Mandelbaum RS, Ciccone MA, Nusbaum DJ, et al. - Treatment responses with local progestin therapy with the levonorgestrel-releasing intrauterine device (LNG-IUD) vs systemic progestin therapy in women with complex atypical hyperplasia (CAH) were assessed. In this single-institution retrospective study, treatment response was evaluated using histopathology on subsequent biopsies in women with CAH who received progestin therapy between 2003-2018. Receipt of progestin therapy was reported in 245 women with CAH (LNG-IUD n = 69 and systemic therapy n = 176). Outcomes suggest possible higher effectiveness of local therapy with the LNG-IUD vs systemic therapy for women with CAH who opt for non-surgical treatment, especially in morbidly obese women. During the study period, researchers observed shifts in treatment paradigm towards increased LNG-IUD use, which resulted in improved complete response rates despite rising rates of obesity.