A call for reminder before it’s too late atypical endometrial hyperplasia and concurrent cancer in reproductive age women

Endometrial hyperplasia is a hyper proliferation of endometrial cells predominantly of stromal glandular components under estrogen influence. This is a premalignant lesion which concomitant with endometrial carcinoma in 40% of cases. Major risk factors are estrogen predominant states such as nulliparity, early menarche, late menopause, obesity, infertility, polycystic ovarian syndromes, estrogen producing tumours. Prolonged use of COCs, tamoxifen also plays a role in endometrial hyperplasia leading to concurrent endometrial carcinoma in reproductive age women. Pointing towards pathology endometrial carcinoma diagnosed at an earlier age are mostly of low grades with lower stage and good clinical outcomes. With this review we emphasize the need of endometrial sampling or fractional curettage in all young women with altered menstrual flow with suspicious of increased endometrial thickening before starting any medications.