Achievements and prospects of therapy for non-atypical endometrial hyperplasia in reproductive-aged women

Background. Endometrial hyperplasia without atypia (EH) is a common condition among women of reproductive age. Although it does not pose a direct threat to life, the vaginal bleeding that accompanies EH can significantly affect the quality of life and lead to other pathologies such as anemia. EH also increases the risk of developing endometrial cancer, making the issues of early diagnosis, treatment, and recurrence prevention highly relevant. Purpose – The study aimed to analyze organizational measures to prevent recurrence or progression of EH in women of reproductive age, with a focus on identifying the main risk factors and evaluating the effectiveness of different treatment approaches. Materials and Methods. A retrospective analysis of 1,226 histopathological samples of endometrial tissue was conducted, along with an examination of archived medical documentation from 2018 to 2023. Clinical follow-up was performed for 554 women who received various treatments for EH. Treatment effectiveness was evaluated based on the results of morphological studies of endometrial biopsies. Results. The lowest recurrence rate was observed in the group of patients who used the levonorgestrel-releasing intrauterine system (LNG-IUS), while the highest recurrence rate was found in women who received no treatment. Disease progression was recorded in only 0.5% of women using LNG-IUS, whereas in untreated women, the rate was 9.4%. The highest rate of disease regression (92.3%) was also recorded in the LNG-IUS group. Conclusions. The study demonstrated that LNG-IUS is the most effective treatment for EH, as it provides the lowest recurrence and progression rates and the highest rate of disease regression. Traditional hormonal therapies showed reduced efficacy over time, indicating a need for revision and systematization of treatment strategies.