Currently, cancers are of leading importance in the structure of mortality worldwide. Among the female population, malignant endometrial neoplasms occupy the second place in their incidence. Endometrial hyperplastic processes are presently considered to be precursors of malignant transformation, which is especially relevant in able-bodied women. There is evidence that the incidence of endometrial hyperplasia (EH) varies from 10 to 55% and reaches its maximum in the population of perimenopausal women. The paper analyzes an update on clinical risk factors for endometrial hyperplasia in perimenopausal women. Among the most significant background conditions, there are diabetes mellitus, obesity, factors of gynecological history and hormone therapy, including that for malignant breast neoplasms. Changes in the expression of estrogen and progesterone receptors play an important role in the development of pathological effects and their relationship to the development of hyperplastic processes. Conclusion. The use of molecular genetic testing in the study of the course and progression of HE and malignant transformation makes it possible to explain the mechanisms of the effects of risk factors and to clarify their significance for assessing the development of the disease. To select therapeutic tactics and to predict drug therapy success, it seems promising to evaluate the receptor status of patients with HE. ©A group of authors, 2021.