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Reverse of progestin-resistant atypical endometrial hyperplasia by metformin and oral contraceptives
Zong-Qi Shen1, Hui-Ting Zhu, Jin-Fang Lin
1Department of Reproduction and Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Background:
Atypical endometrial hyperplasia usually is treated with high-dose progestin or hysterectomy, but the latter deprives the patient of future child bearing.
Cases:
Two women with atypical endometrial hyperplasia complicating polycystic ovary syndrome (PCOS) had failed to respond to high-dose progestin therapy. They were both obese, insulin-resistant, and nulliparous with a desire to preserve fecundity. Metformin and oral contraceptives were administered as alternatives. Endometrial curettage performed 3 months later demonstrated a proliferative endometrium without evidence of residual pathology.
Conclusion:
Insulin resistance might play a role in the occurrence of atypical endometrial hyperplasia complicating PCOS. Metformin and oral contraceptives could be an alternative treatment in the presence of progestin resistance.
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