This study used multi-omic analyses to reveal the mechanisms underlying the progression of abnormal uterine bleeding with ovulatory dysfunction (AUB-O) to AUB with atypical hyperplasia/malignancy (AUB-M), discovering that SFRP4 influences human endometrial epithelial cells (hEECs) apoptosis, migration, invasion, proliferation, and colony formation via the Wnt pathway.