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A 48-year-old female, gravida 5, para 5, has abnormal uterine bleeding. Two years ago, when her symptoms started, her endometrial biopsy revealed simple endometrial hyperplasia without atypia and an ultrasound was normal. After progestin therapy, the hyperplasia and abnormal bleeding resolved. Recently her abnormal bleeding returned, and a current biopsy revealed a return of simple hyperplasia without atypia. The patient is finished having children and would like to pursue definitive treatment. Eight years ago, she was diagnosed with adult-onset diabetes, which has been controlled with an oral hypoglycemic (metformin). The patient’s BMI is 30 kg/m2. She has had no previous surgeries and has no other medical conditions.
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