Postmenopausal uterine bleeding
ICD-10 N95.0 · ICD-11 GA30.1

Treatment of Postmenopausal Vaginal Bleeding with Endometrial Hyperplasia with Atypia When Surgery Is Not Suitable

Clinical Scenario

Postmenopausal vaginal bleeding in the context of endometrial hyperplasia with atypia carries a significant long-term risk. When surgery is not an option for the patient, management requires a structured, multidisciplinary approach.

28% of patients with endometrial hyperplasia with atypia will develop endometrial cancer over 20 years.

Patients who are not suitable for surgery should be managed via a multidisciplinary team (MDT) to ensure safe, individualised care.

Management Approach

Where surgical intervention is not possible, management is directed by an MDT. A progestogen-based treatment is central to this approach — a specific local delivery method is preferred over oral preparations. The complete protocol specifies the preferred option and the full clinical pathway.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.ogrm.2025.09.009
28% of patients with EH with atypia will develop endometrial cancer over 20 years.
Patients who are not suitable for surgery should be managed via a multidisciplinary team (MDT).
As with EH without atypia, LNG-IUS is the preferred progestogen treatment over oral preparations.
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