Endometrial Hyperplasia Symptoms – Endometrial hyperplasia is when the endometrium, the layer of tissue that lines the uterus, becomes thick. Thickening of the uterus may be benign (noncancerous) or precancerous. Benign endometrial hyperplasia does not increase the risk of uterine cancer, while precancerous endometrial hyperplasia can lead to cancer of the uterus if left untreated.
There are two main types of endometrial hyperplasia:
• Simple endometrial hyperplasia (without atypia): contains normal cells unlikely to become cancerous.
• Simple or complex atypical endometrial hyperplasia: overgrowth of abnormal cells causes this precancerous stage.
Causes and Risk Factors of Endometrial Hyperplasia
The thickening of the uterus happens due to an imbalance in the hormones estrogen and progesterone. This imbalance can be due to taking certain types of hormone therapy, such as tamoxifen, or having high estrogen levels in the body due to obesity or polycystic ovary syndrome (PCOS). Endometrial hyperplasia can also develop due to certain cancers, such as ovarian cancer. In some cases, the cause of endometrial hyperplasia is unknown.
Certain factors can increase the risk of developing endometrial hyperplasia, including:
• Being overweight or obese
• Having diabetes
• Taking certain types of hormone therapy, such as tamoxifen
• Having high levels of estrogen in the body due to obesity or polycystic ovary syndrome (PCOS)
• Having certain types of cancers, such as ovarian cancer
• Being over the age of 60
• Taking specific breast cancer treatments
• Getting menstruation at an early age or menopause at a late age
• Family history of colon or uterine cancer
• Never being pregnant
• Long history of delayed, irregular, or no menstruation.
• Thyroid issues
If individuals are concerned about their risk of endometrial hyperplasia, they should talk to their doctor. Doctors help manage the risk factors and ensure that a person gets regular screenings for this condition.
Endometrial Hyperplasia Symptoms and Diagnosis
Endometrial hyperplasia often causes no symptoms. When symptoms do occur, they may include:
• Abnormal vaginal bleeding or spotting
• Heavy or prolonged menstrual bleeding
• Bleeding between menstrual periods
• Bleeding after menopause
If a person experiences these symptoms, they must see their doctor diagnose and treat the condition. Endometrial hyperplasia potentially leads to cancer of the uterus if left untreated.
Diagnosis of endometrial hyperplasia usually starts with a pelvic exam. During a pelvic exam, the doctor feels the uterus and ovaries to check for abnormal growth. They may also order a Pap smear to check for any abnormal cells in the cervix.
If the doctor suspects endometrial hyperplasia, they will order a biopsy of the endometrium. This procedure involves a small tissue sample getting removed from the uterus and later examined under a microscope. The biopsy confirms the diagnosis of endometrial hyperplasia and rules out other conditions.
Endometrial Hyperplasia Treatment
Endometrial hyperplasia treatment involves medication or surgery. Medication is the first line of treatment for this condition. The most common type of medication used to treat endometrial hyperplasia is progesterone. This medication helps thin the endometrium and stop abnormal bleeding. Progesterone is available as a pill, shot, or vaginal gel. It is typically taken for 3-6 months.
In some cases, the medication may not work, or the person may not be able to take it due to side effects. In these cases, surgery may be necessary to treat endometrial hyperplasia. Surgery involves removing the endometrium through a hysteroscopy procedure, a minimally invasive procedure in which a thin, lighted tube is inserted through the vagina and into the uterus. The surgeon then uses a cutting device to remove the endometrium. Surgery is usually only necessary if the person has precancerous endometrial hyperplasia or cancer of the uterus.
After treatment, the doctor will order regular screenings to check for any return of endometrial hyperplasia. These screenings frequently involve a pelvic exam and Pap smear.
Preventing Endometrial Hyperplasia
There are some steps to take to prevent endometrial hyperplasia. These steps include:
• Maintaining a healthy weight
• Eating a healthy diet
• Exercising regularly
• Limiting alcohol intake
• Not smoking
• Managing any chronic health conditions, such as diabetes or PCOS
If individuals take hormone therapy, they should talk to their doctor about the risks and benefits. Hormone therapy increases the risk of endometrial hyperplasia, but it may be necessary for treating other conditions.
Individuals at high risk for endometrial hyperplasia should talk to their doctor about regular screenings. Screenings help catch the condition early and prevent it from progressing to cancer.