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In this study, women with nonatypic endometrial hyperplasia were treated with thermal balloon ablation therapy to investigate the effects of this technique. The heat from thermal balloon ablation causes coagulation and necrosis of the endometrium and superficial myometrium. Thirty-four perimenopausal women (mean age, 48 years; range, 37–64 years) with simple or complex endometrial hyperplasia were enrolled in a randomized trial to compare thermal balloon ablation therapy (n 17) with traditional progestin therapy (n 17).