What to expect from hormone therapy for endometrial hyperplasia

Endometrial hyperplasia means the lining of the womb has become thicker than expected. A biopsy helps identify whether abnormal cells are present and guides treatment. Progestogen, a progesterone-like hormone, can counter the effect of oestrogen on the lining. It may be offered as tablets or through a hormone-releasing intrauterine system. Treatment is different when atypical cells are found, and your clinician will explain whether surgery should be considered.

Irregular bleeding, spotting, breast tenderness, bloating, headaches or mood changes may occur. Some people notice bleeding patterns change before the lining settles.

Use the medicine or device as instructed and attend repeat sampling or scans when arranged. Record bleeding, pelvic discomfort and missed doses. Tell your clinician about medicines that affect clotting, liver disease, migraines, pregnancy plans and any new bleeding after menopause. Do not remove a prescribed device or stop tablets without discussing it, because the lining can thicken again.

Arrange medical advice for bleeding that becomes heavy, prolonged or returns after improving, or for increasing pelvic pain, fever or unusual discharge. Seek urgent help if you feel faint with heavy bleeding or develop sudden severe pain. Prompt review is also needed for possible pregnancy with pain or bleeding.

Ask what your biopsy found, why a particular progestogen method is recommended, and when the lining will be checked again. Clarify how to handle missed doses, what bleeding is expected, whether fertility plans affect treatment, and when hysterectomy or another option would be discussed.