider has obtained a sample of the uterine lining and determined that cancer is not present, endometrial hyperplasia is treated with the hormone progesterone or an intrauterine device (IUD) that contains progesterone. Your provider will recommend the form of progesterone that is appropriate for your condition. If the problem continues or atypical cells are seen on biopsy, other medications or surgery may be considered.