Endometrial hyperplasia has a certain tendency to become cancerous and is therefore classified as a precancerous lesion. However, according to long-term observation, the vast majority of endometrial hyperplasia is a reversible lesion, or remains in a persistent benign state. Only a few cases may develop into cancer after a longer time interval. There are 3 types of hyperplasia according to the morphological changes of the glandular structure and the presence or absence of glandular epithelial cell heterotypy: ① Simple hyperplasia: a physiological response of the endometrium due to long-term stimulation by estrogen without progesterone antagonism. There is no heterogeneity in the morphology of the glandular epithelium. ②Compound hyperplasia: the lesion area is crowded with glands, and the mesenchyme is significantly reduced without the heterogeneity of the glandular epithelium. ③Atypical hyperplasia: the glandular epithelium has heterogeneity and is an intraepithelial tumor of the endometrium, which is classified as mild, moderate or severe according to the degree of the lesion. Different types of endometrial hyperplasia have different principles of management: simple hyperplasia and complex hyperplasia of the endometrium: 1. Young patients: mostly anovulatory gonorrhea, basal body temperature should be measured, and ovulation promotion therapy can be used for those who are indeed monophasic and anovulatory. 2. Reproductive phase: Generally, bleeding can be controlled by scraping the uterus once, if there is still bleeding after scraping, hysteroscopy and B
Ultrasound should be performed to exclude submucosal myoma or other organic lesions. If the bleeding is still present after curettage, hysteroscopy and B ultrasound should be performed to exclude submucosal fibroids or other organic lesions. If menstruation is sporadic and the amount of blood or bleeding is prolonged after curettage, periodic progesterone therapy should be given every two months for a total of 3 cycles and then followed up for observation. 4. Late menopause: ask whether estrogen replacement therapy alone is used. Replacement therapy may be suspended or progestin may be added after curettage.