Florida Hospital Cancer Institute ›› Cancer Programs ›› Gynecologic Cancer ›› Conditions ›› Complex Endometrial Hyperplasia

Effective Treatment for Complex Endometrial Hyperplasia in Orlando

Florida Hospital Cancer Institute offers the latest and most effective treatment for complex endometrial hyperplasia in Orlando for residents of Central Florida and the surrounding regions. Endometrial hyperplasia is the medical term for unusual or excessive cell growth in the inner glandular lining of the uterus, also called theendometrium. Most of the time, endometrial hyperplasia is uncomplicated and easily treated by your ob/gyn provider, with minimal intervention. To learn more about treatment for complex endometrial hyperplasia in Orlando, or to schedule an appointment, call (407) 303-1700 or click here to fill out an online assistance form.

Symptoms of Complex Endometrial Hyperplasia

In most cases, the main symptom of complex endometrial hyperplasia is abnormal uterine bleeding. It's important to be aware if you are experiencing abnormal menstrual cycles. The following are signs and symptoms of abnormal menstrual cycles:

  • Heavier or longer-lasting bleeding during menstrual periods
  • Menstrual cycles that are less then 21 days from the first day of the menstrual period to the first day of the next menstrual period
  • Bleeding after menopause.
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Causes of Complex Endometrial Hyperplasia

The cause of complex endometrial hyperplasia is mainly due to the absence of hormones. During a woman's normal menstrual cycle, the ovaries produce estrogen hormones in the beginning of the cycle. Once the egg is released, a hormone called progesterone is increased in order to prepare the endometrium for the egg to implant. Progesterone levels decrease when the egg is not fertilized, resulting in a shedding of the lining (menstruation). When a woman's body produces an excess amount of estrogen without progesterone, the lining never sheds. This condition most often occurs during menopause when the ovaries cease to release eggs and progesterone isn't created.

The following are some ways that hormones can cause complex endometrial hyperplasia:

  • Medications that act like estrogen
  • Using high doses of estrogen after menopause (without hysterectomy)
  • Polycystic ovary syndrome
  • Infertility
  • Irregular menstrual periods
  • Obesity

Women’s risk of developing complex endometrial hyperplasia increases with these factors:

  • 35 years old or older
  • Caucasian
  • Never being pregnant
  • Menopause occurring at an older age
  • Early age of first menstrual period
  • Personal history of diabetes mellitus, polycystic ovary syndrome, gallbladder disease or thyroid disease
  • Obesity
  • Smoking
  • Family history of ovarian, colon or uterine cancer
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Risk Factors for Complex Endometrial Hyperplasia

Women in menopause or experiencing menopausal symptoms can be more at risk for developing endometrial hyperplasia. Imbalance of hormones or hormonal changes can happen around the time of menopause, and contribute to the development of hyperplasia in some women. Endometrial hyperplasia of the uterus, by itself, is not cancerous, but it does require treatment and monitoring to prevent the risk of cancer.

However, there are times when uterine hyperplasia can get worse, leading to atypical and precancerous cellular changes. This is why any woman with hyperplasia is considered to be at a higher risk for cancer than one without. If you’ve just been diagnosed with a thickened endometrium, you should know that there are many steps between hyperplasia and full-blown uterine cancer — and early identification and intervention for uterine abnormalities is highly successful.

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Types of Complex Endometrial Hyperplasia

Endometrial Hyperplasia and its relation to Cancer

  • Simple hyperplasia - this is simply an increased thickness in the endometrium with an increased number of glands. There is no cytological atypia (abnormal, malignant appearing cells). Treatment is usually with progesterone supplementation and there is a <1% chance of progression to cancer.
  • Complex hyperplasia without atypia - this type is a little thicker than simple hyperplasia, and has more crowding and abnormal architecture to the glands. Without treatment, about 10% of patients will progress to endometrial cancer. Treatment is typically with progesterone, although hysterectomy is an option in women who have completed childbearing and are at acceptable surgical risk.
  • Complex hyperplasia with atypia- similar architectural abnormalities as complex hyperplasia without atypia, only the cells have bizarre appearances. Because of the significant risk of invasive endometrial cancer (40%), all patients with this diagnosis should have a consultation with and/or be managed by a surgeon capable of performing complete surgical staging that includes lymphadenectomy.
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Tests to Diagnose Complex Endometrial Hyperplasia

At Florida Hospital Cancer Institute, our skilled gynecology physicians may recommend a variety of screenings and tests to properly diagnose complex endometrial hyperplasia. Using state-of-the-art, advanced technology, our staff can analyze tissue samples and diagnose the cause of mentrual bleeding (the main symptom). Once the diagnosis has been made, your physician will work with you and your family to develop an individualized treatment plan. 

The following are some of the diagnostic screenings and tests we offer to diagnose complex endometrial hyperplasia:

  • Transvaginal ultrasound
  • Endometrial biopsy
  • Dilation and curettage
  • Hysteroscopy
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Treatment for Complex Endometrial Hyperplasia

Depending on the type and severity of the condition, your physician may recommend the following treatments for complex endometrial hyperplasia. 

If the case is simple, treatment may include a progesterone supplement. For more complex situations, treatment may include progesterone supplement or surgical treatments. During progesterone therapy, your body will shed the extra uterine lining that has built up inside the uterus. If a risk of cancer is high, your physician will recommend surgery, such as a hysterectomy if the patient is finished childbearing. In severe cases, a lymphadenectomy may be recommended. 

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Request an Appointment

To learn more about treatment for complex endometrial hyperplasia in Orlando, or to schedule an appointment, call (407) 303-1700 or click here to fill out an online assistance form.

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