Management of endometrial hyperplasia

Area of Science:

• Gynecology
• Reproductive Endocrinology

Background:

• Endometrial hyperplasia is a frequent gynecological condition.
• Abnormal uterine bleeding is the primary symptom in most cases.
• Unopposed estrogen (endogenous or exogenous) is the key etiological factor.

Purpose of the Study:

• To review current management strategies for endometrial hyperplasia.
• To highlight the importance of etiological evaluation and cause-specific treatment.
• To discuss the risks of concomitant genital cancer and progression to endometrial carcinoma.

Main Methods:

• Literature review of current management approaches for endometrial hyperplasia.
• Analysis of treatment modalities based on patient factors and hyperplasia type.
• Evaluation of diagnostic challenges in differentiating precancerous lesions.

Main Results:

• Progestagens are the primary medical treatment, with higher response rates in hyperplasia without atypia.
• Hysterectomy is a definitive treatment option in selected cases.
• A practical system for differentiating precancerous lesions remains a challenge.

Conclusions:

• Etiologic evaluation and cause-specific treatment are essential for managing endometrial hyperplasia.
• Treatment decisions are individualized based on age, fertility desires, and hyperplasia type.
• Early detection and appropriate management are critical due to cancer risk and progression potential.