Premenopausal patient with persistent EH without atypia

EH: endometrial hyperplasia; D&C: dilation and curettage; EC: endometrial carcinoma; EMBx: endometrial biopsy; LNG: levonorgestrel.
* The 52 mg LNG-releasing intrauterine device (Mirena or Liletta; LNG 52) appears to be the most effective progestin treatment, is easy to comply with, well-tolerated, and provides contraception. Other options include oral progestins or estrogen-progestin oral contraceptives.
¶ If on the LNG 52, add an oral progestin. If on an oral progestin, change to the LNG 52, add the LNG 52, increase the dose of the oral progestin, or use a more potent agent.
Δ Progestin therapy may be given to select patients who are strongly motivated to preserve fertility and in whom physicians deem this an acceptable degree of risk.