Vaginal micronized progesterone versus the levonorgestrel‐releasing intrauterine system for treatment of non‐atypical endometrial hyperplasia: A randomized controlled trial

Abstract

Endometrial hyperplasia is a disease characterized by an increase in the ratio of endometrial glands to stroma. Excessive proliferation of endometrial glands can cause cytological atypia and progress to endometrial carcinoma if the estrogenic activity is unopposed by progesterone. In addition, endometrial hyperplasia causes abnormal uterine bleeding and reduces the quality of life of patients. Although the main treatment in the presence of atypia is hysterectomy, different types of progestins can be used in different ways for nonatypical endometrial hyperplasia. 1 Progestins act by triggering apoptosis and are used as a nonsurgical alternative to hysterectomy. 2 Although oral progestogens are usually preferred in the treatment of endometrial hyperplasia, local treatment is a good alternative due to the fact that it participates less in the systemic circulation and has a greater local effect