Reverse of progestin-resistant atypical endometrial hyperplasia by metformin and oral contraceptives.
BACKGROUND
Atypical endometrial hyperplasia usually is treated with high-dose progestin or hysterectomy, but the latter deprives the patient of future child bearing.


METHODS
Two women with atypical endometrial hyperplasia complicating polycystic ovary syndrome (PCOS) had failed to respond to high-dose progestin therapy. They were both obese, insulin-resistant, and nulliparous with a desire to preserve fecundity. Metformin and oral contraceptives were administered as alternatives. Endometrial curettage performed 3 months later demonstrated a proliferative endometrium without evidence of residual pathology.


CONCLUSIONS
Insulin resistance might play a role in the occurrence of atypical endometrial hyperplasia complicating PCOS. Metformin and oral contraceptives could be an alternative treatment in the presence of progestin resistance.
Shen
Zong-Qi
ZQ
Department of Reproduction and Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Zhu
Hui-Ting
HT
Lin
Jin-Fang
JF
D000328:Adult; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D004714:Endometrial Hyperplasia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D019290:Megestrol Acetate / Q000627:therapeutic use; D008687:Metformin / Q000627:therapeutic use*; D011372:Progestins / Q000627:therapeutic use
D003278:Contraceptives, Oral, Hormonal; D007004:Hypoglycemic Agents; D011372:Progestins; D008687:Metformin; D019290:Megestrol Acetate