Endometrial hyperplasia

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Endometrial hyperplasia

Reproductive system


Endometrial hyperplasia


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USMLE® Step 1 questions

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Endometrial hyperplasia

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USMLE® Step 1 style questions USMLE

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A 55-year-old woman, gravida 1 para 1, presents to the office with complaints of abnormal vaginal bleeding for the past two days. The patient states that she soaked 4 sanitary pads yesterday. Menarche was at age 14, and her menstrual periods had been irregular for the last few years before menopause, which she underwent at the age of 51. Past medical history is significant for generalized anxiety disorder managed by paroxetine for the last 15 years. Family history is significant for diabetes mellitus in her father and hypertension in her paternal grandmother. Vitals are within normal limits. BMI is 33.5 kg/m2. Pelvic examination shows blood clots in the vagina. The remainder of the examination is unremarkable. Endometrial biopsy is shown below:    

Reproduced from: Wikimedia Commons  

Which of the following risk factors in this patient’s history is the most significant in the development of this patient’s condition?  

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First Aid









endometrial hyperplasia p. 665

Endometrial hyperplasia p. 665

follicular cysts p. 670

progesterone and p. 654

Hormone replacement therapy p. 680

endometrial hyperplasia p. 665

Polycystic ovarian syndrome (PCOS)

endometrial hyperplasia p. 665

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With endometrial hyperplasia, endometrial refers to the endometrium, which is the inner lining of the uterus, and hyperplasia means increased growth, so endometrial hyperplasia means excessive growth of the inner lining of the uterus.

The uterus consists of 3 layers, an outer thin layer called the perimetrium or the serosa, a middle smooth muscle layer called the myometrium, and the innermost layer, the endometrium.

The endometrium has two layers, an inner functional layer made up mainly of glands and supporting connective tissue, called stroma, and an outer thin basal layer which regenerates the overlying functional layer after each menstrual cycle.

Now, the growth of the functional layer is regulated by the hormones secreted by the ovaries. Each ovary is made up of a number of ovarian follicles.

Each follicle consists of an oocyte, which is the female germ cell, surrounded by an outer layer made up of theca cells, which secrete androgens, also known as the male hormones, and an inner layer made up of granulosa cells, which secrete estrogen.

Now estrogen stimulates the growth of endometrial glands and stroma.

This effect of estrogen predominates during the first phase of the menstrual cycle.

This is also called the proliferative phase because it’s when the lining of the endometrium grows.

At the end of this phase, ovulation occurs, where one ovarian follicle expels the oocyte into the fallopian tube and it travels to the uterus.


  1. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  2. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  3. "Yen & Jaffe's Reproductive Endocrinology" Saunders W.B. (2018)
  4. "Bates' Guide to Physical Examination and History Taking" LWW (2016)
  5. "Robbins Basic Pathology" Elsevier (2017)
  6. "Endometriosis and infertility" Journal of Assisted Reproduction and Genetics (2010)
  7. "Endometriosis Can Cause Pain at a Distance" Journal of Obstetrics and Gynaecology Canada (2021)
  8. "Endometriosis" The Lancet (2004)

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