Microglandular Hyperplasia of the Cervix: Understanding Your Pathology Report

By Jason Wasserman MD PhD FRCPC
May 17, 2026

Microglandular hyperplasia is a noncancerous condition of the cervix in which the glandular cells grow in greater numbers than usual and form many small, closely packed glands. The word hyperplasia refers to an increase in the number of cells in a tissue. Microglandular hyperplasia is harmless. It does not become cancer, and having this condition does not increase the risk of developing cervical cancer in the future. It is usually discovered by chance when cervical tissue is examined under the microscope for another reason. This article will help you understand what this finding means on your pathology report and why it matters for your care.

What causes microglandular hyperplasia?

Microglandular hyperplasia is most commonly associated with hormonal changes, particularly elevated progesterone levels. It is most often seen in two situations:

Pregnancy — Hormonal changes during pregnancy can stimulate the growth of the glandular cells in the cervix and produce the typical pattern of microglandular hyperplasia.
Use of hormonal birth control — Oral contraceptives, particularly progestin-containing forms, and other hormonal contraceptives, such as the hormonal IUD, can also stimulate this kind of glandular growth.

Microglandular hyperplasia can also occur outside of pregnancy and hormonal contraceptive use, particularly in postmenopausal patients receiving hormone therapy, but this is less common. In all of these situations, the cellular growth is considered a normal response to hormones and is not a sign of precancer or cancer.

What are the symptoms?

Most people with microglandular hyperplasia have no symptoms, and the condition is found by chance during a routine pelvic examination, Pap test, or biopsy done for another reason. In rare cases when the area of hyperplasia is large, it may cause mild pelvic discomfort or irregular vaginal bleeding, but these symptoms are uncommon.

How is the diagnosis made?

Microglandular hyperplasia is diagnosed when a biopsy or other tissue sample from the cervix is examined under the microscope by a pathologist. Most of the time, the biopsy was taken for another reason, such as evaluating abnormal bleeding or following up an abnormal Pap test. The diagnosis can also be made on a cone biopsy or a hysterectomy specimen that was performed for another condition.

An important reason this diagnosis matters is that microglandular hyperplasia can sometimes look very similar to glandular precancerous and cancerous conditions of the cervix, including adenocarcinoma in situ (AIS) and HPV-associated adenocarcinoma, under the microscope. When the appearance is not entirely typical, the pathologist may perform additional tests to confirm the diagnosis. A protein stain called p16 is typically negative or only patchy in microglandular hyperplasia, in contrast to AIS and HPV-associated adenocarcinoma, which usually show strong, continuous staining. A marker of cell division called Ki-67 is also typically low in microglandular hyperplasia compared with these precancerous and cancerous mimics.

What does microglandular hyperplasia look like under the microscope?

When examined under the microscope, microglandular hyperplasia shows several characteristic features:

Numerous small, closely packed glands — The glands are densely arranged but remain well organized and follow the contour of the surface lining of the cervix.
Normal-appearing lining cells — The glands are lined by columnar epithelial cells, the same mucus-producing cells normally found in the cervix.
Mucus content — The glands are typically filled with mucus.
Mild surrounding inflammation — The tissue around the glands may show mild inflammation, which is a common normal finding.
No cancerous features — The cell nuclei are uniform, dividing cells are rare, and there are no features of precancer or cancer.

These microscopic findings confirm that the condition is completely benign.

What happens after this diagnosis?

Microglandular hyperplasia is a harmless finding and does not require treatment. Routine cervical cancer screening continues on the usual schedule. The discussion between you and your doctor about next steps depends on what was found:

Microglandular hyperplasia, no other findings — No specific treatment or follow-up is needed beyond your routine cervical cancer screening.
Microglandular hyperplasia with another reason for the biopsy — Your doctor will discuss follow-up based on the reason the biopsy was originally taken, not on the microglandular hyperplasia finding itself.
Symptomatic microglandular hyperplasia — In rare cases where the area is large enough to cause symptoms, the team may discuss further evaluation or, very rarely, removal of the involved tissue.

It is worth knowing that the underlying hormonal influence (such as pregnancy or hormonal contraceptive use) does not need to be changed because of this finding alone. Microglandular hyperplasia tends to resolve on its own when the hormonal stimulus changes.

Questions to ask your doctor

Was microglandular hyperplasia the only finding in my biopsy?
Could my pregnancy, birth control, or hormone therapy be related to this finding?
Was p16 or another special stain performed to confirm the diagnosis?
Were there any other changes in my cervix that I should be aware of?
Do I need any further tests or treatment for this finding?
Will the microglandular hyperplasia go away on its own?
Does this finding change my cervical cancer screening schedule in any way?
Are there any symptoms I should watch for between routine appointments?