Randomized trial finds vaginal and oral progesterone yield equivalent reductions in endometrial thickness in endometrial hyperplasia, indicating vaginal delivery is an effective alternative.
Progesterone therapy is the main drug for the treatment of endometrial hyperplasia as a precursor of endometrial cancer. Considering the side effects of systemic progesterone use, we decided to compare the effectiveness and side effects of vaginal use versus oral use. This parallel group randomized clinical trial was conducted among 80 women with EH, without atypia, and abnormal uterine bleeding (AUB). Participants were allocated to two groups. Participants in group I received MPA, 2 tablets (5 mg) orally for 14 days per month for 3 months. Participants in group II obtained a 100 mg soft gelatin Progesterone capsule for vaginal use at the same time. 3–4 weeks after the completion of the treatment, the patient’s endometrial thicknesses were measured, and endometrial samples were obtained. Finally, 39 and 36 participants were evaluated from groups I and II. The mean endometrial thickness significantly decreased after the intervention compared to before in each group (All p < 0.05), but no statistically significant difference was seen ( P = 0.37) between groups. The clinical and histologic effects of vaginal MP are the same as MPA, after three cycles of treatment of EH without atypia. IRCT20140820018866N8. Registered 10/11/2019 Prospectively registered, https//www.irct.ir/trial/41,581.
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Tehranian et al. (2026) studied this question.
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