Normally in your reproductive years, the walls of your uterus begin to thicken in anticipation of conception. When conception doesn't take place, the walls begin to break down and shed. This whole process repeats itself monthly until you begin menopause, which occurs between the ages of 45 and 55. However, the uterine wall can still thicken during menopause although it will not shed.
Endometrial hyperplasia is a condition that derives from the overgrowth of endometrial tissue. This a benign medical condition, but it can progress to uterine cancer if it is not carefully monitored. Women who are at risk for developing this medical condition are usually in their menopausal years, or they have a history of sporadic menstrual periods, diabetes, polycystic ovary syndrome, or they take oestrogen without progesterone to relieve symptoms menopause symptoms.
Menopause occurs when the levels of the hormone oestrogen decline to a level that stops menstruation. Oestrogen together with progesterone is responsible for the regulation of menstruation and ovulation. When the hormone level drops, it causes several changes to take place in the body. For one the uterine lining gets thinner due to a lack of adequate oestrogen. Oestrogen normally sends a signal to the uterus to thicken every month, but without a normal amount, it cannot thicken. In addition, the vaginal lining becomes thinner and dryer due to the decreased oestrogen as well.
Symptoms of menopause include hot flashes, night sweats, insomnia, fatigue, vagina dryness, depression, lack of libido or decreased libido, thinning hair, increased abdominal fat, decreased fertility and loss of breast fullness.
During menopause some women chose to take hormone replacement therapy (HRT) to lessen problematic symptoms such as hot flashes and night sweats. Unfortunately, the side effect of this treatment is endometrial hyperplasia. The hormone often being replaced is oestrogen. The amount of oestrogen being replaced is low, so it is just enough to minimise symptoms, and thicken the endometrial lining, but it is not enough to cause the thickened lining to shed. Therefore, it builds up and causes small amounts of bleeding sporadically. This lining will not shed on its own, so you will have no choice but to have treatment in order for the lining to return to normal.
The first thing your physician will want to do is to stop you from taking oestrogen only hormone replacements. Once the oestrogen levels begin to decrease again, the uterine lining should start to thin again. If this is not the case, your doctor will prescribe progesterone to shrink the lining. In some cases you may be recommended to get a hysterectomy as some forms of endometrial hyperplasia can lead to uterine cancer. A hysterectomy is the removal of the reproductive organs.