Endometrial hyperplasia

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Excessive proliferation of endometrial cells, the uterus layer that detaches every month during menstruation. This affection is more frequently associated with over 45 years of age patients.

Usually it is produced by a hormonal imbalance between strogens and progesterone. It is more frequent in overweight women and/or diagnosed with polycystic ovary syndrome.

The most frequent clinical manifestation is profuse menstrual bleeding and/or a prolonged one. It can lead to menstrual irregularity with short menstrual cycles (less than 21 days), with in-between menstruational bleeding and, even with postmenopause bleeding.

The diagnosis is based in an appropriate clinical history and a ginecologic exploration. It will be completed running complementary tests: transvaginal ultrasound where a thickened endometrium will be evidenced, an endometrial biopsy, also, a hysteroscopy that enables the visualisation of the uterine cavity.

The treatment will depend on the kind of hyperplasia, the patient's age and the desire for a future pregnancy. Treatment can range from hormonal treatment with tablets or intrauterine device (IUD) with progesterone, even the need to extract a culture from the uterus or hysterectomy, in those cases with major risk of developing endometrial cancer.

Bibliographic references
  1. Montgomery BE, Daum GS, Dunton CJ. Endometrial hyperplasia: a review. Obstet Gynecol Surv. 2004 May;59(5):368-78. doi: 10.1097/00006254-200405000-00025. PMID: 15097798.
  2. Chandra V, Kim JJ, Benbrook DM, Dwivedi A, Rai R. Therapeutic options for management of endometrial hyperplasia. J Gynecol Oncol. 2016 Jan;27(1):e8. doi: 10.3802/jgo.2016.27.e8. Epub 2015 Dec 1. PMID: 26463434; PMCID: PMC4695458.
  3. Nees LK, Heublein S, Steinmacher S, Juhasz-Böss I, Brucker S, Tempfer CB, Wallwiener M. Endometrial hyperplasia as a risk factor of endometrial cancer. Arch Gynecol Obstet. 2022 Jan 10. doi: 10.1007/s00404-021-06380-5. Epub ahead of print. PMID: 35001185.
Author
Dr. Josep Estadella
Copyright
© TeckelMedical 2026

Symptoms

    Vaginal bleeding


    Abundant and/or long-lasting periods


    Menstrual cycles shorter than 21 days


    Heavy vaginal bleeding


    Irregular periods

Symptoms to watch out for

Fever (temperature higher than 38 ºC)
Intense abdominal pain that unables doing day-to-day life activities
More than usual menstrual bleeding

Self-care

Maintain a balanced diet: increase fruit, vegetable, and white meat consumption and reduce the intake of fatty meals and fritters.
Check with your general practitioner about the prescription for a hormonal treatment.
Regular check-ups with your family gynaecologist.