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Endometrial hyperplasia

I have endometrial hyperplasia. How many people who have this go on to develop cancer of the womb?


What endometrial hyperplasia is

Endometrial hyperplasia is a thickening of the lining of the womb, caused by overgrowth of the cells that line the womb. It is not cancer. But in some women it can develop into womb cancer. The following information gives an outline of the causes, risks and treatment of endometrial hyperplasia.


What causes endometrial hyperplasia?

Endometrial hyperplasia is often related to a lack of balance between the two female hormones, oestrogen and progesterone. There may be times when the body is exposed to oestrogen without progesterone in the body to balance it. Doctors call this unopposed oestrogen. There may be a number of reasons why this imbalance happens. These include the hormone changes that happen at the time of the menopause. Or because of drug treatment such as oestrogen only hormone replacement therapy (HRT) or tamoxifen. Oestrogen only HRT is normally only prescribed to women who have had their womb removed (a hysterectomy). Tamoxifen is a breast cancer drug that can have a similar effect on the womb to oestrogen, which is why it can cause hyperplasia.

There are two types of endometrial hyperplasia

  • Hyperplasia without atypical changes
  • Hyperplasia with atypical changes

Atypical changes mean that the cells have changed and become abnormal and this is associated with a higher risk of womb cancer.


How hyperplasia is diagnosed

The most common symptom of endometrial hyperplasia is abnormal vaginal bleeding. This might be prolonged, heavy periods, or bleeding between periods. It’s important to always report any abnormal bleeding to your GP.

Endometrial hyperplasia can be diagnosed by a vaginal ultrasound scan, hysteroscopy or a dilatation and curettage (D and C) operation.


The risk of womb cancer

Women who don’t have atypical changes have a very small risk of developing a cancer. But women with atypical changes have an increased risk of womb cancer. Between 1 and 2 out of every 10 women (10 to 20%) with endometrial hyperplasia go on to develop womb cancer. This risk is higher for women with atypical hyperplasia who have been through the menopause.

There is more information about the risks of womb cancer in our womb cancer section


Treating endometrial hyperplasia

Endometrial hyperplasia can be treated. When planning treatment your doctor will take into account

  • The cause of the hyperplasia
  • Whether you have atypical cell changes
  • Your age and if you have been through the menopause
  • Whether you want to have children
  • How fit you are to have an operation

If you are young and don’t have atypical cell changes, you may just need treatment with progesterone to balance the effects of oestrogen. But if you have been through the menopause, or have atypical cell changes, then your doctor is more likely to recommend surgery. This would be removal of your womb (hysterectomy) and ovaries.

We have a large section about womb cancer that you may find helpful, including information on womb cancer surgery.

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Updated: 11 October 2014