Endometrial hyperplasia historical perspective

The history of endometrial hyperplasia goes back to the 1900s. Initially endometrial carcinoma was discovered and with the development of histological grades, endometrial hyperplasia was explored.The association between estrogen and development of endometrial cancer was first reported in the 1970s. During this time, the incidence of endometrial cancer significantly increased between 1970 and 1975 following the introduction of estrogen replacement therapy.

• The earliest descriptions of endometrial cancer were reported in the early 1900s.
• The association between estrogen and development of endometrial cancer was first reported in the 1970s when the incidence of endometrial cancer significantly increased between 1970 and 1975 following the introduction of estrogen replacement therapy.^[1]
• Surgical staging of endometrial cancer was first suggested in 1988 and was later revised in 2009.^[2]
• The first laparoscopic hysterectomy was reported in 1992.^[3]

The current use of estrogen therapy (ET) and estrogen–progestin therapy (EPT) is the end result of many years of research and clinical practice.

• The history of estrogen goes back to 1900s, when ovarian extracts were used for treatment of dysmenorrhea and amenorrhea.
• In 1923, researchers isolated the use of ovarian extract.
• In the late 1920s researchers evaluated the impact of ovarian extracts on menopausal symptoms.
• In 1928, the first commercially available injectable estrogen was developed.
• In 1942, Ayerst Laboratories commercially introduced the first orally active estrogen, Premarin (conjugated estrogens) in the United States.
• In the mid-1970s, researchers recognized the association between unopposed estrogen therapy and endometrial cancer.
• In the following decades, it was observered that long-term estrogen therapy and estrogen progestin therapy use was associated with a small increase in the risk of breast cancer.
• In 1990s, estrogen therapy and estrogen progestin therapy was prescribed for the prevention and the treatment of menopausal symptoms.

• In 2002, the estrogen progestin therapy was withdrawn because of small increases in the risk of breast cancer and CHD.
• In 2004, the estrogen therpay arm of the Women’s Health Initiative (WHI) was also prematurely discontinued.
• The WHI reported, estrogen therapy had no effect on CHD risk and increased the risk of stroke and deep venous thrombosis (DVT) in this population.^{[4][5][6][7][8][9]}

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