Treatment

1. Cystic hyperplasia or endometrial hyperplasia without cytologic atypia is treated with depo-medroxyprogesterone, 200 mg IM, then 100 to 200 mg IM every 3 to 4 weeks for 6 to 12 months. Endometrial hyperplasia requires repeat endometrial biopsy every 3 to 6 months.

2. Atypical hyperplasia requires fractional dilation and curettage, followed by progestin therapy or hysterectomy.

3. If the patient's endometrium is normal (or atro-phic) and contraception is a concern, a low-dose oral contraceptive may be used. If contraception is not needed, estrogen and progesterone therapy should be prescribed.

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