What Is Endometrial Hyperplasia?
Endometrial hyperplasia describes a condition in which the lining of the uterus, called the endometrium, becomes too thick.
The condition itself is not cancerous; however, it sometimes can lead to uterine cancer, notes the American College of Obstetricians and Gynecologists (ACOG).
What Causes Endometrial Hyperplasia?
If your body has too much of the hormone estrogen without the hormone progesterone, you may develop endometrial hyperplasia.
To understand how endometrial hyperplasia develops, it may help to first understand how hormonal changes during a typical menstrual cycle affect your uterine lining.
Estrogen is made by the ovaries during the first part of your cycle. That leads to growth of the lining to prepare your body for pregnancy.
However, after an egg is released (ovulation), progesterone increases with the goal of supporting a fertilized egg.
But if pregnancy does not happen, levels of both hormones decline. That decrease in progesterone is what triggers your period, the shedding of the lining.
If you do not ovulate, progesterone is not made and the lining does not shed, according to the ACOG.
So the lining may keep growing in response to the estrogen and, in time, the cells in the lining can become abnormal.
In some women, the overgrowth, called hyperplasia, can lead to cancer.
Risk Factors
While there are many risk factors that increase the chances of developing endometrial hyperplasia, having one or more of these does not mean that you will develop the condition.
Per the ACOG and the American Cancer Society (ACS), some common risk factors for endometrial hyperplasia include:
- Being over age 35
- Starting periods early or menopause late
- Obesity
- Being a cigarette smoker
- Having a family history of uterine cancer, colon cancer, or ovarian cancer
- Having a history of diabetes, polycystic ovary syndrome (PCOS), gallbladder disease, or thyroid disease
Endometrial Hyperplasia Symptoms
Abnormal uterine bleeding (heavier than usual bleeding between periods) is the most common symptom.
If you have a menstrual cycle shorter than 21 days, check with your doctor. Count from the first day of your period to the first day of your next one.
If you are post-menopausal, report any uterine bleeding to your healthcare provider.
Endometrial Hyperplasia Diagnosis
If you have abnormal uterine bleeding, your doctor may order certain tests and exams, per the Cleveland Clinic, which may include:
- Transvaginal ultrasound
- Biopsy
- Dilation and curettage (D&C)
- Hysteroscopy
Endometrial Hyperplasia Types
Your doctor and other healthcare providers will look to see whether certain cell changes are present before diagnosing the exact type of endometrial hyperplasia.
If abnormal changes are found, the diagnosis is called atypical.
If the diagnosis is endometrial hyperplasia, there are two types, according to the Cleveland Clinic:
- Simple or Complex Hyperplasia Without Atypia In this diagnosis, the endometrial hyperplasia displays normal-looking cells that are not likely to become cancerous. The condition may improve without treatment, or hormone therapy may be recommended.
- Simple or Complex Hyperplasia With Atypia This diagnosis means that cancer is more of a risk, and so immediate treatment options are recommended.
Endometrial Hyperplasia Treatment
Endometrial hyperplasia can often be treated with progestin.
This synthetic hormone is given either orally, topically as a vaginal cream, in an injection, or with an intrauterine device, according to the ACOG.
If you have simple hyperplasia, which is the most common type, the risk of it becoming cancerous is very small.
If you have atypical hyperplasia, the chances of cancer developing are higher.
For simple hyperplasia that is atypical, the chance of any lesions turning into cancer is about 8 percent if left untreated, notes the ACS, while complex hyperplasia that is atypical turns into cancer in about 29 percent of untreated cases.
If the diagnosis is atypical, and you are done bearing children, your doctor may recommend removal of the uterus (hysterectomy), as the risk of uterine cancer rises with atypical hyperplasia.

Ryland J. Gore, MD, MPH
Medical Reviewer
In addition to her professional responsibilities, Gore previously served on the board of directors for Every Woman Works, an Atlanta-based nonprofit organization whose mission is to empower women and help them transition into independence and stability from common setbacks. Gore served as the chairwoman of the American Cancer Society’s Making Strides Against Breast Cancer campaign in Atlanta for three years (2019 to 2021). She is currently the co-director of Nth Dimensions’ Strategic Mentoring Program and the alumni board chair of the Summer Health Professions Educational Program (SHPEP), which is a collaborative effort by the Robert Wood Johnson Foundation, Association of American Medical Colleges, and the American Dental Education Association.
Gore is a highly sought after speaker, consultant, and lecturer on breast cancer and breast health, as well as women’s empowerment topics.

Anne L. Fritz
Author
Anne L. Fritz is a New York City-based freelancer with more than 15 years experience.
She enjoys covering a range of healthcare topics and has a particular interest in advances on the anti-aging front including lasers and cosmetic injectibles.
Prior to launching her freelance career, Anne was Style Director at Life & Style magazine and Fashion & Beauty Editor at Woman’s Day. She has also worked at InStyle.com, MarthaStewart.com and Working Mother magazine.
Anne is a graduate of Syracuse University and a Washington D.C. native.
- Endometrial Hyperplasia. American College of Obstetricians and Gynecologists. December 2022.
- Endometrial Cancer Risk Factors. American Cancer Society. March 27, 2019.
- Endometrial Hyperplasia. Cleveland Clinic. February 16, 2023.