A condition of the endometrium (lining of the uterus) becomes unusually thick because of hyperplasia (too many cells).
It causes heavy or abnormal bleeding, that can lead to anemia (complication).
It is not cancer, but atypical endometrial hyperplasia raises the risk of endometrial cancer and uterine cancer.

(Mechanism)
• estrogen: Thickens the endometrium during ovulation.
• progesterone: Prepares the uterus for pregnancy. If conception doesn't occur, its levels drop, that triggers the uterus to shed its lining as a menstrual period.

(Causes)
• It tends to occur during or after menopause. It rarely occurs in women younger than 35.
• Female hormone imbalance: Too much estrogen and not enough progesterone. As a result, the uterus does not shed the endometrial lining, but continues to grow and thicken. Tamoxifen (breast cancer treatments), early age for menstruation or late onset of menopause, long history of irregular or absent menstruation, never being pregnant, family history of ovarian, uterine or colon cancer, polycystic ovary syndrome can be the cause.
• The adipose tissue can convert the fat producing hormones (e.g. leptin) to estrogen. This is the how obesity contributes to elevated circulating levels of estrogen and increases the risk of endometrial hyperplasia. Also, diabetes, gallbladder disease, or thyroid disease can be the cause.
• Smoking.
• White race.

(Prevention)
• Progesterone along with estrogen after menopause (hormone replacement therapy).
• Take the birth control pill. It includes a combination of an estrogen (e.g. ethinylestradiol) and a progestogen (i.e. progestin).
• Quit smoking.
• Maintain a healthy weight.

(Diagnosis)
Ultrasound: Images of the uterus can show if the endometrium is thick.
Biopsy: Tissue samples from the endometrium to confirm or rule out cancer.
Hysteroscopy: Examines the cervix and looks inside the uterus. It can be done along with a dilation and curettage for biopsy.

(Treatment)
• Progestin therapy can ease symptoms.
• Women at risk for cancer (atypical endometrial hyperplasia) may choose more frequent hysteroscopic assessment or a hysterectomy to eliminate cancer risk.

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