Endometrial hyperplasia is a condition where the uterine lining becomes abnormally thick, often due to hormonal imbalances. It can range in severity, from cases without atypia- where the cells are normal but overgrown, to those with atypia- which involve abnormal, precancerous cells and carry a higher risk of developing into cancer. Understanding the type and severity of hyperplasia is essential, as timely and tailored treatment plays a critical role in managing symptoms and preventing further complications.
At Rylon Clinic in London, we provide personalised care for patients with endometrial hyperplasia. Our expert team offers a comprehensive range of medical and surgical treatments tailored to individual needs, whether you are a younger patient seeking fertility-preserving options, or someone exploring surgical solutions like robotic hysterectomy. We prioritise your health and wellbeing with a focus on timely interventions, expert counselling, and advanced procedures. If atypia is diagnosed, we can arrange access to advanced gynaecology cancer diagnostics.
By choosing Rylon Clinic, you’ll benefit from access to cutting-edge treatments, continuity of care, and compassionate support every step of the way. Whether you're seeking a diagnosis, exploring fertility-preservation strategies, or considering surgical options, our team is here to provide the guidance and care you need.
Understanding atypia in endometrial hyperplasia
Endometrial hyperplasia is classified into two main types: with atypia and without atypia (often termed as simple or complex hyperplasia). These classifications are based on whether abnormal or precancerous cells are present in the thickened uterine lining, and they play a crucial role in determining the appropriate treatment and monitoring plan.
Hyperplasia without atypia
This type of hyperplasia is called simple and is the less severe form and is characterised by an overgrowth of normal cells in the uterine lining. While it carries a low risk of progressing to cancer (typically less than 5% over 20 years) [1] it still requires treatment to manage symptoms and prevent potential progression into the complex type. Treatments often focus on hormonal therapy, such as high-dose progesterone, to restore balance and reduce the thickness of the endometrial lining.
Hyperplasia with atypia
In hyperplasia with atypia, the uterine lining contains abnormal cells, also referred to as precancerous cells. This form carries a significantly higher risk of progressing to endometrial cancer, with up to 29% of cases progressing if left untreated [2]. Because of this elevated risk, more aggressive treatment options, such as total hysterectomy, may be recommended for those who have completed their families or for patients in their late 40s or 50s [1].
Key differences in risks and progression
Without atypia: Low cancer risk, often reversible with hormonal therapy and lifestyle changes.
With atypia: High cancer risk, often requiring surgical intervention or close monitoring with hormonal therapy if fertility preservation is desired.
Timely diagnosis and tailored treatment are essential for both types of hyperplasia to ensure the best outcomes. At Rylon Clinic, we offer advanced diagnostic tools and a range of treatments designed to address both forms, with a focus on preserving health and fertility wherever possible. If you’ve been diagnosed with endometrial hyperplasia, our team can guide you through the next steps with expert care and personalised support.
What are the risks of endometrial hyperplasia progressing to cancer?
Endometrial hyperplasia can carry varying levels of risk depending on whether it is classified as with atypia or without atypia. Understanding these risks and timelines is crucial for making informed decisions about treatment and ensuring timely intervention to reduce the likelihood of progression to endometrial cancer.
Hyperplasia without atypia: Low risk but not without concern
As stated earlier, in cases of hyperplasia without atypia, the risk of progression to cancer is generally low. However, while the risk is minimal, the condition can still cause significant symptoms, such as abnormal bleeding and discomfort, and may worsen if left unmanaged. Early treatment, typically with high-dose progesterone therapy, can often reverse the condition and restore normal endometrial health.
Hyperplasia with atypia: Higher risk of cancer progression
Hyperplasia with atypia carries a higher risk of developing into endometrial cancer. Without treatment, up to 29% of cases may progress to cancer within 1 to 3 years [2]. This makes timely and proactive management essential. For patients who no longer wish to preserve fertility, surgical options such as a robotic hysterectomy are often recommended to eliminate the risk entirely. For those who wish to retain fertility, high-dose progesterone therapy with close monitoring may be an option.
Factors that increase the risk of progression
Delayed treatment: The longer hyperplasia is left untreated, the greater the likelihood of progression.
Hormonal imbalance: Prolonged exposure to unopposed oestrogen, often seen in conditions like PCOS, can exacerbate the thickening of the uterine lining.
Age: The risk of progression increases with age, particularly in postmenopausal individuals.
The importance of timely intervention
Timely intervention is the key to reduce the risks associated with both types of hyperplasia. Treatments such as hormonal therapy or surgery can effectively manage the condition, prevent cancer progression, and alleviate symptoms. Regular monitoring through ultrasounds and biopsies is also vital to ensure treatment success and to detect any early changes.
