| Basic Information |
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| Description |
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An overgrowth of tissue in the endometrium (inner lining of the
uterus). This is not cancerous, but some hyperplash, even though
reversible, is considered premalignant. Terms used to describe the
hyperplash (simple, complex, adenomatous and atypical helps explain
its premalignant potential.
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| Frequent Signs and Symptoms |
- Bleeding between normal menstrual periods.
- Heavy menstrual flow (saturating a tampon or pad once every hour).
- Bleeding after menopause.
- Vaginal discharge, especially after menopause.
- Lower abdominal cramps occur in some patients.
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| Causes |
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Excessive estrogen (a female hormone) as compared with the amount of
progesterone (another female hormone). This excess is caused internally,
or from the use of hormone-containing medications. Endometrial hyperplasia rarely occurs in women who have a normal menstrual cycle.
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| Risk Increases With |
- Use of oral contraceptives or estrogen replacement therapy
(after menopause) without the addition of a progesterone drug.
- History of chronic anovulation such as with polycystic
ovary disease.
- Obesity in postmenopausal women.
- Late menopause (over age 55).
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| Preventive Measure |
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No specific preventive measures.
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| Expected Outcome |
- In most cases, hormonal treatment with a progesterone
(progestin) will reverse the hyperplasia caused by the excess
estrogen.
- In other cases, it is often curable with D & C (dilatation
and curettage) or hysterectomy. If a woman chooses not to have
surgery, hormone therapy usually controls symptoms.
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| Possible Complications |
- Perforation of the uterus and abdominal pelvic infection
as a rare complication of surgery (endometrial biopsy, D & C
or hysteroscopy).
- Excessive, uncontrollable bleeding.
- Confirmation that the hyperplasia is precancerous.
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| Treatment/Post Procedure Care |
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| General Measures |
- Diagnostic tests may include laboratory studies, such as
blood tests of hormone levels and Pap smear. An endometrial biopsy
and a D & C (dilatation and curettage) as a treatment and to obtain
tissue for microscopic examination (biopsy) to rule out any malignancy
may be necessary.
- Treatment will be individualized based on the medical
tests findings, your age, and your reproductive desires.
- Occasionally a hysterectomy (surgery to remove the
uterus) is performed, particularly when hormone therapy
has failed and precancerous cells are discovered.
- Try to reduce psychological stress that can complicate
your illness and delay your recovery. If you can't resolve
the stress, ask for help from family, friends or competent
counselors.
- Use heat to relieve pain. Place a heating pad or
hot-water bottle on your abdomen or back.
- Take frequent hot baths to relax muscles and relieve
discomfort. Sit in a tub of hot water for 10 to 15 minutes.
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| Medication |
- Progesterone (progestin), a female hormone, is often
prescribed.
- Avoid aspirin; it may increase bleeding.
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| Activity |
- No restrictions unless you have surgery. Then resume your
activities gradually.
- You may resume sexual relations once medical clearance is
given.
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| Diet |
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Usually, no special diet is required. If you are overweight a weight
reduction plan might help regulate cycles and decrease estrogen in
the body.
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| Notify Your Healthcare Provider If |
- You or a family member has symptoms of endometrbl
hyperplasia.
- The following symptoms occur during hormone treatment or
after surgery or D & C:
- excessive bleeding (saturating more than 1 pad or tampon
every hour).
- Signs of infection, such as fever, pain, a general ill
feeling, headache, dizziness or muscle aches.
- New, unexplained symptoms develop. Drugs used in
treatment may produce side effects.
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