Endometrial hyperplasia in Indian perimenopausal women: A retrospective analysis

Perimenopause is the time between changes in menstrual cycle toward menopause or permanent infertility. The aim of this study was to analyze the clinical, sonographic, and histological characteristics of perimenopausal women with abnormal uterine bleeding that was subsequently managed surgically.

This retrospective study used existing data from 102 perimenopausal female with abnormal uterine bleeding, who underwent surgical procedure during one-year period of a tertiary care hospital in Kashmir, India from Jan 2018 to April 2019. Standard sagittal views of the uterus were used to measure the endometrial thickness using transvaginal sonography (TVS). Dilatation and Curettage (D&C) was performed for obtaining endometrial tissue for pathological evaluation.

The most common complaint was menorrhagia with a mean duration of 12 months. The maximum endometrial thickness was seen with patients who finally had a diagnosis of endometrial hyperplasia with atypia and polyps. Patients with normal endometrium on pathology and those with chronic endometritis had similar endometrial thickness on TVS. Endometrial thickness was correlated with the severity of the lesion with an average thickness of 3 mm in atrophy, 10-12 mm in hyperplasia, and 18 mm in carcinoma.

Endometrial hyperplasia needs active and vigilant surveillance for its diagnosis and management. In perimenopausal women, the endometrial thickness is fickle and may not reflect the development of atypia.