ENDOMETRIAL HYPERPLASIA

General Information

DEFINITION--An overgrowth of tissue in the endometrium (inner lining of the uterus). This is not cancerous.

BODY PARTS INVOLVED--Endometrium.

SEX OR AGE MOST AFFECTED--Women over age 35.

SIGNS & SYMPTOMS

• Bleeding between normal menstrual periods.
• Heavy menstrual flow (saturating a tampon or pad once every hour).
• Bleeding after menopause.

CAUSES--Excessive estrogen, a female hormone. This is caused internally or from the use of hormone-containing medications. Endometrial hyperplasia rarely occurs in women who have a normal menstrual cycle.

RISK INCREASES WITH--Use of oral contraceptives or estrogen replacement therapy after menopause.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory tests, such as blood tests of hormone levels and Pap smear (See Glossary).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• D & C (see Dilatation and Curettage of the Uterus in Surgery section) to obtain tissue for microscopic examination to rule out malignancy.
• Hysterectomy (see in Surgery section) sometimes.

POSSIBLE COMPLICATIONS

• Perforation of the uterus and peritonitis as a complication of surgery (rare).
• Excessive, uncontrollable bleeding.

PROBABLE OUTCOME--Often curable with D & C or hysterectomy. If a woman chooses not to have surgery, hormone therapy usually controls symptoms.

How To Treat

GENERAL MEASURES--

• 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.
• Don't douche unless your doctor recommends it.
• For an explanation of surgery and postoperative care, see Hysterectomy in Surgery section.

MEDICATION--

• If the D & C does not relieve symptoms and you don't want a hysterectomy (or you are a poor surgical risk), you will probably be prescribed progesterone, a female hormone.
• Avoid aspirin; it may increase bleeding.

ACTIVITY--No restrictions unless you have surgery. Then resume your activities gradually. Ask your doctor about resuming sexual relations following surgery or D & C. Don't hesitate to discuss this--it is an important part of your life.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of endometrial 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, general ill feeling, headache, dizziness or muscle aches.
• New, unexplained symptoms develop. Hormones used in treatment may produce side effects.