Heavy Menstrual Bleeding, Improving Knowledge, Improving Lives
Endometrial hyperplasia as cause for Heavy Menstrual Bleeding

Endometrial hyperplasia 


  • 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



  • 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



  • Transvaginal ultrasound1
  • Hysteroscopy with endometrial biopsy1



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

Endometrial hyperplasia Library

Find more information and download materials on endometrial hyperplasia in the teaching and resources library.


  1. Royal College of Obstetricians and Gynaecologists.
  2. Gallos ID, et al. Am J Obstet Gynecol 2012;207:266.e1–12.

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