Prevention of recurrence of endometrial hyperplasia in premenopausal women

Authors

DOI:

https://doi.org/10.18370/2309-4117.2025.76.21-24

Keywords:

endometrial hyperplasia, recurrence, prevention, premenopause, dienogest

Abstract

Objective of the study: to evaluate the effectiveness of the proposed therapy aimed at preventing recurrence of endometrial hyperplasia (EH) in premenopausal patients.
Materials and methods. The study included 42 patients with EH aged 48–51 years. The diagnosis of EH was verified by clinical, instrumental and morphological methods of research. The efficacy of therapy was evaluated by performing a punch biopsy of the endometrium after 1 year of treatment and every 3 months in the dynamics of observation. In order to prevent recurrence of the disease in premenopausal age, all patients with EH received dienogest (Vigest-KV) 2 mg/day for 12 months in a continuous mode.
Results. All the women with verified EH had clinical signs of abnormal uterine bleeding. The average thickness of the endometrium in patients according to ultrasound study before treatment was 22.1 ± 2.4 mm. After the therapy, it was 5.1 ± 0.1 mm, after 3 months of follow-up – 6.4 ± 0.24 mm, 6 months after the therapy – 7.8 ± 0.35 mm. According to the results of the punch biopsy after treatment, 95.2% (40) of patients showed regression of the disease, in 4.8% (2) women there was persistence of EH. Physiological endometrium was morphologically verified in 100% of women with disease regression after 3 months of observation, disease relapse occurred in 4.2% (2) of patients after 6 months of observation.
Conclusions. The method of choice for the prevention of recurrence of EH in the premenopausal age is drugs with a peripheral mechanism of action for block ovulation, which allows maintaining estrogen levels within the therapeutic window and improves the quality of life of women without creating a state of estrogen deficiency in the body.
Long-term continuous dienogest therapy in premenopausal women with EH can reduce both the persistence of the disease and the rate of disease recurrence by up to 4.8%.

