Department of Obstetrics and Gynecology

Gynecologic Oncology Program

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Post-Traumatic Stress Disorder

Endometrial Overgrowth

The lining of the womb reacts to female hormones throughout life. A balanced cycle of the female hormones, progesterone and estrogen, is needed to produce a normal period. If the estrogen part of the cycle becomes too strong, the lining of the womb will overgrow. This thickened lining causes heavy and irregular bleeding. Sometimes this can lead to a lower blood count. The cycle can be shorter or longer than usual, even to the point of having no periods for many months.

Women at risk for this overgrowth, in addition, will usually have one of the following:

• a severe weight problem

• the inability to get pregnant due to an ovarian problem called polycystic ovarian syndrome or

• medical problems, such as diabetes or high blood pressure

Testing and treatment depend on how severe the problem is and how long it has been going on. The desire for children is considered as well. Because women often become used to heavier periods without complaining, a blood count can tell how bad the problem has become. A sample of the lining may be taken with a tiny straw-like instrument before treatment is started. This will test for any other causes of bleeding, like cancer. At this point, treatment can begin, usually with hormones to correct the problem. Birth control pills, progesterone tablets or shots, and fertility drugs are used with young women. Surgery is rarely needed.

Women over 40 who develop endometrial overgrowth are at higher risk for a cancer of the uterine lining. When not treated for more than 1 year, 25 percent of these women will get cancer. A sampling of the lining shows signs of these changes. If no cancer is found, treatment will usually begin with progesterone therapy and close follow-up is needed by a healthcare provider. Most women find their bleeding will become less severe and more regular with treatment. Advanced cases may require surgery to remove both the uterus and the ovaries. Doing this will prevent cancer from developing.

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