One of the things that women fear most with a pelvic ultrasound is the finding that their uterine wall is thickened; cancer comes to mind.
And in fact, uterine (endometrial) cancer in most cases begins with a thickened uterine lining.
But this doesn’t mean that every case of uterine wall thickening is a harbinger for cancer.
So this then begs the question: If not all cases of uterine wall (endometrial) thickening are cancer, what are the other conditions?
“Hyperplasia is a benign thickening of the lining of the uterus, a result of estrogen stimulation without the mitigating effects of progesterone,” says Julian Schink, MD, Chief of Gynecologic Oncology, Cancer Treatment Centers of America; Medical Director of Gynecologic and Medical Oncology, Midwestern Regional Medical Center.
However, Dr. Schink adds, “Hyperplasia unresolved for years can result in endometrial cancer.
“Thickening of the uterine lining is often just benign hyperplasia, or it can be from benign uterine polyps.”
Endometrial Hyperplasia: a Thickened Uterine Wall
This is thickening of the uterine lining and it is not always a sign of cancer, even though, as Dr. Schink points out, it can eventually lead to malignancy.
High levels of the hormones estrogen and not enough progesterone are the prerequisite factors that pave the way to the development of hyperplasia — of which there are four grades — in increasing degree, as determined by an endometrial biopsy:
- Simple hyperplasia
- Complex hyperplasia
- Simple hyperplasia with atypia
- Complex hyperplasia with atypia
These factors are more prevalent after menopause, but they can occur during the phase of perimenopause.
Risk Factors for Endometrial Hyperplasia
These risk factors are not in any particular order.
• Being over the age of 35
• Early start of menstruation. The average age is 12.
• Late menopause. Menopause is considered late if it occurs after age 55.
• Zero pregnancies or first childbirth after age 30
• Smoking — and there is no safe amount of smoking. So even “light” smoking is a risk factor for a thickened uterine wall.
• Diabetes, thyroid disease or polycystic ovarian syndrome
• Obesity. Obesity is defined as being at least 20 percent over the ideal weight that a woman should be for her height.
• First-degree relative with ovarian, colon or uterine cancer. A first-degree relative is a mother, a sister or a daughter.
No matter how thick the uterine lining is, a diagnosis of cancer cannot be made based on the measurement from an ultrasound. Only a biopsy can confirm cancer.
