Endometrial hyperplasia is when the lining of the uterus (endometrium) becomes too thick, usually because of irregular periods. If the lining isn’t shed regularly, it can cause unusual bleeding and, over time, increase the risk of endometrial cancer.

What Causes Endometrial Hyperplasia?

Some factors increase the risk of developing this condition:

Hormonal Imbalances

Conditions like polycystic ovary syndrome (PCOS) or obesity can lead to higher levels of estrogen without enough progesterone to balance it.

Irregular or Infrequent Periods

Irregular periods are cycles that:

• Are shorter than 24 days.
• Are longer than 35 days.
• Vary significantly in length (by more than 7–9 days).

If periods are irregular or infrequent, the uterine lining doesn’t shed as it should, allowing it to grow thicker over time.

Elevated Prolactin Levels or Thyroid Disorders

Sometimes, conditions like high prolactin (a hormone linked to milk production) or issues with the thyroid gland can mimic the symptoms of endometrial hyperplasia.

You can screen for these hormonal and thyroid imbalances through Taylor'sin-depth reproductive health screening.

Family History

Having close family members with endometrial cancer or hyperplasia increases your risk.

Age

Women in their 40s and 50s are at greater risk, especially during the years leading up to menopause, when hormone levels naturally fluctuate.

Hormone Therapy

Women using estrogen-only hormone therapy (for menopause symptoms) without progesterone are at higher risk, as this can overstimulate the uterine lining.

‍
Symptoms to Watch For

Endometrial hyperplasia doesn’t always cause noticeable symptoms, but certain changes in your periods or bleeding patterns could be warning signs.

Irregular or Missed Periods

Cycles shorter than 24 days, longer than 35 days, or that vary significantly can signal hormonal imbalances affecting the uterine lining.

Heavy or Prolonged Bleeding

Heavy bleeding, also called menorrhagia, includes:

• Having to change pads or tampons every 1–2 hours because they’re soaked.
• Bleeding that lasts more than 7 days.
• Passing clots the size of a 50-cent coin (2.5 cm) or larger.
• Symptoms of anaemia (a condition caused by low iron levels from blood loss), such as:some text
  • Feeling tired or weak.
  • Dizziness or light-headedness.
  • Heart palpitations (a racing or irregular heartbeat).

Spotting Between Periods

Unexpected bleeding between periods should be investigated, especially if it happens frequently.

How Is Endometrial Hyperplasia Diagnosed?

If your doctor suspects endometrial hyperplasia, they may recommend tests to confirm the diagnosis and rule out other conditions:

1. Ultrasound Scan. An ultrasound scan of the pelvic area measures the thickness of the uterine lining. A thicker-than-normal lining for your age or cycle stage may indicate hyperplasia.
   
   
2. Endometrial Biopsy A small sample of the uterine lining is taken and tested for abnormal cells. This helps determine the type of hyperplasia and whether there is a risk of cancer.
   

How Is It Treated?

Treatment depends on the severity of the hyperplasia and whether abnormal or pre-cancerous cells are found.

Progesterone Therapy

Progesterone can balance estrogen levels and reduce the thickness of the uterine lining. This can be delivered as:

• Pills taken orally.
• A hormone-releasing intrauterine device (IUD) placed in the uterus.
• Injections for a more controlled dose.

Surgery

If the hyperplasia is advanced or there are concerns about cancer, surgery might be recommended. This could involve:

• Dilation and Curettage (D&C): A procedure to remove the thickened uterine lining.
• Hysterectomy: Removal of the uterus, typically reserved for cases where cancer is present or strongly suspected.

Why Early Diagnosis Matters

Left untreated, endometrial hyperplasia can lead to more serious conditions like endometrial cancer. Early intervention can restore hormonal balance, regulate cycles, and protect reproductive health.

When Should You See a Doctor?

You should see a doctor if you experience any of the following:

• Irregular periods that are consistently outside the 24–35-day range or vary significantly.
• Heavy or prolonged bleeding (menorrhagia), especially if accompanied by symptoms of anaemia.
• Spotting between periods or unusual changes in menstrual patterns.

Even if the symptoms seem mild, it’s better to get them checked early to rule out more serious conditions and start appropriate treatment.

Take Control of Your Reproductive Health

Endometrial hyperplasia is manageable with early diagnosis and treatment. Pay attention to your body’s signals, and don’t ignore irregular bleeding, unusual discharge, or period changes. If you have concerns, don't wait to visit a women's health clinic or gynaecologist to stay on top of your health.