What is Endometrial Hyperplasia?

woman in pain

Hyperplasia can be a pre-cancer to endometrial cancer. Signs of hyperplasia are heavy menstrual bleeding, inter-menstrual bleeding, and postmenopausal bleeding. If caught early enough, hyperplasia can be treated before it progresses to cancer.

Endometrial hyperplasia is a condition in which the lining of the uterus (the endometrium) becomes thickened. This occurs when there is an overgrowth of the cells that make up the endometrium.

There are two types of endometrial hyperplasia: simple hyperplasia and complex hyperplasia. Simple hyperplasia is characterized by an overgrowth of normal endometrial cells, while complex hyperplasia is characterized by an overgrowth of abnormal cells. Complex hyperplasia with atypia is considered a precancerous condition, as it increases the risk of developing endometrial cancer.

Endometrial hyperplasia is caused by a hormonal imbalance, typically an excess of estrogen in relation to progesterone. Factors that can contribute to this hormonal imbalance include obesity, diabetes, polycystic ovary syndrome (PCOS), and the use of certain medications such as tamoxifen.

Symptoms of endometrial hyperplasia include abnormal vaginal bleeding, such as heavy or prolonged periods, spotting between periods, and postmenopausal bleeding. However, it’s important to note that these symptoms can also be caused by other conditions and are not specific to endometrial hyperplasia.

Diagnosis of endometrial hyperplasia is typically made through a pelvic exam, ultrasound, and biopsy. Biopsy is either performed in the office or in the operating room. Treatment options include hormonal therapy, such as progesterone therapy, and surgery, such as a hysterectomy.

It’s important for women who have any symptoms of abnormal vaginal bleeding to discuss them with their healthcare provider and to schedule regular gynecological exams. Hormonal imbalances can be treated and endometrial hyperplasia can be prevented by taking steps to maintain a healthy weight, control diabetes and other conditions, and by avoiding certain medications that increase the risk of endometrial hyperplasia.

Important Facts and Myths About Endometriosis

Millions of women and girls have it, but most don’t understand it. Here, we take a deep dive into some of the most misleading claims about endometriosis and help you understand the truth about this painful gynecologic condition.

Endometriosis and the symptoms that come with it are enough of a burden without having to sift through conflicting information. Education and accurate facts are some of the most powerful tools to deal with a condition like endometriosis.

So in this blog, Dr. Joseph Roofeh and our team pull back the curtain, scale back the medical jargon, and give you the straight truth on a few common endometriosis myths.

Myth: Endometriosis is just a heavy period

Yes: endometriosis does present symptoms that look and feel like a heavy period, such as bleeding, pain, and cramps — but it’s so much more than that.

Endometriosis is not a normal part of menstruation; unfortunately, many providers will write your concerns off as an overreaction to what’s perceived as “normal.” In fact, one study found that it can take upwards of seven years to get an accurate diagnosis.

We take a different approach. When you come to us with pain and abnormal bleeding, we leave no stone unturned and ensure we’ve done everything to accurately assess what’s causing your symptoms.

Myth: There’s a way to prevent endometriosis

Unfortunately, because we don’t know exactly what causes endometriosis, there’s no foolproof way to prevent it. You can reduce your chances of developing by lowering the levels of estrogen in your body because estrogen is one of the main culprits in thickening the lining of your uterus. You can keep your hormone levels in check by doing the following:

  • Exercising regularly
  • Keeping your weight and body fat percentage in a healthy range
  • Avoiding consuming large amounts of alcohol and caffeine, both of which can raise estrogen levels

Also, if you’re taking hormonal birth control, opt for a method with a lower dose of estrogen to make sure you don’t flood your system with extra of the hormone.

Myth: Endometriosis is always painful

Pain and cramping are usually among the first signs of endometriosis. The key word there is “usually.” Endometriosis can present without pain and sometimes isn’t diagnosed until you start investigating.

Myth: I can’t get pregnant if I have endometriosis

Though endometriosis is one of the leading causes of female infertility in the US and can contribute to an increased risk of miscarriages, most women with endometriosis can become pregnant without any medical assistance.

A note on pregnancy with endometriosis

Some have claimed that pregnancy is a “cure” for endometriosis. It’s possible to get relief from your symptoms during pregnancy, but don’t count on it to eliminate them.

Myth: You’ll find relief after menopause

Endometriosis symptoms typically occur during menstruation, so you may think menopause is the answer. However, many women continue to struggle with endometriosis long after they’ve had their last monthly cycle. Even when you’ve hit menopause, your ovaries still release a small amount of estrogen, which can trigger endometrial growth.

So it’s a gamble whether or not menopause will bring an end to your symptoms. Many menopausal women still dealing with endometriosis end up opting for surgery to eliminate it. 

A note on hysterectomies

It may seem logical that getting rid of your uterus will stop abnormal uterine growth; however, endometriosis can continue if there are lesions still present outside of your uterus. Also, a hysterectomy doesn’t remove your ovaries, where estrogen production happens.

Myth: Endometriosis only impacts your pelvic region

It’s rare, but endometrium-like tissue can appear in other places beyond your pelvic region. For example, endometrium-like tissue has been found in the lungs.

Your next steps

The first signs of endometriosis often show up during a routine pelvic exam or an ultrasound — we confirm it with a biopsy or surgery that more closely analyzes suspicious growth. Then, we get to work creating a customized treatment plan. Usually, we begin by recommending over-the-counter medications to relieve pain.