Causes and risk factors
- Excess weight (fatty tissue produces oestrogen)
- Polycystic ovary syndrome and irregular ovulation
- Oestrogen therapy without progesterone, tamoxifen use
- The menopausal transition, diabetes
Symptoms and diagnosis
The most common symptom is abnormal uterine bleeding: heavy or prolonged periods, bleeding between periods or bleeding after the menopause. The lining may appear thick on transvaginal ultrasound; a definitive diagnosis requires an endometrial biopsy or a tissue sample taken under hysteroscopy.
Types of hyperplasia
Treatment
- For hyperplasia without atypia, the hormonal intrauterine system (levonorgestrel-releasing IUS) is one of the most effective options; oral progestin can also be used. Weight loss and correcting risk factors are important. Follow-up biopsies are taken every 3–6 months during treatment.
- For atypical hyperplasia, hysterectomy (usually laparoscopic) is recommended for women who do not wish to have children. Women who want to have children may keep their uterus with high-dose hormone treatment and frequent biopsies; surgery is reconsidered once childbearing is complete.
Frequently asked questions
My endometrial thickness is high – do I have hyperplasia?
Not every thickening is hyperplasia; it is assessed according to the phase of the cycle, menopausal status and any medication. A biopsy is taken if needed.
Can hyperplasia turn into cancer?
In hyperplasia without atypia the risk is low and it usually regresses with treatment. Atypical hyperplasia is considered a precancerous condition and should be treated.
How long should the hormonal coil stay in?
It is usually used for at least 6 months and may be continued as protection after biopsies return to normal. The duration is decided with your doctor.
Book a consultation
Prof. Dr. Derya Sivri Aydın sees patients at Medical Park Bahçelievler Hospital, Istanbul. International patients are supported by the hospital's International Patient Services Center.
The information on this page is for general guidance only; the right diagnosis and treatment for you are decided after a consultation. Last updated: November 2026.