Endometrial Hyperplasia

Endometrial hyperplasia occurs when the lining of the uterus becomes thickened.

Causes

Endometrial hyperplasia occurs due to hormonal imbalance when excess estrogen is secreted in comparison to progesterone. Due to lack of ovulation, progesterone is not secreted but the endometrium continues to grow due to estrogen secretion.  This usually happens in menopausal and pre-menopausal women.

Other causes include certain medications which are similar to estrogen, long term estrogen use, irregular menstrual periods, obesity, etc.

Being more than 40 years, family history, co-morbidities such diabetes mellitus and polycystic ovarian syndrome, never been pregnant, etc are some of the risk factors of developing endometrial hyperplasia.

Symptoms

Abnormal uterine bleeding is the principal symptom of endometrial hyperplasia. Post menopausal bleeding and menstrual cycle lasting less than 21 days are some of the instances of abnormal uterine bleeding.

What tests will be required for diagnosis?
  • Ultrasound scan to measure endometrial thickness
  • Biopsy of the endometrium, this can be done as outpatient procedure without anesthesia. Biopsy report is gold standard for confirmation of endometrial hyperplasia.
  • CT / MRI scan may be required
Treatment

Correcting hormonal imbalance by taking progestin is one of the treatments of hyperplasia.  Progestin can either be taken orally, injected or given through an intrauterine device. Endometrial hyperplasia can be prevented by taking birth control pills to regularize the menstrual periods.