Prevention of recurrence of endometrial hyperplasia in premenopausal women

Objective of the study: to evaluate the effectiveness of the proposed therapy aimed at preventing recurrence of endometrial hyperplasia (EH) in premenopausal patients.Materials and methods. The study included 42 patients with EH aged 48–51 years. The diagnosis of EH was verified by clinical, instrumental and morphological methods of research. The efficacy of therapy was evaluated by performing a punch biopsy of the endometrium after 1 year of treatment and every 3 months in the dynamics of observation. In order to prevent recurrence of the disease in premenopausal age, all patients with EH received dienogest (Vigest-KV) 2 mg/day for 12 months in a continuous mode. Results. All the women with verified EH had clinical signs of abnormal uterine bleeding. The average thickness of the endometrium in patients according to ultrasound study before treatment was 22.1 ± 2.4 mm. After the therapy, it was 5.1 ± 0.1 mm, after 3 months of follow-up – 6.4 ± 0.24 mm, 6 months after the therapy – 7.8 ± 0.35 mm. According to the results of the punch biopsy after treatment, 95.2% (40) of patients showed regression of the disease, in 4.8% (2) women there was persistence of EH. Physiological endometrium was morphologically verified in 100% of women with disease regression after 3 months of observation, disease relapse occurred in 4.2% (2) of patients after 6 months of observation.Conclusions. The method of choice for the prevention of recurrence of EH in the premenopausal age is drugs with a peripheral mechanism of action for block ovulation, which allows maintaining estrogen levels within the therapeutic window and improves the quality of life of women without creating a state of estrogen deficiency in the body.Long-term continuous dienogest therapy in premenopausal women with EH can reduce both the persistence of the disease and the rate of disease recurrence by up to 4.8%.