title: Reverse of progestin-resistant atypical endometrial hyperplasia by metformin and oral contraceptives.
abstract: 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.
authors.affiliation: Department of Reproduction and Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
authors.forename: Zong-Qi
authors.initials: ZQ
authors.lastname: Shen
authors.forename: Hui-Ting
authors.initials: HT
authors.lastname: Zhu
authors.forename: Jin-Fang
authors.initials: JF
authors.lastname: Lin
mesh_terms: 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
chemical_list: D003278:Contraceptives, Oral, Hormonal; D007004:Hypoglycemic Agents; D011372:Progestins; D008687:Metformin; D019290:Megestrol Acetate