Endometrial hyperplasia covers a group of abnormalities encompassing pre-malignant lesions of the endometrium. It is classified according to cellular and structural appearances, and is recognized as an oestrogen-dependent condition. Pre-disposing factors include therapies resulting in exogenous oestrogenic stimulation, and conditions causing excessive oestrogen production.
The risk of progression to cancer in untreated cases is uncertain as a result of a tendency by gynaecologists to intervene, but the classification identifies those types of hyperplasia that are more likely to develop into invasive malignancy.
Many cases are asymptomatic and probably resolve spontaneously. Symptoms may include irregular pre-menopausal vaginal bleeding, as well as post-menopausal bleeding and discharge. Management of endometrial hyperplasia will be influenced by the type of abnormality, along with the woman's age, symptoms and desire for future fertility. Therapeutic options include various hormonal treatments and surgical interventions, of which hysterectomy is the most important in cases associated with cellular atypia.
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