At Rylon Clinic, we prioritise early diagnosis and personalised care to help patients manage endometrial hyperplasia effectively. Whether you're dealing with atypia or non-atypical hyperplasia, our expert team will guide you through the best treatment options, ensuring peace of mind and optimal outcomes.
Preserving fertility in younger patients
For younger individuals diagnosed with endometrial hyperplasia, the condition can raise concerns about fertility and future family planning. Fortunately, with prompt intervention and the right treatment approach, preserving fertility is often possible. At Rylon Clinic, we prioritise fertility preservation for younger patients, offering personalised care and counselling to ensure that health goals align with family-building aspirations.
The role of counselling in fertility preservation
Fertility preservation begins with a thorough discussion about the patient’s goals and treatment options. Counselling helps younger patients understand the condition, the risks, and the steps required to safeguard their reproductive health. This personalised approach ensures that treatment decisions are well-informed and aligned with future family planning.
At Rylon Clinic, our team provides compassionate support, helping patients navigate the emotional and practical aspects of treatment while addressing any concerns about fertility.
Fertility after progesterone therapy
For younger patients, high-dose progesterone therapy is often the preferred treatment for managing hyperplasia while preserving fertility. Progesterone helps to thin the uterine lining and reverse abnormalities without compromising the uterus's ability to support a future pregnancy. Once successful regression of the hyperplasia has been achieved, many patients can safely conceive under the guidance of a fertility specialist.
Monitoring and follow-up
Ongoing monitoring is essential to ensure the hyperplasia has resolved before attempting conception. Regular ultrasounds and endometrial biopsies help confirm that the uterine lining has returned to a healthy state, minimising risks during pregnancy.
Empowering younger patients to plan for the future
At Rylon Clinic, we understand the importance of preserving fertility for younger patients, especially when managing conditions like endometrial hyperplasia. Our expertise extends to fertility treatments, offering patients comprehensive care that aligns with their future family goals. With expert counselling, effective treatment plans, and personalised follow-up care, we help patients achieve the best possible outcomes. If you have concerns about hyperplasia or need support with fertility, our dedicated team is here to guide you through every step of the process.
Tailored treatment options for endometrial hyperplasia
At Rylon Clinic, we recognise that every patient’s needs are unique, and we take a personalised approach to treating endometrial hyperplasia. Factors such as age, fertility goals, and overall health guide our recommendations, ensuring that each patient receives the most appropriate care for their circumstances. From medical management to advanced surgical options, we offer comprehensive solutions designed to restore health and wellbeing.
Medical management
As discussed previously, for many patients, high-dose progesterone therapy is a highly effective treatment for reversing endometrial hyperplasia. This approach works by thinning the uterine lining and restoring hormonal balance. Options include oral progesterone, which is easy to administer, and the use of uterine coils, such as the Mirena IUD, which delivers progesterone directly to the endometrial lining for more targeted results. These treatments are particularly suitable for patients who wish to avoid surgery or those who require a conservative approach to manage hyperplasia due to medical co-morbidities.
Fertility preservation
For younger patients who wish to preserve fertility, progesterone therapy offers an excellent solution. With appropriate counselling and a well-monitored treatment plan, abnormalities in the uterine lining can often regress successfully, enabling future pregnancies. As discussed earlier, once the endometrial hyperplasia has resolved, patients can safely plan for conception under the guidance of a specialist. This approach combines effective treatment with the reassurance that family-building goals can still be achieved.
Management for complex cases
Some patients, particularly those with co-morbidities or conditions that make them unsuitable candidates for surgery, may still benefit from medical management. High-dose progesterone therapy, including combinations of a uterine coil and oral progesterone, can often treat hyperplasia in these cases.
At Rylon Clinic, our commitment to personalised care ensures that each patient receives a tailored treatment plan that aligns with their health needs and personal goals. Whether you’re seeking fertility-preserving options, advanced surgical solutions, or medical management for complex cases, our team is here to guide you every step of the way.
Hysterectomy as an option for non-fertility planning patients
Surgical intervention
For patients in their late 40s, 50s, or those who have completed their family planning, hysterectomy is often the most definitive treatment for endometrial hyperplasia. This option is particularly effective for managing cases with atypia or when medical therapies have not delivered the desired outcomes. Removing the uterus eliminates the risk of hyperplasia progressing to endometrial cancer, offering peace of mind and long-term health benefits.
