• Dr Peter Chew

Endometrial hyperplasia

I am 45 years old. I had an episode of heavy and prolonged periods recently. My gynaecologist suggested that I should have a dilatation and curettage (D&C) to find out the cause. This was done a week ago and the report showed “endometrial hyperplasia”. What is this condition? Could it lead to cancer?

In a normal menstrual cycle, the lining of the womb (endometrium), changes cyclically in response to hormones secreted by the ovary. After menstruation, the endometrium is thin but soon it grows in thickness in response to the rising levels of the hormone, oestrogen, produced by the growing follicles of the ovary. In the middle of the cycle, an egg is released from the follicle (ovulation). The levels of another hormone called progesterone begin to increase. This hormone prepares the endometrium to receive and nourish a fertilized egg. If pregnancy does not occur, both oestrogen and progesterone levels fall causing a complete shedding of the endometrium .A new menstrual cycle then begins.

Endometrial hyperplasia is a medical condition when the endometrium becomes too thick from an overgrowth of the cells. It is often caused by an imbalance of oestrogen and progesterone resulting in an excess of the former. The endometrium continues to grow in response to oestrogen. The overgrown cells may crowd together and may become abnormal. This condition, called hyperplasia, may lead to cancer in some women.

Endometrial hyperplasia usually occurs in the following situations:

During peri-menopause (menopausal transition) when ovulation occurs irregularly.

After menopause, when ovulation stops and progesterone is no longer produced.

Use of medications that act like oestrogen

Long-term use of high doses of oestrogen after menopause

Polycystic ovarian syndrome(PCOS)


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