Endometrial hyperplasia 

DEFINITION 

• Endometrial hyperplasia is defined as the irregular proliferation of endometrial glands with an increase in the gland to stroma ratio when compared with proliferative endometrium. When atypical cells are identified, it can progress to endometrial malignancy if left untreated¹

SYMPTOMS 

• Abnormal uterine bleeding is the most common presentation of endometrial hyperplasia. This includes heavy menstrual bleeding, intermenstrual or irregular bleeding, postmenopausal bleeding and unscheduled bleeding on hormone replacement therapy¹

DIAGNOSIS 

• Transvaginal ultrasound¹
• Hysteroscopy with endometrial biopsy¹

TREATMENT 

• Without atypical cells: address reversible risk factors and observation with follow-up biopsy.¹ Treatment with levonorgestrel intrauterine system or oral progestins may increase regression rates²
• With atypical cells: total hysterectomy should be considered¹