At Rylon Clinic, we specialise in robotic hysterectomy, a state-of-the-art, minimally invasive procedure that provides a safer, more precise alternative to traditional surgery. Robotic hysterectomy uses advanced technology to ensure reduced blood loss, smaller incisions, and quicker recovery times [3]. This makes it an ideal option for patients seeking a less invasive approach with excellent outcomes.
For patients who are medically unsuitable for surgery or wish to explore non-surgical options, our team also offers tailored medical management plans. However, for those no longer prioritising fertility, robotic hysterectomy remains the gold standard for addressing advanced or recurrent cases of endometrial hyperplasia.
If you are considering hysterectomy as part of your treatment plan, our team at Rylon Clinic can provide comprehensive guidance to help you make an informed decision. To learn more about this advanced surgical option, contact us to book a consultation.
Why choose Rylon Clinic for endometrial hyperplasia treatment?
Rylon Clinic provides expert, personalised care for individuals managing endometrial hyperplasia. We understand that every patient’s situation is unique, which is why we tailor treatment plans to meet your specific needs, whether you are seeking fertility-preserving options, exploring surgical solutions, or addressing more complex medical conditions.
Our approach is rooted in a commitment to compassionate, patient-centred care. From your initial consultation through to diagnosis and treatment, our experienced team offers clear guidance and expert support, ensuring you feel confident and informed every step of the way. We take into account your individual health concerns, personal circumstances, and long-term goals to create a plan that’s right for you.
With a specialist focus on conditions like endometrial hyperplasia and related fertility concerns, Rylon Clinic provides advanced diagnostic tools and cutting-edge treatments, including robotic hysterectomy and high-dose progesterone therapy. Our aim is to deliver the highest standard of care in a supportive and professional environment, helping you achieve the best possible outcomes for your health.
Expertise in personalised care
We pride ourselves on offering a compassionate and patient-centred approach. From your initial consultation through diagnosis and treatment, our specialists are committed to supporting you with clear guidance, expert advice, and ongoing care. We consider every aspect of your health, age, and personal goals to create a treatment plan that’s as unique as you are.
At Rylon Clinic, we offer flexible appointment options to accommodate your needs, including both in-person consultations at our London locations and virtual appointments for added convenience. Our services are accessible to both self-paying patients and those with private medical insurance. We are recognised by most private medical insurance companies, and our fees are generally within their set limits to minimise any excess payments.
For self-funded patients, we strive to keep costs to a minimum. To book an appointment, simply choose a suitable time using our online booking system, where you have the choice of either a video or a face-to-face consultation.
If you have any questions about payment options or need assistance with booking, please contact our medical secretary, who will be happy to help.
Advanced treatment options
At Rylon Clinic, we offer a comprehensive range of treatments for endometrial hyperplasia, combining the latest medical advancements with proven therapies. These include:
High-dose progesterone therapy: An effective and minimally invasive solution for managing hyperplasia, particularly for younger patients and those seeking fertility preservation.
Robotic hysterectomy: A cutting-edge, minimally invasive surgical option for patients who no longer wish to preserve fertility or require definitive treatment. This procedure ensures precision, minimal recovery time, and excellent outcomes.
Holistic fertility counselling: For patients wishing to maintain fertility, we provide detailed counselling and personalised care plans to maximise the chances of future pregnancies following successful treatment.
Take the first step toward personalised care
Early diagnosis and timely treatment are essential for effectively managing endometrial hyperplasia and reducing the risk of complications. Whether you’re experiencing symptoms like abnormal bleeding or have already been diagnosed, seeking expert care can make all the difference in achieving the best possible outcomes. Contact us to schedule your appointment and start your journey toward personalised, expert care.
References
Singh and Puckett (2023) Endometrial Hyperplasia. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/n/statpearls/article-21104/
Kurman et al. (1985) The behavior of endometrial hyperplasia. A long-term study of "untreated" hyperplasia in 170 patients. Cancer. https://pubmed.ncbi.nlm.nih.gov/4005805/
Baracy et al. (2022) Minimally invasive hysterectomy for benign indications-surgical volume matters: a retrospective cohort study comparing complications of robotic-assisted and conventional laparoscopic hysterectomies. Journal of robotic surgery. https://pubmed.ncbi.nlm.nih.gov/34981444/
Author: Mr Osama Naji
Mr Naji offers a “one-stop” gynaecology clinic for instant detection of various gynaecological cancers as well as providing all the diagnostic and treatment services needed under one roof.
Mr Naji provides advanced gynaecology scanning which is essential when conducting any gynaecology consultation, he is bilingual in English and Arabic and has an NHS base at the highly reputable Guy's and St Thomas' Hospital in London.
He is passionate about raising awareness of various subtle signs and symptoms of gynaecological conditions that are often overlooked by patients.
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