Endometrial Hyperplasia: Treatment and Prevention

What is endometrial hyperplasia

Endometrial hyperplasia is an abnormal growth of the inner layer of the uterus (endometrium) caused by excessive cell division. This condition may be associated with hormonal imbalances, such as excess estrogen or lack of progesterone, as well as chronic inflammatory processes or metabolic changes.

Without timely treatment, the disease can lead to serious consequences. Abnormal uterine bleeding contributes to the development of anemia and decreased hemoglobin levels. Furthermore, atypical hyperplasia is considered a precancerous condition. Without medical intervention, the risk of developing endometrial cancer increases to 30%. This condition can also cause infertility due to disruption of the normal functioning of the endometrial tissue.

Timely consultation with a physician allows for an accurate determination of the causes of the pathology, selection of effective treatment and prevention of serious complications. MedTour, as one of the leaders in medical tourism, provides patients with access to the best clinics and doctors both in Ukraine and abroad. The company’s specialists help develop personalized solutions for each patient, taking into account their needs, preferences, and medical indications.

What Is the Endometrium and Endometrial Hyperplasia?

The endometrium is the tissue that lines the inner surface of the uterus. It plays a key role in the female reproductive system. The endometrium consists of epithelial cells and underlying connective tissue, providing favorable conditions for the attachment and development of the fertilized egg. During each menstrual cycle, the endometrium undergoes hormonal changes: its cells grow and thicken under the influence of estrogens, and then, under the influence of progesterone, prepare for a possible pregnancy.

If the hormonal balance is disrupted, the process of regulating cell division in the endometrium can get out of control, leading to its excessive thickening. This condition is called hyperplasia. To better understand what endometrial hyperplasia is, it is important to know that it is not just an increase in the thickness of the layer, but a pathological process accompanied by proliferation (excessive growth and division) of cells.

Causes of Endometrial Hyperplasia

Endometrial hyperplasia develops under the influence of various factors, the main one of which is hormonal disorders. Excessive exposure to estrogens on endometrial tissue, combined with a lack of progesterone, leads to uncontrolled growth of the cells in the inner uterine layer.

• One of the common causes of hormonal imbalance is polycystic ovary syndrome (PCOS). This condition is accompanied by ovulation disorders, which contributes to the accumulation of estrogens and increases the risk of hyperplasia development.

• Overweight and obesity also play a significant role in the development of the disease. Adipose tissue actively participates in the conversion of androgens into estrogens, which increases the overall level of the hormone in the body and creates conditions for the pathological growth of endometrial cells.
• Genetic predisposition should not be underestimated. If close relatives have been diagnosed with hyperplasia or related diseases, the risk of developing the disease increases.

Understanding the risk factors allows individuals to pay timely attention to changes in their bodies and seek medical assistance to prevent possible complications.

Types of Endometrial Hyperplasia

The disease is classified according to the nature of cellular changes and the degree of their severity. Its main forms are described below.

Glandular Endometrial Hyperplasia

Glandular endometrial hyperplasia is an excessive growth of the glands of the inner layer of the uterus. This form is considered the mildest and is often benign. With glandular endometrial hyperplasia, the structure of the glands is preserved, but their number increases significantly. The main reason for its development is hormonal disorders, such as excess estrogen combined with a lack of progesterone.

Although glandular endometrial hyperplasia is usually not immediately life-threatening, symptoms such as irregular or heavy uterine bleeding should not be ignored. If left untreated, the condition may progress and increase the risk of malignant changes.

Focal Endometrial Hyperplasia

This type is characterized by local thickening of the endometrial tissue in certain areas. These changes are often associated with the formation of polyps, which can be either benign or precancerous.

Symptoms of focal endometrial hyperplasia include irregular menstruation, pain, and discomfort in the lower abdomen. Diagnosis typically includes pelvic ultrasound, hysteroscopy, and biopsy to determine the nature of the changes. Early detection helps prevent complications and begin treatment in a timely manner.

Cystic endometrial hyperplasia

It is a proliferation of endometrial glands with the formation of cystic cavities. Such changes occur due to the accumulation of secretions inside the glands, which leads to their expansion.

This form of hyperplasia is also associated with hormonal disorders and requires a comprehensive treatment approach. Hormonal therapy is most commonly used to restore the balance of estrogens and progesterone, as well as surgical intervention in cases of complications or when conservative treatment proves ineffective. Treatment for glandular-cystic endometrial hyperplasia is aimed not only at eliminating symptoms, but also at preventing the risk of malignant transformation.

