3. • Biopsy is unnecessary when endometrial
thickness is less than 5mm.
• Biopsy is indicated when clinical history
suggests long term unopposed estrogen
exposure.,even when endometrial thickness is
normal (5-12mm).
• And biopsy should be done when ET>12mm
even when clinical suspicion is low.
4. • When an office biopsy reveals endometrial
hyperplasia,further investigation is required to
exclude atypia or co-existing cancer.
• And if subsequent curretage reveals atypical
endometrial hyperplasia, there is significant
risk of adenocarcinoma.
5. • Simple and complex endometrial hyperplasia
without atypia has low risk of progression to
endometrial cancer.
• And can be corrected using progestin treatment.
• Cyclic progestin therapy –meprate 5-10mg/day or
norethindrone acetate 5mg/day for 14days for 3-
6months.
• Another option- levonorgestrel releasing
intrauterine system.
6. • Endometrial hyperplasia with atypia is best
treated by hysterectomy.
• Women intent of preserving their
reproduction potential can be treated with
progestins but more potent and longer
duration of treatment –megestrol acetate
80mg twice daily for 3-6months.
• LNG-IUS is another option.
