Endometrial Hyperplasia
Endometrial Hyperplasia
Endometrial hyperplasia is a condition that occurs with the excessive proliferation of cells lining the inner layer of the uterus (endometrium). Normally, this layer thickens under the influence of hormones in each menstrual cycle and sheds if pregnancy does not occur. However, in some cases, the tissue grows excessively due to the imbalance of estrogen hormone not being countered by progesterone, leading to endometrial hyperplasia. It is more commonly seen in women experiencing menstrual irregularities before and after menopause or in individuals with prolonged estrogen exposure. It can be controlled with early diagnosis and appropriate treatment; if untreated, some types may increase the risk of developing uterine cancer.
What is Endometrial Hyperplasia?
Endometrial hyperplasia is the abnormal thickening due to an increase in the number of glands and cells in the inner layer of the uterus. This condition is an indicator of hormonal imbalances. Especially in menstrual cycles without ovulation, progesterone production is insufficient, and the endometrium continuously grows under the influence of estrogen. This thickened tissue sometimes causes irregular, prolonged, or excessive menstrual bleeding. Endometrial hyperplasia is divided into two main groups: “without atypia” (no cellular changes) and “with atypia” (precancerous cellular changes). Diagnosis is usually made through ultrasound and endometrial biopsy.
How is Endometrial Hyperplasia Treated?
The treatment plan is determined based on the type of hyperplasia, the patient’s age, fertility desires, and menopausal status. Hormone-balancing treatments (such as progesterone medications or intrauterine hormone-releasing systems) are generally preferred for the non-atypical type. In cases of atypical hyperplasia, surgical approaches (such as removal of the uterus – hysterectomy) may be considered. The condition of the endometrium is monitored with regular ultrasound checks and biopsies after treatment. Thanks to early diagnosis, in most cases, the tissue returns to normal, and the risk of progression to cancer can be prevented.
Causes of Endometrial Hyperplasia
The main cause of this condition is the continuous stimulation of the uterine lining by estrogen when the effect of progesterone is insufficient. Ovulation disorders (such as polycystic ovary syndrome), obesity, postmenopausal estrogen use, hormone-secreting tumors, or certain medications can disrupt the estrogen balance. Additionally, prolonged menstrual delays can also set the stage for excessive thickening of the endometrium. Identifying risk factors is important for the success of the treatment plan.
Symptoms and Diagnostic Methods
The most prominent symptom of endometrial hyperplasia is irregular menstrual bleeding. These bleedings are usually prolonged, excessive, or restart in the postmenopausal period. Some patients may experience spotting between periods or a feeling of fullness in the pelvic area. The first step in diagnosis is usually transvaginal ultrasonography, where the thickness of the uterine lining is measured. In suspicious cases, an endometrial biopsy (curettage) is performed, and the tissue sample is sent for pathological examination. This examination reveals the presence of cellular changes. 97a
Hormone Therapy in Endometrial Hyperplasia
Hormone therapy is particularly effective in cases of non-atypical hyperplasia. Progesterone medications or hormone-releasing devices placed inside the uterus (such as Mirena) help thin the endometrium. The treatment duration is usually between 3 to 6 months. Post-treatment, healing is assessed with a control biopsy. Regular follow-up plays a critical role in preventing recurrences. 338
Surgical Options
Atypical endometrial hyperplasias, especially in postmenopausal women, are treated surgically due to the risk of uterine cancer. In this case, a hysterectomy (removal of the uterus) may be recommended. In patients of reproductive age who wish to have children, uterus-preserving treatment methods are preferred, but more frequent monitoring is required. The decision for surgical treatment should be made considering the patient’s overall health and fertility desires.
Relationship Between Menopause and Endometrial Hyperplasia
Any type of vaginal bleeding seen in the postmenopausal period should be carefully investigated. Since ovulation stops during this period, progesterone production ceases, leading to estrogen dominance. Incorrect dosage or unbalanced medication use in women receiving hormone therapy can also cause endometrial hyperplasia. A thickened endometrium in menopause should be evaluated with a biopsy as it may be precancerous. 50e
Effects of Nutrition and Lifestyle
Maintaining an ideal weight and regular exercise are important for preserving hormone balance. Obesity increases the risk of endometrial hyperplasia as it causes additional estrogen release from fat tissue. A diet rich in fiber, vegetables, and fruits supports hormonal balance by reducing insulin resistance. Avoiding alcohol and smoking is also beneficial for overall reproductive health. 33f
| Feature | Description |
|---|---|
| Prevalence | Increases in the premenopausal and postmenopausal periods |
| Symptoms | Irregular, excessive, or intermenstrual bleeding |
| Diagnostic Methods | Ultrasound, endometrial biopsy (curettage) |
| Treatment Options | Hormone therapy, intrauterine device, surgery |
| Follow-up Process | Ultrasound and biopsy check every 3–6 months |
Endometrial Hyperplasia Costs
The cost of endometrial hyperplasia treatment varies depending on the method applied, laboratory and pathology examinations, and, if necessary, surgical intervention. Since a personalized treatment plan is prepared for each patient, a fixed price range is not specified. For current pricing information and detailed evaluation, please contact our clinic. 4de
Endometrial hyperplasia can be completely controlled with accurate diagnosis and appropriate treatment. Early diagnosis and regular follow-up in women’s health reduce cancer risk and preserve quality of life.
Frequently Asked Questions About Endometrial Hyperplasia
Question: Can endometrial hyperplasia turn into cancer?
In atypical types, if untreated for a long time, the risk of developing uterine cancer may increase. Regular follow-up and early intervention significantly reduce this risk. 97a
Question: Does endometrial hyperplasia prevent pregnancy?
Hyperplasia can make the uterine lining unsuitable for pregnancy. Once the tissue returns to normal after treatment, the chance of pregnancy increases. 930
Question: Does it recur after treatment?
If hormonal imbalance persists, it may recur. Therefore, lifestyle adjustments and follow-ups are important after treatment. 33f
Question: How is the diagnosis of endometrial hyperplasia made?
Thickness is measured with transvaginal ultrasound, and a definitive diagnosis is made through pathological examination of the tissue sample obtained by biopsy. 52c
