Endometrial hyperplasia

Abstract

Endometrial hyperplasia covers a group of abnormalities encompassing premalignant lesions of the endometrium. It is classified according to cellular and structural appearances, and is recognised as an oestrogen-dependant condition. Predisposing 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 premenopausal vaginal bleeding, as well as postmenopausal 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.