Atypical Hyperplasia - Disappears?

Hi
I am just 40 years old. I had an endometrial biopsy in May (following a bout of heavy painful periods after having none  for 2 years). The results showed atypical hyperplasia so I was referred to a gynaeacologist. He indicated that it would probably be best to have a hysterectomy. In August I had a hysteroscopy and D&C. I got the results of that recently and apparently there were no abnormalities. Of course, it is a huge relief but I am confused. How can it just disappear like that? Is this common? Do I need to be concerned in the future?
Thanks

[Elaine Brown, MD]

Hi!
My only fear is that the lesion may have been missed on the hysteroscopy.
Atypical hyperplasia is a pre-malignant condition and isn't something to fool around with.
If you were my patient, I would treat you with 14 days of progesterone for each of the next three months.  At the end of that time, I would do a saline ultrasound, and possibly an ultrasound guided endometrial biopsy of any suspicious areas.  If everything looked OK, I would encourage you to consider a way to regulate your cycles.  A Mirena IUD can be perfect for this.  It releases progesterone to the lining only, and doesn't cause any side effects systemically.  Since it is releasing progesterone locally though, it prevents the lining from building up and becoming pre-malignant again.  It also lasts for 5 years.  Another option would be depo provera, or oral contraceptive pills if you are not a smoker.
Whatever you do, DO NOT go more than three months without having a period, or if you do, contact your doctor!
Good luck!
Dr B