You’ve skipped a period—maybe even a few—and you’re not pregnant.
Is it stress? Travel? Hormones being “weird”? Or… is it something more?
While the occasional missed cycle is normal, frequent or long-term absence of periods can affect the health of your uterus—and that’s something worth paying attention to.
In this article, we’ll explain:
- What your period really does for your body
- What happens when it’s absent for too long
- What endometrial hyperplasia is—and why it matters
- How to stay on top of your cycle and uterine health
Let’s break the silence around periods and talk about what’s happening inside our bodies when they don’t show up.
What Is the Endometrium?
The endometrium is the inner lining of your uterus.
Each month, in response to hormone shifts, it thickens to prepare for pregnancy. If you don’t conceive, it sheds during your period.
This monthly shedding:
- Keeps the lining fresh and regulated
- Prevents cells from growing too thick or unstable
- Is a vital part of reproductive and hormonal health—even if you’re not trying to conceive
When you don’t get your period regularly, the endometrium continues to build—without shedding. That’s when problems can start.
What Is Endometrial Hyperplasia?
Endometrial hyperplasia is when the uterine lining becomes abnormally thick, often due to excess estrogen and insufficient progesterone.
This condition isn’t cancer—but it can increase the risk of endometrial cancer over time, especially if left untreated.
There are two main types:
- Simple hyperplasia (without atypia): Low cancer risk, often reversible
- Complex hyperplasia (with atypia): Higher risk of progressing to cancer
➡️ NIH – Endometrial Hyperplasia Overview
What Causes Endometrial Hyperplasia?
It’s often caused by unopposed estrogen—meaning your body makes estrogen but doesn’t produce enough progesterone to balance it.
This can happen in several scenarios:
1. Missed or Infrequent Periods
- Seen in PCOS, perimenopause, and postmenopause
- Estrogen builds up the lining, but without ovulation, there’s no progesterone to thin it
2. Obesity
- Fat cells can produce extra estrogen
- Increases risk of endometrial thickening over time
3. Estrogen-Only Hormone Therapy
- Common in women post-hysterectomy or after menopause
- Must be balanced with progesterone if the uterus is intact
4. Certain Ovarian Disorders
- Including PCOS and estrogen-producing tumors
➡️ Read: What Is PCOS and How It Affects Periods
Symptoms to Watch For
Some people with endometrial hyperplasia have no symptoms at all. Others may notice:
- Missed periods or irregular cycles
- Very heavy or prolonged periods
- Spotting between periods
- Pelvic pain or cramping
- Unusual vaginal discharge
If your period has been absent for months—or your bleeding pattern has changed—it’s worth speaking to a doctor.
Expert Insight
Many people think missed periods are harmless. But when your body isn’t shedding the uterine lining regularly, it can lead to overgrowth and, in some cases, precancerous changes. Early detection and hormone balance are key.
How Is It Diagnosed?
Doctors may use the following tools to assess your endometrial health:
- Transvaginal ultrasound – Measures the thickness of the uterine lining
- Endometrial biopsy – A sample of tissue to check for abnormal cells
- Hysteroscopy – Camera-based inspection of the uterus (in some cases)
Testing is especially important if you:
- Are over 35 and have irregular bleeding
- Are postmenopausal and experience bleeding
- Have a family history of uterine or ovarian cancer.
Treatment Options
Treatment aims to prevent abnormal cell growth and restore a healthy cycle.
Depending on the type and severity, your doctor may recommend:
Hormonal Therapy
- Progestin pills or IUDs to thin the lining
- Birth control pills (for cycle regulation in younger women)
- HRT with progesterone (if postmenopausal)
Surgical Options
- Dilation and curettage (D&C) to remove excess tissue
- Endometrial ablation (for recurrent thickening in non-fertility-seeking individuals)
Lifestyle & Follow-up
- Weight management
- Blood sugar regulation (especially in PCOS)
- Ongoing ultrasounds or biopsies to monitor changes
➡️ Book a Care Navigator session for hormone support
Real-Life Story
“I hadn’t had my period in six months, and I figured it was just stress or age. But my doctor found my endometrial lining was unusually thick. I started progesterone therapy and everything regulated within a few months. I’m glad I didn’t wait longer.”
— Nadia, 39
Myth vs Reality
| Myth | Reality |
| “Skipping periods is no big deal.” | Chronic missed periods can increase your risk of uterine issues. |
| “You only need a period if you want to get pregnant.” | Regular bleeding is vital to clear your uterine lining and protect endometrial health. |
| “Birth control is just for contraception.” | Hormonal methods can protect the uterus by regulating cycles. |
| “Endometrial hyperplasia is rare.” | It’s more common than most people realize, especially in PCOS and menopause. |
Final Thoughts
Your period is more than an inconvenience—it’s a vital sign.
When your cycle goes missing, your body is sending a signal.
Endometrial hyperplasia is preventable and treatable—especially when caught early. Understanding your hormonal patterns and prioritizing regular bleeding (even via medication) can protect your long-term reproductive health.
Call to Action
Concerned about irregular or missing periods?
Take our free 5-minute hormone health quiz to better understand your risk factors—and what to do next.
👉 https://zorahealth.co/quiz/reproductive-health
Sources
- NIH – Endometrial Hyperplasia
- Mayo Clinic – Missed Periods
- Endocrine Society – Hormone Imbalance and Uterine Health
- American College of Obstetricians and Gynecologists – AUB
Anna Haotanto is the Founder of Zora Health and a passionate advocate for women’s empowerment. Anna’s personal experiences with egg-freezing, PCOS, perimenopause and the challenges of fertility have fueled her mission to provide high-quality information, financing, and support to help women and couples navigate their fertility journeys with confidence. She is also recognised for her achievements in finance, entrepreneurship, and women’s empowerment, and has been featured in various media outlets. You can also follow her on Linkedin or Instagram.
