RCOG | Endometrial hyperplasia

28th April 2016 by Louise Hudman

RCOG | Endometrial hyperplasia

This is a new guideline from RCOG on diagnosing and managing endometrial hyperplasia. This is a very common condition, so highly relevant for us and I had no idea on some of the management options. I am therefore doing a general summary.

Types

  • Endometrial Hyperplasia without atypia – fewer than 5% will progress to cancer over 20 yrs and most regress spontaneously.
  • Endometrial Hyperplasia with atypia – there is a much high risk of cancer (8% at 4 yrs, 12% at 9 yrs and 27% at 19 yrs and concomitant cancer is found in 43% of women at hysterectomy).

Risk Factors

Oestrogen exposure, whether exogenous (tamoxifen / oestrogen only HRT) or endogenous (obesity, PCOS or perimenopause with anovulation or estrogen secreting tumours).

[Tweet “Obesity and PCOS are both risk factors for endometrial hyperplasia”]By Nephron (Own work) [CC BY-SA 3.0 ) or GFDL , via Wikimedia Commons

Symptoms

  • Heavy menstrual bleeding (beware the over 45s)
  • IMB
  • Irregular bleeding
  • Unscheduled bleeding on HRT
  • Postmenopausal bleeding

 Investigations

  • Endometrial biopsy
  • Hysteroscopic Biopsy (if above undiagnostic or if hyperplasia is found on a polyp)
  • USS transvaginal

Read for free

Sign up to access everything.

Free trial

Login

Already a member? Login to view this content.

Login

"...the NASGP LocumDeck service makes my running things as a self employed GP almost effortless - I don't think I would want to work without it. Invoicing is streamlined and the website is very user-friendly. After a sometimes busy week at work the last thing you want is to spend hours on business admin - LocumDeck is a real timesaver."

Dr James O’Mahony

See the full list of features within our NASGP membership plans

Membership