A positive history of irregular menstrual cycles (PCOD) may be present.^[1] A detailed drug history may be helpful in the assessment of possible risk factors for endometrial hyperplasia. A history of inappropriate hormone replacement therapy in post menopausal women and history of tamoxifen use in breast cancer patients may be present.^[2][3][4]

• Bleeding during the menstrual period that is heavier or lasts longer than usual
• Menstrual cycles that are shorter than 21 days (counting from the first day of the menstrual period to the first day of the next menstrual period)
• Any bleeding after menopause
• A detailed drug history may be helpful in the assessment of possible risk factors for endometrial hyperplasia.
  • Inappropriate hormone replacement therapy in post menopausal women (with insufficient progesterone component)^[2][3]
  • History of tamoxifen use^[4]
    • Tamoxifen is a non-steroidal anti-estrogen that binds to the estrogen receptor and is used primarily for adjuvant therapy in breast cancer
    • Tamoxifen may also act as an estrogen agonist in a low estradiol environment
    • Up to 50% of breast cancer patients who are treated with tamoxifen may develop an endometrial lesion within 6-36 months
    • Any patient who develops bleeding while on tamoxifen needs evaluation
• A positive history of irregular menstrual cycles (PCOD) may be present.^[1]

We observed an association between EH/EC and a history of gestational diabetes specific to younger women. Future studies focusing on the relationships between gestational diabetes, obesity, and EC, including age at diagnosis, are warranted.^[5]

• The majority of patients with endometrial hyperplasia present with abnormal uterine bleeding.^[1]
• Any postmenopausal bleeding should raise suspicion for malignancy.

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