Endometrial hyperplasia may be separated into four kinds in accordance with histological manifestations: easy hyperplasia, complicated hyperplasia, easy atypical hyperplasia, and complex atypical hyperplasia.

Without treatment endometrial hyperplasia may become endometrial malignancy, easy hyperplasia usually fails to become endometrial malignancy (the danger is 1Percent), but complex atypical hyperplasia possesses an endometrial cancer probability of about 25%.

The occurrence of endometrial malignancy ranked next among female genital tumors, about 25.7/100000. Most endometrial carcinomas are endometrioid adenocarcinomas with precancerous lesions.

There are several identified risk factors for endometrial hyperplasia and endometrial cancer: excessive estrogen (whether improved synthesis in overweight females or ingestion of non-antagonistic estrogen can lead to alterations in gland proliferation), diabetic issues, unproductive women and polycystic ovary disorder.

When the primary symptom of the individual is abnormal vaginal hemorrhage, endometrial lesions should be suspected. Ultrasonography will help leave out other lesions (polyps, uterine leiomyomas) and assess the thickness and status of the endometrium.

Endometrial tissues examples can more aid in prognosis, clinicians can obtain tissues examples by diagnostic curettage, Pipelle biopsy or hysteroscopy. Nevertheless, the above strategies may skip prognosis and produce false-negative final results. Once diagnosed as endometrial hyperplasia, surgical treatment or medication is needed. If medicine treatment solutions are considered, which medication treatment solutions are far better?

Professor Hashim, Section of Obstetrics and Gynecology, College of Mansoura, Egypt, summarized the research on the efficiency of levonorgestrel intrauterine product (LNG-IUS) and mouth progesterone in the treatment of endometrial hyperplasia without atypical hyperplasia and posted the results in Am J Obestet Gynecol.

The organized review contains the outcomes of seven randomized handled trials. The research incorporated only sufferers without atypical hyperplasia who were treated with LNG-IUS or oral progesterone and implemented up for 3-24 months. Final results assessment provided 766 patients (329 patients given LNG-IUS and 437 sufferers treated with oral progesterone contain medroxyprogesterone acetate, norethisterone acetate, and dydrogesterone acetate).

The study learned that patients addressed with LNG-IUS have been significantly a lot better than those treated with mouth progesterone. The longer the follow-up time is, the better clear the advantage of LNG-IUS is going to be. At 24 several weeks, OR was 7.46. LNG-IUS is better than mouth progesterone in the treating of easy or complex hyperplasia.

However, there was no substantial variation inside the regularity of irregular vaginal bleeding between the two teams. The LNG-IUS team was significantly less prone to require hysterectomy compared to mouth progesterone group.

The precise therapy for endometrial hyperplasia is actually a hysterectomy, but surgical treatment will not be appropriate for all individuals. Some patients still want to retain their reproductive capability, while others are physically struggling to stand up to the surgical treatment. In these cases, patients could be given long-term high-dose progesterone therapy.

Progesterone possesses an anti-proliferative result and may also decrease additional gland mutation. Individuals can also consider Fuyan Pill which can be natural and safe without side effects. It offers the features of activating blood circulation and getting rid of blood stasis, clearing away heat and dampness. It can effectively take care of endometrial hyperplasia, fix your endometrium, equilibrium Qi and bloodstream.

LNG-IUS has several advantages over mouth arrangements. First of all, conformity is superior to oral preparation. Second of all, because LNG-IUS is administered locally rather than systemically, in contrast to oral preparations, the neighborhood concentration of progesterone significantly increased to achieve the effect of the intrauterine remedy, the treatment effect is way better.

To conclude, LNG-IUS is better than mouth progesterone in the management of simple or intricate endometrial hyperplasia. Nonetheless, randomized trials only incorporated individuals without atypical hyperplasia. The stick to-up time of most scientific studies is lower than 1 year, the long-term adhere to-up effect still requirements further research. Since there is no info to exhibit that LNG-IUS is effective in individuals with atypical hyperplasia, such cases still need to be given caution.