Endometrial hyperplasia is a rare condition that is most commonly found in perimenopausal and menopausal women. When left untreated, it can increase the risk of uterine cancer in some women, but thankfully, effective treatment options are available. There are also steps you can take to lower your risk of developing endometrial hyperplasia in the first place.*

What is endometrial hyperplasia?

Endometrial hyperplasia occurs when there are too many cells in the uterus lining (endometrium), making it unusually thick. It is not cancerous, but some types can increase the risk of developing endometrial cancer down the road.

It’s estimated that the condition affects less than 1% of women, but it is mostly found in those who are in perimenopause, the several-year span leading up to menopause, as well as in some post-menopausal women. 

Risk factors for developing endometrial hyperplasia can include:

• Diabetes, thyroid disease, and gallbladder disease
• Polycystic ovary syndrome (PCOS)
• Family history of cancer 
• Certain breast cancer treatments
• Obesity
• Smoking
• Hormone therapy
• White race

Causes of endometrial hyperplasia

Endometrial hyperplasia is caused by a hormone imbalance in the reproductive system. During ovulation, estrogen thickens the lining of the uterus, and progesterone prepares the uterus to receive a fertilized egg. If one is not implanted, progesterone levels drop, which causes the uterus to shed its lining. This is when menstrual bleeding occurs.

If the ovaries don’t make enough progesterone, the uterus won’t shed its lining. Each month it will continue to grow and get thicker. Having too much estrogen, a common concern for women with obesity, can cause the same imbalance. During perimenopause, levels of both estrogen and progesterone fluctuate wildly before settling into new, lower levels that end menstruation.

Symptoms of endometrial hyperplasia

Common symptoms of endometrial hyperplasia include:

• irregular or skipped periods,
• unusually heavy bleeding during menstruation, and
• postmenopausal bleeding.

You may also want to reach out to your doctor if you experience:

• discomfort during sex or urination,
• abnormal vaginal discharge,
• pelvic pain, or
• abdominal cramping.

Depending on your specific situation, your doctor may order an ultrasound, endometrial biopsy, or hysteroscopy to better determine what’s causing your symptoms.

Prevention and treatment

For many women, progestin therapy can be an effective treatment for endometrial hyperplasia. Progestin can be taken orally, through an IUD, or as injections. Depending on the severity of your symptoms, and your degree of risk for cancer, your doctor may suggest a hysterectomy. 

According to the Cleveland Clinic, there are steps you can take to lower your risk of developing endometrial hyperplasia during the menopause transition:

• If you use estrogen therapy, ask your doctor about adding progesterone to the mix.
• If you smoke, work toward quitting.
• Maintain a body weight that falls within a healthy range for your frame.
• Ask your doctor about taking birth control as an alternate form of hormone therapy.

If you are experiencing symptoms of endometrial hyperplasia, speak with your healthcare provider. They can give you an accurate diagnosis and help you develop a treatment plan that’s right for you. 

*Endometrial Hyperplasia: Causes, Symptoms & Treatment. (n.d.). Cleveland Clinic. Retrieved September 2, 2022, from https://my.clevelandclinic.org/health/diseases/16569-atypical-endometrial-hyperplasia