ENDOMETRIAL
HYPERPLASIA
Endometrial Hyperplasia Specialists at CIGC
The GYN surgical specialists at The Center for Innovative GYN Care are experts in diagnosing and treating endometrial hyperplasia, a complex disorder that in its simplest form may resolve on its own or, in other presentations, can be malignant or have the potential to develop into cancer. Because of its different forms and multiple surgical and nonsurgical treatment options, a GYN specialist is best suited to diagnosing and treating endometrial hyperplasia.
Having performed more than 25,000 GYN procedures, the highly trained laparoscopic specialists at The Center for Innovative GYN Care will be your health care partners every step of the way. They take the time to discuss the broad range of biopsy and treatment options for your individual case so you’ll have confidence in your care from the very start. And if your selected treatment choice involves surgery, you’ll be treated with advanced, minimally invasive techniques developed at CIGC and designed to minimize pain, scarring, complications and recovery time.
What Is Endometrial Hyperplasia?
Endometrial hyperplasia is a condition in which the lining of the uterus — the endometrium — becomes thickened and causes abnormal vaginal bleeding. It is most likely to develop in women who are past menopause but in rare cases may also occur in premenopausal women or those around age 35.
This disorder is the result of an imbalance between the female hormones estrogen and progesterone. Too much estrogen causes an overgrowth of cells in the uterine lining.
There are several kinds of endometrial hyperplasia. Depending on the form, the condition can be benign, carry the potential to turn cancerous or already be cancerous when diagnosed.
Symptoms
Because the thickened uterine lining must be shed, all patients with endometrial hyperplasia will experience abnormal bleeding.
This condition is most concerning in women who are past menopause. Because their ovaries are no longer triggering menstrual cycles, postmenopausal women with any kind of bleeding should immediately be evaluated by a specialist.
Women who have not yet reached menopause will experience heavier and longer menstrual cycle bleeding. Their menstrual cycles likely will be shorter, too, lasting 21 or fewer days. Conversely, their cycles may skip months.
Additional symptoms of endometrial hyperplasia may include anemia from persistent heavy bleeding, uterine cramping, pelvic pain and pain with urination and/or intercourse. In its most severe form, cancer may occur.
Causes
Endometrial hyperplasia is the result of too much estrogen and too little progesterone, the female hormones that respectively are in charge of building up and then sloughing off the uterine lining, depending on whether the woman is pregnant.
With this disorder, the excess estrogen overstimulates and overproduces cells (hyperplasia) that make up the lining, while the shortage (or a lack) of progesterone allows this growth to go unchecked. Cell overgrowth in the endometrium can progress to or coexist with endometrial cancer.
Taking estrogen-only hormone therapy to alleviate menopause symptoms can in some cases cause cell overgrowth.
Diagnosis
Some physicians use a transvaginal ultrasound to inspect the uterus, but the most conclusive diagnosis can be made with a combination of uterine biopsy and hysteroscopy. During this latter procedure, a thin, lighted device is inserted into the uterus so it can relay a picture of the uterus to a screen monitored by the physician.
Risk Factors
The American College of Obstetricians and Gynecologists says that in addition to being postmenopausal or on estrogen-only hormone therapy, women may be at greater risk for endometrial hyperplasia if they are Caucasian/White. Other risk factors include:
- Have frequently missed periods or been irregular for a long time.
- Are obese.
- Have diabetes, polycystic ovary syndrome (PCOS), gallbladder or thyroid disease.
- Have never been pregnant.
- Began menstruating at an early age or entered menopause at a late age.
- Are Caucasian/White.
- Smoke.
Endometrial Hyperplasia Treatments
Treatment options for endometrial hyperplasia depend on the type of the disorder. The most concerning type is atypical hyperplasia, in which the cells in the lining of the uterus are abnormal. This condition may lead to uterine cancer. Another factor guiding treatment options is whether the patient wishes to maintain the uterus for fertility.
A trial-and-error period of hormone therapy with progesterone and repeated biopsies may eliminate the condition in women without atypia who are still capable of fertility. Hysteroscopy can be used along with a dilation and curettage (D&C) to remove the thickened lining during biopsies as well.
Women who have atypical hyperplasia and are either postmenopausal or don’t want to become pregnant should strongly consider laparoscopic hysterectomy. This form of the disorder is cancerous in 30% to 40% of cases at diagnosis.
Finally, eliminating risk factors can reduce the chances that endometrial hyperplasia will recur after treatment. Obese patients can lose weight, smokers can stop, and women on estrogen-only therapy can add progesterone to the treatment.
The CIGC Difference
Specialists with The Center for Innovative GYN Care are renowned laparoscopic surgeons with more than 44 years of combined experience. They are experts in evaluating and treating endometrial hyperplasia with both surgical and nonsurgical approaches. Our specialists, developers of two advanced surgical procedures, have dedicated their careers to minimally invasive GYN procedures that provide women with the best outcomes, smallest scars and shortest recoveries.
The surgeons at CIGC recognize that each patient’s needs are unique; therefore, the physicians are committed to helping patients understand all possible treatment options and enabling them to make informed health care decisions for themselves.
Part of the treatment process for endometrial hyperplasia and other GYN conditions may involve nonsurgical health care therapies for pain, anxiety and other complications. We offer holistic treatment options — including pelvic floor physical therapy, acupuncture and more — by certified experts at The CIGC Wellness Center. Services are offered onsite at CIGC’s Rockville location or virtually for your convenience.
Our Doctors
Our fellowship-trained, minimally invasive GYN specialists are experts in the diagnosis and treatment of complex GYN conditions. Dr. Paul MacKoul’s board certifications include the practice of gynecologic oncology. They have successfully helped thousands of women and are routinely lauded by patients for their compassionate, thorough and professional care.
Why CIGC?
Award-Winning Gynecological Surgery Center
CIGC is recognized as a Center of Excellence in Minimally Invasive Surgery by the American Association of Gynecologic Laparoscopists (AAGL).
Advanced Techniques
Patients come to CIGC from around the world to be treated with our DualPortGYN® and LAAM® procedures, whose outcomes are unmatched and have been reported in major medical journals. Compared to open, robotic-assisted and standard laparoscopic techniques, CIGC surgical specialists use fewer and smaller incisions to minimize scarring and speed up recovery, resulting in lower complication rates. We get endometrial hyperplasia surgery patients back to their daily lives in a week on average — free from their GYN symptoms and worries.
Our Surgical and Wellness Centers
CIGC surgeries are performed at ambulatory surgery centers that are not attached to a hospital, meaning procedures are done on an outpatient basis and patients can go home the same day. These benefits are especially important during the COVID-19 pandemic.
With convenient locations near major cities like Washington D.C and New York City, each center is fully outfitted with state-of-the-art equipment and staffed with friendly, compassionate professionals. We follow CDC guidelines to ensure the enhanced cleanliness and safety of each center. We also offer telemedicine consultations in addition to in-person appointments to discuss treatment options.
The CIGC Wellness Center, located at CIGC’s flagship location in Rockville, Maryland, offers nonsurgical, alternative treatments for the management of GYN conditions such as fibroids, endometriosis and pelvic pain. Services also help you achieve your whole-body wellness goals
