Endometrial Curettage in Abnormal Uterine Bleeding and Efficacy of Progestins for Control in Cases of Hyperplasia

Background: Abnormal uterine bleeding (AUB) is the most important symptom of endometrial hyperplasiaand endometrial curettage (EC) is the gold standard diagnostic procedure. We present the results of patientswho underwent EC for AUB and the efficacy of progestin administration in those with endometrial hyperplasia.Materials and
Methods: A total of 415 female patients who presented to Duzce Public Hospital in 2011-2012 forAUB and who underwent EC were included. We determined the reasons for AUB, and females with hyperplasiawere treated with 10 mg/day medroxyprogesterone acetate for 14 days/month or 160 mg/day megestrol acetatecontinuously for 3 months. We evaluated the efficacy of progestins for periods of three and/or six cycles byrepeating EC. A statistical analysis of specific endometrial causes according to age of presentation was conductedusing the chi-square test.
Results: Among the 415 females (average age, 53.5 years) followed for 6 months, 186had physiological changes (44.8%), 89 had simple hyperplasia (21.44%), 1 had atypical hyperplasia (0.2%),6 had (1.44%) complex hyperplasia, 3 had (0.72%) atypical complex hyperplasia, and 5 had adenocarcinoma(1.2%). Regression rates were 72.7-100%, and the optimum results were observed after 6 months of hormonaltherapy.
Conclusions: The main cause of AUB was physiological change. Progestin therapy resulted in significantregression even in females with atypical hyperplasia.