Symptoms of endometrial hyperplasia

The disease can manifest itself with various symptoms, depending on the degree and form of pathological changes. The main symptoms of endometrial hyperplasia include:

• menstrual cycle disorders (abnormal uterine bleeding, heavy or prolonged menstruation, irregular cycle, or bloody discharge between periods);
• pain in the lower abdomen, pelvic discomfort, and a feeling of heaviness in the pelvic area;
• reproductive issues (infertility or recurrent miscarriages);
• hormonal changes (ovulation disorders, hormonal imbalance, or elevated estrogen levels);
• general weakness, rapid fatigue,and reduced productivity.

It is important to take into account that sometimes, especially in the early stages, the symptoms of endometrial hyperplasia are weakly expressed or completely absent. This highlights the importance of regular preventive check-ups.

Diagnosis of endometrial hyperplasia

Diagnosis requires a comprehensive approach, including modern imaging methods and laboratory tests:

1. Ultrasound is the main diagnostic method, which helps to assess the thickness of the inner layer of the uterus, its structure and its compliance with the phase of the menstrual cycle. The endometrium of proliferative type, detected by ultrasound, is characterized by a thickening of the layer and excessive growth of glands, which indicates pathological activity of cells.
2. Hysteroscopy is a visual examination of the uterine cavity using a special device – an endoscope. It can be used to identify focal thickenings, polyps, and other structural changes.
3. Biopsy is the collection of a sample of endometrial tissue for histological examination. This method provides a precise diagnosis of endometrial hyperplasia, determination of the form of the disease, and identification of possible precancerous changes.

Timely diagnosis makes it possible to choose the correct therapeutic tactics and avoid complications.

Treatment for endometrial hyperplasia

The choice of treatment strategy depends on the form of the disease, the patient’s age, and reproductive plans. Treatment for endometrial hyperplasia can be either a conservative or surgical approach.

Medication therapy

Hormonal therapy forms the basis of treatment, aimed at restoring the balance of estrogens and progesterone. The following medications are commonly prescribed:

• progestogens (progesterone-based drugs) to reduce the growth activity of endometrial cells;
• hormonal contraceptives to regulate the menstrual cycle;
• Gonadotropin-releasing hormone agonists (GnRH), which suppress estrogen production.

This type of treatment is especially effective for glandular and glandular-cystic hyperplasia.

Surgical treatment of endometrial hyperplasia

When medication proves ineffective or in cases of complex forms of hyperplasia, the following procedures are used:

• Uterine Curettage (Dilation and Curettage, D&C) is the removal of the thickened layer of the endometrium. This is often performed as both a diagnostic and therapeutic measure.
• Ablation is the destruction of the inner lining of the uterus using laser, radio waves, or other technologies. This method is suitable for women who do not plan to have children in the future.
• Hysterectomy is the complete removal of the uterus. This radical approach is used in cases of recurrent forms of hyperplasia or suspected malignant transformation.

An essential aspect of the treatment for glandular-cystic endometrial hyperplasia is the mandatory use of hormonal therapy to prevent the regrowth of cysts.

Complications and Prevention of Endometrial Hyperplasia

Without timely treatment, the disease can lead to severe consequences:

• risk of malignant transformation – certain forms of hyperplasia, especially atypical ones, have a high potential for malignancy (progression to cancer);
• chronic bleeding – can cause anemia and deterioration of general health;
• fertility issues – pathological changes in the endometrium can prevent embryo implantation and increase the risk of infertility.

To reduce the risk of hyperplasia, it is important to:

• undergo regular gynecological check-ups and ultrasound diagnostics;
• monitor hormone levels, especially during periods of hormonal changes (puberty, menopause);
• maintain a healthy lifestyle: eat a balanced diet, monitor weight, and control chronic diseases.
• timely treatment of hormonal disorders such as polycystic ovary syndrome (PCOS) or hypothyroidism.

Following these recommendations will help maintain women’s health and prevent the development of serious diseases.

Trust your health care to professionals

 The MedTour company offers comprehensive assistance in choosing a clinic and doctor, as well as organizing effective treatment for endometrial hyperplasia. We cooperate with leading medical centers and experienced specialists in Ukraine and abroad, providing our patients with access to modern diagnostic and therapeutic methods. Call the phone number listed on the website or fill out the feedback form to receive a free consultation with a coordinating doctor and take the first step towards a healthy life.

Published: 02.01.2025

Updated: 26.01.2025

Medical author, Medical editor:

Olena Kursabaieva

Medical author, Medical editor:

Natalia Segen