Endometrial hyperplasia: search for optimal solutions and strategies

Dumanovskaya M.R., Chernukha G.E., Tabeeva G.I., Asaturova A.V.

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, Moscow, Russia
Endometrial hyperplasia (EH) is one of the main causes of abnormal uterine bleeding (AUB), which reduces quality of life in women and is a significant risk factor for malignant transformation of the endometrium, which together determines the importance of the problem, especially in developing cancer prevention programs. The current issue is to standardize morphological classifications to level the subjectivity of making histological diagnoses and to search for biomarkers that can predict the pathological process. The literature review discusses treatment options for EH, in particular the principles of hormone therapy that remains a generally recognized treatment option aimed at reversing the pathological process, preventing AUB and disease progression to endometrioid adenocarcinoma (EA), and restoring normal endometrial function and fertility. Worthy of separate attention is the management tactics for reproductive-aged patients with atypical EH, especially with unrealized generating function.
Conclusion. The clinical protocols for the management tactics in patients with EH, which have been proposed to clinicians over the past 5 years, can standardize approaches to solving the problem. However, despite the substantial recent progress in the development of the discussed problem, there remain unresolved problems, one of the main ones is to search for reliable predictors for EH, its possible progression in EA, and to predict disease relapses and therapy response.


endometrial hyperplasia
levonorgestrel intrauterine system
cancer prevention


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Received 24.11.2020

Accepted 07.12.2020

About the Authors

Madina R. Dumanovskaya, Cand. Sci. (Med.), Researcher, Department of Gynecological Endocrinology, V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. E-mail: dumanovskaya@gmail.com. ORCID: 0000-0001-7286-6047.
117997, Russia, Moscow, Oparina str., 4.
Galina E. Chernukha, Dr. Med. Sci., Professor, Chief Researcher of the Department of Gynecological Endocrinology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. ORCID: 0000-0002-9065-5689. 117997, Russia, Moscow, Oparina str., 4.
Gyuzyal I. Tabeeva, Cand. Sci. (Med.), senior researcher, Department of Gynecological Endocrinology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. ORCID: 0000-0003-1498-6520. 117997, Russia, Moscow, Oparina str., 4.
Alexandra V. Asaturova, Cand. Sci. (Med.), Head of the 1st Pathology Department, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. ORCID: 0000-0001-8739-5209. 117997, Russia, Moscow, Oparina str., 4.

For citation: Dumanovskaya M.R., Chernukha G.E., Tabeeva G.I., Asaturova A.V. Endometrial hyperplasia: search for optimal solutions and strategies.
Akusherstvo i Ginekologiya /Obstetrics and Gynecology. 2021; 4: 23-31 (in Russian)

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