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Management of Endometrial Hyperplasia (Green-top Guideline No. 67)

Summary: Endometrial hyperplasia is defined as irregular proliferation of the endometrial glands with an increase in the gland to stroma ratio when compared with proliferative endometrium.

Endometrial cancer is the most common gynaecological malignancy in the Western world and endometrial hyperplasia is its precursor. In the UK, 8617 new cases of endometrial cancer were registered in 2012. The incidence of endometrial hyperplasia is estimated to be at least three times higher than endometrial cancer and if left untreated it can progress to cancer.

The most common presentation of endometrial hyperplasia is abnormal uterine bleeding. This includes heavy menstrual bleeding, intermenstrual bleeding, irregular bleeding, unscheduled bleeding on hormone replacement therapy (HRT) and postmenopausal bleeding.

COVID disclaimer: This guideline was developed as part of the regular programme of Green-top Guidelines, as outlined in our document Developing a Green-top Guideline: Guidance for developers (PDF), and prior to the emergence of COVID-19.

Version history: This is the first edition of this guideline.

Please note that the RCOG Guidelines Committee regularly assesses the need to update the information provided in this publication. Further information on this review is available on request.

Developer declaration of interests: Available on request.



This page was last reviewed 26 February 2016.