European Journal of Molecular & Clinical Medicine

Abstract

Background--The World Health Organization defines natural menopause as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity without an obvious intervening cause and is confirmed only after 12 consecutive months of amenorrhea.In asymptomatic postmenopausal women sonographically thickened endometrium (usually≥5 mm)  as an indication to proceed to further, more invasive investigations to find out endometrial pathology to reduce morbidity and mortality.
AIM-- To evaluate endometrial pathology in asymptomatic postmenopausal women with endometrial thickness ≥5 mm on transvaginal ultrasound.
Methods-- This was a Descriptive study done in All Asymptomatic Postmenopausal Women attending Gynecology OPD in the Department of   Obstetrics and Gynecology Kasturba Hospital, BHEL, Bhopal, Madhya Pradesh, India between - MAY 2018 to AUGUST 2019 .sample size 100 patients. In inclusion criteria, all asymptomatic postmenopausal women having endometrial thickness≥5 mm and written informed consent. In exclusion criteria, women with abnormal pap smear report grossly abnormal cervix and diagnosed genital tract malignancy, bleeding diathesis, and cardiac diseases.
Result--Out of 100 patients on which transvaginal sonography was performed Majority of the patients had endometrium thickness (mm) of 9 mm (23%) followed by 8 mm (22%) and 10 mm (14%). There were further taken hysteroscopy guided biopsy which shows 2% of women ca endometrium diagnosed and 19 % of the women endometrial polyp was diagnosed, 16% had endometrial hyperplasia without atypia and 1% patients had endometrial hyperplasia with atypia.
Conclusion-- The risk of cancer is high if the endometrium is thick (≥8mm) in asymptomatic postmenopausal women. The results of our study highlight the need for routine use of transvaginal ultrasound as a screening test for endometrial cancer. We should consider though the rising incidence of endometrial cancer, and the requirement for more and larger prospective trials with surrogate criteria for the thickened endometrial stripe in postmenopausal women in TVS for both symptomatic and asymptomatic postmenopausal women.