Objective — to optimize the choice of a treatment option for premenopausal patients with abnormal uterine bleeding on the basis of the ovarian morphofunctional status. Subject and methods. Ninety-eight premenopausal patients aged 45—55 years with abnormal uterine bleeding caused by endometrial hyperplastic processes were examined. A study group consisted of 68 patients who underwent organ-sparing intrauterine surgical interventions, such as total electrosurgical endometrial resection in 16 cases, subtotal electrosurgical resection of an endometrial polyp and submucous myomatous nodules in 22 cases, and thermal balloon endometrial ablation in 30 cases. A comparison group included 30 patients receiving hormonal therapy. The obtained results of ultrasound and hormonal studies were compared with those in 30 healthy premenopausal women. All the patients underwent pelvic ultrasound scanning, hysteroscopy, separate diagnostic curettage of the uterine mucosa, and histological scrape examination. Results. Endometrial ablation/resection using different power types is an effective treatment in premenopausal patients with endometrial hyperplastic processes and submucous uterine myoma. However, all the intrauterine treatments used in patients with abnormal uterine bleeding (thermal balloon ablation, electrosurgical resection, hormonal therapy) may lead to recurrent endometrial hyperplastic processes associated with the appearance of retention formations and true ovarian tumors at different times. Conclusion. All premenopausal patients with a history of endometrial hyperplastic processes regardless of the treatment method should be followed up.