Histopathological study of endometrium in postmenopausal women

Introduction: Menopause is permanent cessation of menstruation secondary to genetically programmed loss of ovarian follicles and cessation of ovarian estrogen secretion. Post menopausal bleeding is an alarming symptom of genital pathologies and requires complete evaluation to exclude malignancy (5% to 15%). Over half of the cases show atrophic endometrium. Endometrial proliferation which may develop into hyperplasia or even carcinoma or estrogen available from other sources. The aim of this study: Evaluation of postmenopausal women with bleeding or other symptoms, correlating endometrial thickness and histopathology. Materials and Methods: 142 menopausal women presenting to KGH (2013- 2014 year) with either pm bleeding or ET>4mm in transvaginal sonography with other symptoms like white discharge or ovarian tumors or fibroid or polyps were subjected to endometrial curettage for histopathology; cervical or other than uterine pathology were exclude. Based on endometrial echogeneity categoried as four structural categories: homogeneous, heterogeneous low or high-echo. Analysis is based on morphological criteria to assess endometrium. Endometrial histology as five categories: normal, residual proliferation, hyperplasia (polyp), atypical adenomatous hyperplasia; and endometrial carcinoma Result: In this study regressive cystic atrophy accounts for 50% and endometrial thickness is 4 or <4mm in all these cases. One case had malignancy and 2 cases showed endometrial hyperplasia. A case with fibroids with polyp had ET>8mm. Conclusion: ET 4 or less exclude endometrial pathology.