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Endometrial hyperplasia risk — DRCOG MCQ

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HardGynaecologyEndometrial hyperplasia riskDRCOG

A 33-year-old woman with obesity and PCOS has unpredictable prolonged bleeding after months of amenorrhoea. Pregnancy test is negative. She has not used progestogen treatment for several years. What would you advise?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Explain that prolonged anovulation increases endometrial hyperplasia risk and arrange assessment

PCOS with prolonged anovulation can lead to unopposed oestrogen exposure and increased endometrial hyperplasia risk, especially with obesity. Younger age does not remove the need to assess persistent abnormal bleeding. Emergency contraception is not a treatment for chronic anovulatory bleeding. Cervical causes require examination rather than assumption.

Reference: NICE CKS PCOS; NICE NG88