Endometrial hyperplasia

Endometrial hyperplasia is the excessive proliferation of cells in the endometrium, the layer of the uterus that is shed each month during menstruation. This condition is more common in patients over the age of 45.

It is usually caused by a hormonal imbalance between estrogen and progesterone. It is more common in women who are overweight and/or have polycystic ovary disease.  

The most common clinical manifestation is heavy and/or prolonged menstrual bleeding. It may be associated with menstrual irregularity, short menstrual cycles (less than 21 days), intermenstrual bleeding, and even postmenopausal bleeding.

Diagnosis is based on an adequate clinical history and gynecological examination. It is completed with the performance of complementary tests: transvaginal ultrasound, which reveals an excessively thick endometrium; endometrial biopsy; hysteroscopy, which allows visualization of the uterine cavity.

Treatment depends on the type of hyperplasia, the patient's age, and the desire for future pregnancy. Treatment can range from hormone therapy with pills or a progesterone intrauterine device (IUD) to the need for removal of the uterus or hysterectomy in cases where there is a higher risk of developing endometrial cancer.