Postmenopausal Asymptomatic Endometrial Thickening: Patient Characteristics and Pathology

Background: Finding of asymptomatic postmenopausal endometrial thickening on ultrasonography presents a frequent reason for referral by young clinicians and considered as clinical-management problem because there is no consensus about best management. Also underlying factors for endometrial thickening not well defined.

Objective: To determine the relationship between risk factors and asymptomatic postmenopausal endometrial thickening, and to characterize endometrial pathology in women with endometrial thickening.

Methods: A cohort study was carried out on 146 consecutive postmenopausal women without vaginal bleeding, who were allocated according to endometrial thickness into two groups: ≥ 5 mm (Group A) and <5 mm (Group B) endometrial thickness. Study outcomes were differences between levels or distributions of risk factors between these groups and endometrial pathology of those with thickening.

Results: In Group A, endometrial thickness (mean ± SD) was 8.4 ± 3.9 mm. In Group B, endometrial thickness was 2.8 ± 0.6 mm. Compared with Group A, Group B had a higher mean age (75.6 years versus 53.9 years, p<0.001) andmean parity (4.8 versus 4.1, p<0.04), and longer time since menopause (9.2 years versus 6.3 years, p<0.006). Group A had a higher percentage of women who experienced early menopause (52.1% versus 26.0%), and a higher mean body mass index (32.4 kg/m² versus 30.30 kg/m², p<0.001). The histopathological examination results of Group A included 49.3% simple endometrial hyperplasia, 6.8% hyperplasia with a typia and 4.1% endometrial carcinoma.

Conclusion: Endometrial carcinoma and atypia are present in a proportion of asymptomatic postmenopausal women with a thickened endometrium (≥ 5 mm). Endometrial thickness (above or below 5 mm) is seemed related to several risk factors.

Author(s): Allam NE* and Mohamed TM

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