Uterine Lining Overgrowth – What It Is and How to Deal With It

If your doctor mentioned "uterine lining overgrowth" (also called endometrial hyperplasia), you might wonder what that really means. In plain terms, the inner wall of the uterus – the endometrium – gets thicker than normal. This isn’t just a harmless change; it can cause spotting, heavy periods, and in some cases, increase the risk of uterine cancer. Knowing the warning signs and treatment paths can save you time, anxiety, and unnecessary doctor visits.

What Triggers Uterine Lining Overgrowth?

Hormones are the main driver. Too much estrogen without enough progesterone lets the lining grow unchecked. Common culprits include:

• Polycystic ovary syndrome (PCOS) – the ovary makes extra estrogen.
• Obesity – fat tissue produces estrogen, raising levels in the blood.
• Perimenopause – hormone swings get wild, often leaving estrogen on top.
• Use of estrogen‑only hormone replacement or some contraceptives.
• Diabetes or insulin resistance, which can tweak hormone balance.

Even conditions that affect thyroid function or certain medications (like tamoxifen) can tip the scales. The good news is many of these triggers are modifiable. Losing a few pounds, managing blood sugar, or adjusting birth control with your doctor can shrink the lining back to normal.

How Is It Managed?

First, your doctor will confirm the diagnosis with an ultrasound and a tissue sample (endometrial biopsy). The biopsy tells whether the cells are just thickened or show early precancer changes. Treatment then follows the severity:

• Progestin therapy: A pill, IUD, or injection that adds progesterone, counteracting estrogen and thinning the lining.
• Weight loss & lifestyle: A 5‑10% drop in weight often drops estrogen enough to improve the lining.
• Metformin: Often used for PCOS, it improves insulin sensitivity and can lower estrogen levels.
• Surgery: If the overgrowth is severe or shows atypical cells, a hysterectomy (removal of the uterus) may be recommended.
• Regular monitoring: Even after treatment, doctors usually schedule repeat ultrasounds every 6‑12 months to be sure the lining stays normal.

Most women respond well to progestin IUDs – they release a steady dose of hormone right where it’s needed and double as a birth control method. If you prefer pills, take them exactly as prescribed and report any breakthrough bleeding.

Don’t ignore abnormal spotting, especially if it’s after menopause. Early detection means simpler treatment and far less risk of cancer. Keep a simple calendar of your periods and any odd bleeding; bring it to every appointment.

In short, uterine lining overgrowth isn’t a one‑size‑fits‑all condition. It’s a signal that something in your hormone balance needs attention. By spotting the symptoms early, tweaking lifestyle factors, and following your doctor’s treatment plan, you can restore a healthy uterine lining and keep future risks low.