Which of the following factors causes endometrial hyperplasia?
Estrogen
Danazole
Perimenopausal age
None of the above
Most cases of endometrial hyperplasia result from high levels of estrogens, combined with insufficient levels of the progesterone-like hormones. This may occur in conditions including obesity, polycystic ovary syndrome, estrogen producing tumours (e.g. granulosa cell tumour) and ceain formulations of estrogen replacement therapy. Endometrial hyperplasia is a significant risk factor for the development or even co-existence of endometrial cancer. Hyper estrogenic state is associated with marked endothelial hyperplasia which regress with progestins.