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Endometrial hyperplasia 🩺
For education and revision only. Check current NICE/BNF, specialist guidance and local NHS policy before clinical use. Newly added V19 material has not received independent clinical sign-off.
Endometrial hyperplasia is a proliferation of endometrial glands, frequently related to prolonged unopposed oestrogen and associated with abnormal uterine bleeding.
Clinical assessment
- Risk factors include obesity, chronic anovulation/PCOS and exogenous oestrogen without appropriate progestogen.
- Consider investigation of persistent abnormal or postmenopausal bleeding; a normal scan does not replace required histological assessment.
Histology determines risk
- Distinguish hyperplasia without atypia from atypical hyperplasia/EIN, which has greater malignant potential and needs specialist management.
- Treatment ranges from progestogen and surveillance for selected patients to definitive surgery when appropriate; fertility wishes and pathology matter.
- Ensure cancer referral pathways for unexplained postmenopausal bleeding and document follow-up completion.
Related Makindo topics
UK sources / further reading: RCOG endometrial hyperplasia | NICE NG12 suspected cancer
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