Excessive uterine bleeding with abundant endometrial tissue is most likely due to which condition?

• A. Endometritis
• B. Endometrial metaplasia
• C. Endometrial hyperplasia
• D. Endometriosis

Answer: (C)

Excessive uterine bleeding accompanied by an overly thick endometrium points to endometrial hyperplasia, a condition caused by prolonged estrogen stimulation without enough counteracting progesterone. When estrogen drives continuous endometrial proliferation—often seen with anovulatory cycles, obesity, or aging—the lining becomes abnormally thick and more prone to heavy, irregular bleeding. This contrasts with endometritis, an infection of the endometrium that presents with fever and foul discharge rather than just tissue overgrowth; endometrial metaplasia is a benign change in the type of endometrial cells and doesn’t typically cause heavy bleeding from thickened tissue; and endometriosis involves ectopic endometrial tissue outside the uterus, causing pelvic pain and infertility rather than a uniformly thickened endometrium inside the uterine cavity.