Author Biography

O.V. Kravchenko, Bukovina State Medical University, Chernivtsi

MD, professor, head of the Department of Obstetrics, Gynecology and Perinatology

References

  1. Qin H, Lin Z, Vásquez E, et al. Association between obesity and the risk of uterine fibroids: a systematic review and meta-analysis. J Epidemiol Community Health. 2021 Feb;75(2):197–204. DOI: 10.1136/jech-2019-213364
  2. Kondratiuk VK, Kondratiuk KO, Gasparyan KА, et al. Modern opportunities and prospects for preserving woman’s health. Reproductive Health of Woman. 2022;5:19–25. DOI: 10.30841/2708-8731.5.2022.265470
  3. Tatarchuk TF, Kosey NV, Regeda SI, et al. The role of reproductive health disorders in the development of metabolic syndrome in women. Journal of the National Academy of Medical Sciences of Ukraine. 25(1) 2019:77–87.
  4. Antypkin YG, Vdovychenko YP, Graziottin A, et al. Uterine bleeding and quality of life of a woman. Resolution of the expert council. Reproductive Endocrinology 3(47) (2019):8–12. DOI: 10.18370/2309-4117.2018.47.13-18
  5. Kaminsky VV, Sumenko VV, Bondaruk OY, Gak OI. The role of mix-infections in pathological processes of the glandular epithelium of the genital organs with atypia of cells of unclear genesis in women with infertility. Zdorovye zhyttia. 8(144) 2019: 58–63. DOI: https://doi.org/10.30841/2708-8731.3.2020.215009
  6. Khaskhachykh DA, Potapov VO, Kukina GO. Differentiated approach to the treatment of endometrial hyperplasia without atypia in women of reproductive age. Actual issues of pediatrics, obstetrics and gynecology. 2019;2 (24):149–54.
  7. Gromova OL, Potapov VO, Khaskhachikh DA, et al. Analysis of the reasons for the ineffectiveness of hormone therapy for endometrial hyperplasia without atypia in premenopausal women. Bulletin of Vinnytsia National Medical University. 2020;24(4):625–31.
  8. Li W, Wang S, Qiu C, et al.Comprehensive bioinformatics analysis of acquired progesterone resistance in endometrial cancer cell line. J. Transl. Med. 2019;17(1):58. DOI: 10.1186/s12967-019-1814-6
  9. Scott OW, Tin TinS, Bigby SM, et al. Rapid increase in endometrial cancer incidence and ethnic differences in New Zealand. Cancer Causes Control. 2019:30(2):121–7. doi: 10.1007/s10552-019-1129-1
  10. Potapov VO, Khaskhachikh DA, Kukina GA, et al. Endometrial receptor status in hyperplastic processes in premenopausal women. Neonatology, surgery and perinatal medicine. 2021;11.1(39):33–8.
  11. Boychuk AV, Shadrina VS, Vereshchagina TV. Endometrial hyperplasia – a modern systemic and pathogenetic view of the problem (literature review). Topical issues of pediatrics, obstetrics and gynecology. 2019;1:67–72. DOI: 10.11603/24116-4944.2019.1.9906
  12. Shiwani H, Clement NS, Daniels JP, Atiomo W. Metformin for endometrial hyperplasia. Cochrane Database Syst Rev. 2024;5(5):CD012214. DOI:10.1002/14651858.cd012214.pub3
  13. Benyuk V, Goncharenko V, Kravchenko Y, et al. Modern aspects of the etiology and pathogenesis of hyperplastic processes of the endometrium. Reproductive health of women 4(2021):7–18. DOI: 10.30841/2708-8731.4.2021.238156
  14. Beniuk VO, Ginzburg VG, Govseev DO, et al. New approaches to the prevention of recurrence of endometrial hyperplasia in premenopausal women. Reproductive endocrinology. 2021:2:63–6. DOI: 10.18370/2309-4117.2021.58.63-7215.
  15. Abdullaev VE, Grigorenko AM. The results of treatment of endometrial hyperplasia with the use of anti-inflammatory nonsteroidal drugs in the setting of chronic endometritis and without concomitant inflammatory process. Bukovinian Medical Journal. 2022;26(3):3–8. DOI: 10.24061/2413-0737.XXVI.3.103.2022.1
  16. Raffone A, Travaglino A, Saccone G, et al. Should progesterone and estrogen receptors be assessed for predicting the response to conservative treatment of endometrial hyperplasia and cancer? A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2019;98(8):976–87. DOI: 10.1111/aogs.13586
  17. Ren H, Zhang Y, Duan H. Recent advances in the management of postmenopausal women with non-atypical endometrial hyperplasia. Climacteric. 2023;26(5):411–18. DOI: 10.1080/13697137.2023.2226316
  18. Potapov VO, Khaskhachykh DA, Finkova OP, et al. Epigenetic profile of endometrial proliferation in the different morphotypes of endometrial hyperplasia. Reprod. Endocrinol2021;57:68–78. DOI: 10.18370/2309-4117.2021.57.68-78
  19. Khaskhachikh DA, Potapov VO, Kukina GO. Treatment of endometrial hyperplasia without atypia with micronized progesterone. Expected and actual results. Topical issues of pediatrics, obstetrics and gynecology. 2021;2:125–30 DOI: 10.11603/24116-4944.2021.2.12425
  20. Horban NY, Vovk IB, Lysiana TO, et al. Peculiarities of uterine cavity biocenosis in patients with different types of endometrial hyperproliferative pathology. J. Med. Life. 2019;12(3):266–70.
  21. Polyakova EM, Lutsenko, NS, Gaidai NV. Diagnosis of endometrial hyperplasia in routine gynecological practice Zaporizhzhya Medical Journal. 2019;21(1):95–9. DOI: 10.14739/2310-1210.2019.1.155836
  22. Semenyuk AO. Tactics of management of women of reproductive age with hyperplastic endometrial processes on the background of overweight. Women’s reproductive health. 2020;3:28–31. DOI: 10.30841/2708-8731.3.2020.215009
  23. Auclair MH, Yong PJ, Salvador S, et al. Guideline No. 390-Classification and Management of Endometrial Hyperplasia. J Obstet Gynaecol Can. 2019;41(12):1789–800. DOI: 10.1016/j.jogc.2019.03.025
  24. Dore M, Filoche S, Danielson K, Henry C. Efficacy of the LNG-IUS for treatment of endometrial hyperplasia and early stage endometrial cancer: Can biomarkers predict response? Gynecol Oncol Rep. 2021;36:100732. DOI: 10.1016/j.gore.2021.100732
  25. Polishchuk TP. Prevention of relapses in postmenopausal women with benign endometrial pathology. Reproductive health of women. 2020;3:24–7.

Published

2025-03-31

How to Cite

Kravchenko, O. (2025). Prevention of recurrence of endometrial hyperplasia in premenopausal women. REPRODUCTIVE ENDOCRINOLOGY, (76), 21–24. https://doi.org/10.18370/2309-4117.2025.76.21-24

Issue

Section

Management of menopause