What is endometrial hyperplasia?
Endometrial hyperplasia is a condition of the female reproductive system. The lining of the uterus (endometrium) becomes unusually thick because of having too many cells (hyperplasia). It’s not cancer, but in certain women, it raises the risk of developing endometrial cancer, a type of uterine cancer.
How common is endometrial hyperplasia?
Endometrial hyperplasia is rare. It affects approximately 133 out of 100,000 women.
Who might have endometrial hyperplasia?
Women who are perimenopausal or menopausal are more likely to have endometrial hyperplasia. It rarely occurs in women younger than 35. Other risk factors include:
- Certain breast cancer treatments (tamoxifen).
- Early age for menstruation or late onset of menopause.
- Family history of ovarian, uterine or colon cancer.
- Gallbladder disease.
- Hormone therapy.
- Never being pregnant.
- Polycystic ovary syndrome (PCOS).
- Thyroid disease.
- White race.
- Long history of irregular or absent menstruation.
What are the types of endometrial hyperplasia?
Doctors classify endometrial hyperplasia based on the kinds of cell changes in the endometrial lining. Types of endometrial hyperplasia include:
- Simple endometrial hyperplasia (without atypia): This type of endometrial hyperplasia has normal-looking cells that aren’t likely to become cancerous. This condition may improve without treatment. Hormone therapy helps in some cases.
- Simple or complex atypical endometrial hyperplasia: An overgrowth of abnormal cells causes this precancerous condition. Without treatment, your risk of endometrial or uterine cancer increases.
What causes endometrial hyperplasia?
Women who develop endometrial hyperplasia produce too much estrogen and not enough progesterone. These female hormones play essential roles in menstruation and pregnancy. During ovulation, estrogen thickens the endometrium, while progesterone prepares the uterus for pregnancy. If conception doesn’t occur, progesterone levels drop. The progesterone drop triggers the uterus to shed its lining as a menstrual period.
Women who have endometrial hyperplasia make little, if any, progesterone. As a result, the uterus doesn’t shed the endometrial lining. Instead, the lining continues to grow and thicken.
Additionally, obesity contributes to the elevation of estrogen levels. The adipose tissue (fat stores in the abdomen and body) can convert the fat producing hormones to estrogen. This is the how obesity contributes to elevated circulating levels of estrogen and increases the risk of endometrial hyperplasia.
What are the symptoms of endometrial hyperplasia?
Women with endometrial hyperplasia may experience:
- Abnormal menstruation, such as short menstrual cycles, unusually long periods or missed periods.
- Heavy menstrual bleeding).
- Bleeding after menopause (when periods stop).