Complex endometrial hyperplasia is a condition in which unusual or excessive growth of cells in the uterine lining (endometrium). Endometrial hyperplasia can be treated easily in most of the cases, but where as in complex or abnormal cases, the abnormal cells may also develop into endometrial cancer.

There are 2 kinds of complex hyperplasia, both were carrying a higher risk of cancer:

Complex endometrial hyperplasia without atypia : Cells are thicker when compared with simple hyperplasia, but are normal in the appearance. Patients are having a 10% higher risk of developing the cancer.

Complex endometrial hyperplasia with atypia : Cells will be thicker than simple hyperplasia and have bizarre appearances. There was a significantly increasing risk of the endometrial cancer about 40%.


Hormones & the absence of the hormones are the causes of the complex endometrial hyperplasia. In normal menstrual cycles, the ovaries will produce the hormone estrogen in the beginning of the cycle, causing the lining to grow & thicken. Then, once the egg is been released, the hormone called progesterone increases to prepare the endometrium layer for the implantation of egg. Then progesterone levels will be decreased when the egg is not been fertilized, causing the shedding of the lining (menstruation). These are some other ways in which hormones can also cause complex endometrial hyperplasia:

  • Medicines which act like estrogen
  • Using higher doses of estrogen after the menopause (without hysterectomy)
  • Polycystic ovary syndrome
  • Infertility
  • Irregular menstrual periods
  • Obesity


One of the most common symptoms & signs of the complex endometrial hyperplasia is abnormal uterine bleeding. If there are noticed abnormal menstrual cycles, speak with your doctor, particularly if you are at the risk for complex endometrial hyperplasia.

These are some of the signs of the abnormal menstrual cycles:

  • Heavier or longer-lasting bleeding during the menstrual periods
  • Menstrual cycles which are less than 21 days from the 1st day of the menstrual period to the 1st day of the next menstrual period
  • Bleeding after menopause.


Based on the type of the hyperplasia & the severity of the condition, the suggested treatments for the complex endometrial hyperplasia will differ. Simple endometrial hyperplasia can be treated with a progesterone supplement. But where as in complex cases of the endometrial hyperplasia, treatments include progesterone treatment or surgical treatments.