An integrated approach to the management of patients with endometrial hyperplasia and metabolic syndrome

Despite the achieved success in the treatment of endometrial hyperplasia processes, some issues related to the treatment of these diseases have not been completely resolved, especially in the presence of metabolic syndrome.

Aim. To optimize the management of patients with endometrial hyperplasia and metabolic syndrome.

Materials and methods. The study included 50 women with a verified diagnosis of recurrent endometrial hyperplasia. As a control value, a BMI of 25.0 kg/m² was taken, two subgroups were identified – with normal body weight and with overweight and obesity of the 1st degree. Treatment with GnRH was carried out in the following regimen: intramuscular injection of the drug at a dose of 3.75 mg once every 4 weeks with an assessment of the results after 3 and 6 months. In the course of the study, we assessed metabolic parameters, parameters of the hemostasis and fibrinolysis system before and during therapy. The baseline studied parameters were compared with the control group of healthy women without endometrial hyperplastic processes and overweight as well as patients of the control group with metabolic syndrome.

Results. Hormonal treatment of recurrent endometrial hyperplasia without atypia using GnRH a positive effect on the dynamics of clinical manifestations, which is confirmed by the data of ultrasound and histological research methods and does not cause a sharp procoagulant shift, regardless of the patient’s body weight.

Conclusion. Our results allow GnRH to be the drugs of choice in the treatment of endometrial hyperplasia in overweight patients, since they have a fairly safe and effective effect. It is necessary to remember about an integrated approach to patient management and to carry out the prevention of endothelial dysfunction in this group of patients due to the high risk of complications to potentiate a beneficial effect on hemostasiological and metabolic parameters.