Endometrial hyperplasia has a tendency to become cancerous and may reverse to normal with medication, or may develop into cancer. The vast majority of endometrial hyperplasia is a reversible lesion or remains in a persistent benign state. Only a few cases may progress to cancer after a longer time interval. There are 3 types of endometrial hyperplasia: simple hyperplasia, complex hyperplasia and atypical hyperplasia. Diagnosis The appearance of the endometrium is seen using hysteroscopy, and scraping or negative pressure aspiration can be performed under direct vision. The degree of hyperplasia is ultimately determined by the pathological pattern of the endometrium. Treatment 1. Drugs (1) Ovulation-promoting drugs (2) Progesterone drugs. The method and dose of medication vary according to the degree of endometrial hyperplasia.[3] GnRH agonists
can increase blood gonadotropin levels and deplete gonadotropin stocks in the pituitary gland, thereby suppressing the pituitary gland and reducing estradiol levels to postmenopausal levels. All of the above drugs are administered in a course of three months. At the end of each course, the uterus is scraped or the endometrium is removed for histological examination, and depending on the response to the medication, the treatment may be stopped or the dose of the medication may be increased or decreased. The duration of treatment is inconsistent. 3, 6, 9 and 12 months vary, with an average of 9 months. The difference is related to the severity of the underlying etiology of the onset. The dose and duration of medication can be guided by the results of periodic endothelial biopsies. Monitoring of endometrial atypical hyperplasia During drug therapy, attention must be paid to monitoring endometrial atypical hyperplasia during the course of treatment. After progestin therapy for young patients with fertility requirements, when the endometrium has improved and progestin is discontinued, ovulation promotion or other medical techniques to help pregnancy should be considered in time to prevent the recurrence of endothelial hyperplasia or highly differentiated cancer. 2.Local use of the Manned Ring: a device for local release of progestin in the hope of long-term protection of the endometrium to avoid recurrence. 3.Surgery: For perimenopausal women without fertility requirements, endometrial debulking or hysterectomy can be chosen.