Includes malignancy and uterine hyperplasia

Endometrial Hyperplasia

adipose tissue lead to an increase of estrogen
- peripheral aromatase converts androgens into estrogen
HRT, specifically unopposed estrogen
- patient can forget to take progesterone
- non-medical Rx: sometimes supplements contain lots of unopposed estrogen
Estrogen-producing tumor: Ovarian cancer or Adrenal carcinoma
- ex. Granulosa cell tumor

Risk factors

Risk Factor	Relative Risk
Unopposed estrogen: ‣, long repro life,	2-10
Late menopause	2.4
‣	2
Chronic anovulation	3
‣	1.5
‣*MOST COMMON	10
‣	2.8
HNPCC *most common inherited cause	22-50% lifetime risk
‣	6-8

Older Adult > 65 (RF) : bigger than 40/45 yr old
- Less common for pre-menopausal women
- Lining sheds every month → preventing overgrowth
  - Anyone who’s not menstruating regularly can be a RF (ex. PCOS)
Persistent/Failed medical management of AUB - Abnormal Uterine Bleeding
Radiation therapy in pelvic
Cancer syndromes
- Concern for HNPCC (MMR), ~~BRCA1/2 (HRD),~~ Cowden syndrome (P10)
~~Myth on diet:~~
- ~~Diet with high animal fat → controversial~~
- ~~No increased risk with a soy based diet either~~

	Type I - Estrogen dependent → More common (80%)	Type II - Estrogen independent
Tumor Grade	Low	High
Histological Subtype	Usually what people refer to as ‘endometrial adenocarcinoma’	Clear cell, mucinous, serous
Age RF	younger, 50-60	60+
Menopause RF	Can present in pre-menopausal women	more likely in post-menopause
Other RF	unopposed estrogen: ‣, ‣, ‣ w/t Progesterone
Prognosis	Treatable, better prognosis and better differentiated	Poor prognosis

Other rare