About this condition
Endometrial hyperplasia refers to excessive growth of the lining inside the uterus. It can be associated with heavy, irregular or intermenstrual bleeding, and sometimes is found during other investigations. The symptoms are not specific; other endometrial conditions can cause similar bleeding.
Possible causes and features
Hyperplasia does not automatically mean cancer. A crucial distinction is between hyperplasia without atypia and changes with atypia, because the risk profile, surveillance and treatment approach differ. The diagnosis depends on examining tissue rather than on a symptom pattern.
Ultrasound may show a thickened lining or a suspicious finding, but cannot establish the microscopic cellular type. Depending on the clinical picture, a gynecologist may recommend endometrial biopsy or hysteroscopy with tissue sampling and histology.
Assessment and next steps
Management depends on the pathology report, age, bleeding, menopausal status, other risks and plans for pregnancy. In selected cases without atypia, progestogen treatment and repeat checks may be used. Atypical findings need specialised discussion of more serious risks and different treatment options.
Do not start hormonal medicines without a medical assessment. Recurrent abnormal bleeding, increasingly heavy periods and any bleeding after menopause merit investigation regardless of an earlier reassuring scan. The clinician should explain why each test or follow-up interval is recommended.
Related topics: Bleeding between periods; Bleeding after menopause; Hysteroscopy.
Signs and symptoms
- Irregular, prolonged or heavy uterine bleeding.
- Spotting between periods or bleeding after menopause.
- Sometimes no noticeable symptoms.
Diagnosis and tests
The clinician assesses symptoms, risks and ultrasound results. When indicated, endometrial tissue is sampled, sometimes during hysteroscopy, for histological examination. Only the tissue result can identify atypia and guide appropriate care.
Care and treatment approaches
For some cases without atypia, progestogen treatment and repeat examinations may be recommended. Hyperplasia with atypia requires a different plan, possibly including surgery after specialist counselling. Fertility goals and health risks matter.
When to seek urgent care
Heavy blood loss, fainting, marked weakness or severe pelvic pain needs emergency care and may warrant calling 103 or 112 in Ukraine. All bleeding after menopause requires timely investigation even when symptoms are mild.
Frequently asked questions
Does endometrial hyperplasia mean cancer?
No. It is not the same diagnosis, although atypia is associated with higher risks and needs different management.
Is ultrasound enough to confirm hyperplasia?
No. Ultrasound can identify thickness changes, but biopsy and histology assess cellular features when indicated.
Can hyperplasia cause irregular bleeding?
Yes, abnormal bleeding is a possible sign, but other conditions must be ruled out during assessment.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
