The inflammatory “past” and “present” of endometrial proliferative diseases. A strategy for clinical management

Significant changes in the lifestyle of the global population at present (in particular, the high prevalence of metabolic syndrome) have led to a “spike” in the incidence of proliferative endometrial diseases. A “strong” pathogenetic association between metabolic syndrome, abnormal uterine bleeding (AUB), heavy menstrual bleeding (HMB) and endometrial hyperplasia (EH) has been established. The key triggers of these disorders are a systemic inflammatory pattern due to both generalized circulation and local accumulation of proinflammatory cytokines (in particular, adipocytokines). This article reflects current strategies for the comprehensive management of patients with AUB, HMB and EH based on updated domestic clinical (2024) and international guidelines. Key words: endometrial hyperplasia, heavy menstrual bleeding, abnormal uterine bleeding, inflammation