Hysteroscopy: a necessary method for detecting uterine pathologies in post-menopausal women with abnormal uterine bleeding or increased endometrial thickness

Objective: To investigate the histologic and hysteroscopic findings of post-menopausal women with uterine bleeding and asymptomatic women with increased endometrial thickness equal or more than 5 mm.

Materials and Methods: This cross-sectional study was done between May 2014 and June 2015 on 110 post-menopausal women aged 40-82 years old. They were divided into two groups: women with abnormal uterine bleeding (AUB group) and asymptomatic women with increased endometrial thickness (asymptomatic group).

Results: Among the participants 67 women had abnormal uterine bleeding and 43 women were asymptomatic. In the AUB group sensitivity, specificity, positive and negative predictive values of hysteroscopy for normal findings were 98%, 100%, 100% and 90%, respectively. In the asymptomatic group the same values were 98%, 100%, 100% and 85%, respectively. The sensitivity, specificity, positive and negative predictive values of hysteroscopy for polyps and myomas were 100%. Also, the sensitivity, specificity, positive and negative predictive values were 100% in hyperplasia cases found by hysteroscopy in both groups.

Conclusion: Increased endometrial thickness in postmenopausal women with or without abnormal uterine bleeding is mostly due to benign lesions such as polyps and submucosal myomas. Hysteroscopy is a safe and reliable method for evaluating and treating these lesions.