Premenopausal patient: Persistent EH without atypia

D&C: dilation and curettage; EC: endometrial carcinoma; EH: endometrial hyperplasia; EMBx: endometrial biopsy; LNG: levonorgestrel.

* The 52 mg LNG-releasing intrauterine device (Mirena or Liletta; LNG 52 mg IUD) 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 mg IUD, add an oral progestin. If on an oral progestin, change to the LNG 52 mg IUD, add the LNG 52 mg IUD, 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.