Question
A 46 years old lady has abnormal uterine bleeding with simple hyperplasia of the endometrium. The treatment of choice would be:
| A. |
Total Hysterectomy
|
| B. |
Progesterone therapy
|
| C. |
Estrogen + progesterone therapy
|
| D. |
Estrogen therapy
|
Show Answer
|
Correct Answer » B
Explanation
|
|
- The patient has abnormal uterine bleeding (AUB).
- Histology shows simple endometrial hyperplasia without atypia.
- This condition is due to unopposed estrogen stimulation of the endometrium.
- Treatment aims to counteract estrogen effect.
- Progesterone induces secretory transformation and shedding of endometrium.
- It prevents progression to endometrial carcinoma.
- First-line management in simple hyperplasia without atypia is medical therapy with progesterone.
Explanation why other options are incorrect
Option A. Total hysterectomy
- Reserved for:
- Atypical hyperplasia
- Failed medical therapy
- Completed family with high risk
- Not first-line in simple hyperplasia without atypia
Option C. Estrogen + progesterone
- Estrogen component worsens hyperplasia
- Not indicated in this condition
Option D. Estrogen
- Contraindicated
- Would further stimulate endometrial proliferation
