Endometrial hyperplasia involves an increase in the proliferation of the inner lining of the uterus. This lining is known as the endometrium and it generally increases in thickness throughout a woman’s menstrual cycle to prepare the uterus for a possible pregnancy. However, when the woman fails to conceive around her ovulation, her uterus begins to shed the endometrium resulting in the menstrual period. This happens every month in women in their reproductive age. However, some women develop an abnormally thick endometrium due to excessive growth during the proliferation phase of the menstrual cycle. This is known as endometrial hyperplasia. Although, most endometrial hyperplasias are noncancerous, this disease requires careful follow-ups and monitoring as it is one of the risk factors of endometrial cancer.
Causes of Endometrial Hyperplasia
Endometrial hyperplasia is believed to result from increased levels of the hormone estrogen. This hormone is also responsible for helping the endometrium grow during a normal menstrual cycle in preparation for pregnancy. As a woman begins to approach menopause, her estrogen levels tend to increase. Hence, this condition has an increased incidence in women nearing their menopausal years. Additionally, obesity, polycystic ovarian syndrome, and diabetes mellitus are likely to increase one’s risk of developing this condition, as they tend to result in higher estrogen levels.
Symptoms of Endometrial Hyperplasia
Abnormalities in the menstrual bleeding are common symptoms of endometrial hyperplasia, particularly since this condition involves the endometrium. Increased vaginal bleeding, spotting in between periods, prolonged bleeding, sudden changes in menstrual bleeding, or vaginal bleeding after menopause are some of the symptoms that women with this disorder may experience. Another, symptom of endometrial hyperplasia could be anemia or low hemoglobin levels. Although, anemia isn’t a direct result of endometrial hyperplasia, it may arise from increased or prolonged blood loss due to a thicker endometrium.
Pap Smear and Endometrial Biopsy
Endometrial hyperplasia is diagnosed with an endometrial biopsy. A pap smear may sometimes show atypical glandular cells that would suggest the possibility of endometrial hyperplasia. However, the pap smear is not diagnostic and only an endometrial biopsy can provide an accurate diagnosis.
Treatment of Endometrial Hyperplasia and Endometrial Cancer
The treatment of endometrial hyperplasia may vary according to the age of the woman and the severity of the symptoms. Most women are better with cyclical or progesterone only contraceptive pills. The former tend to reduce the estrogen levels in the blood stream, whereas the later tend to relive endometrial hyperplasia by stopping the menses completely. However, severe symptoms or a possibility of endometrial cancer may require hysterectomy.