What are the treatment options for endometrial hyperplasia?

Endometrial hyperplasia means the lining of the womb has become thicker than expected. An endometrial biopsy checks the cells and helps distinguish hyperplasia without atypia from hyperplasia with atypia, which has a different level of concern and treatment approach.

Progesterone helps counter the effect of oestrogen on the womb lining. It may be given as tablets or through a hormonal coil, which releases medicine inside the womb. Follow-up biopsies check whether the lining is responding. Hysterectomy may be recommended when atypical cells persist, when medicine is unsuitable, or when childbearing is complete. A radical hysterectomy is generally reserved for a different clinical concern, such as suspected invasive cancer, rather than routine uncomplicated hyperplasia.

Ask your gynaecology team to explain the biopsy wording, whether atypia is present, and when the next sample is due. Tell them whether you hope to become pregnant, because fertility plans affect the balance between progesterone treatment, surveillance, and surgery. Track bleeding patterns and mention medicines or conditions that may affect hormones.

Take prescribed treatment consistently and attend repeat assessments even if bleeding improves. Seek advice before stopping a hormonal medicine or removing a hormonal coil.

Arrange medical review for bleeding after menopause, bleeding between periods, very heavy periods, or bleeding that returns after treatment. Seek urgent help for soaking through protection rapidly, dizziness, fainting, severe pelvic pain, or weakness suggesting significant blood loss. Contact your clinician for fever, worsening pain, or unusual discharge after a procedure.

Does my biopsy show atypia? Could a hormonal coil or tablets treat it? How often will I need repeat biopsies? How would treatment affect pregnancy plans? What findings would make surgery the safer option?