Which symptom prompts evaluation for endometrial hyperplasia or cancer?

• A. Abnormal uterine bleeding
• B. Frequent headaches
• C. Pelvic floor prolapse
• D. Dysuria

Answer: (A)

Abnormal uterine bleeding is the symptom that prompts evaluation for endometrial hyperplasia or cancer. When the endometrium grows excessively or becomes malignant, bleeding patterns often change—such as heavier or longer periods, irregular timing, or any vaginal bleeding in someone who is postmenopausal. Because endometrial pathology can present primarily with bleeding, this symptom is the red flag that triggers further workup (such as endometrial sampling or imaging). Other symptoms like headaches, pelvic floor prolapse, or dysuria don’t point to endometrial disease and are instead unrelated issues, so they aren’t the trigger for evaluating endometrial hyperplasia or cancer.