Endometrial Hyperplasia

Endometrial hyperplasia is a condition affecting the lining of the uterus, called the endometrium. It occurs when the endometrium becomes abnormally thick due to an excess of estrogen without enough progesterone to balance it. This imbalance causes the cells in the lining to grow too much, which can lead to irregular menstrual bleeding or spotting. The condition mainly affects women during their reproductive years or after menopause. If left untreated, it can increase the risk of developing endometrial cancer, a type of uterine cancer. Regular monitoring and evaluation are important to manage this condition.

Endometrial hyperplasia is characterized by the abnormal proliferation of the endometrial glands relative to the stroma, resulting in a thickened endometrium. It is primarily caused by prolonged exposure to unopposed estrogen, often due to anovulatory cycles, obesity, polycystic ovary syndrome, or estrogen-secreting tumors. The condition is classified histologically into simple or complex types, with or without cytologic atypia, which influences the risk of progression to endometrial carcinoma. The presence of atypical hyperplasia is a significant risk factor for malignant transformation. Clinically, it presents with abnormal uterine bleeding, especially in postmenopausal women. Understanding the pathophysiology and histologic classification is critical for appropriate management and cancer prevention.