HYPERPLASIA OF ENDOMETRIUM IN PERIMENOPAUSAL WOMEN WITH ABNORMAL UTERINE BLEEDING

Abstract

Objective: To determine the frequency of endometrial hyperplasia in histopathology of endometrial curettings in perimenopausal women with abnormal uterine bleeding.

Study Design: Prospective case series study.

Place and Duration of Study: Conducted in obstetric and gynae department of Dow University of Health and Sciences/Lyari General Hospital, from Jul 2009 to Jan 2010.

Material and Methods: Two hundred and eighty one perimenopausal women with abnormal uterine bleeding were included with age range between 40 to 55 years. Dilatation and curettage were carried out, under general anesthesia and endometrial samples were taken by scrapping walls of the uterus. Collected samples were fixed in 10% formalin and sent to histopathology department, Dow Medical College Karachi. Histopathology report of each patient was studied for hyperplasia and frequency of hyperplasia and its relation with type of abnormal uterine bleeding (menorrhagia, polymenorrhagea and menometrorrhagia) was determined.

Results: Mean age (± SD) was 44.13 ± 3.7 years with age range of 40–55 years. Most common type of abnormal uterine bleeding (AUB) was menorrhagia found in 211 (75.08%) women followed by menometrorrhagia in 40 (14.23%) and polymenorrhagea in 30 (10.67%) women. Endometrial hyperplasia was found in 37 (13.17%) women. Most common pattern of abnormal uterine bleeding associated with hyperplasia was polymenorrhagea 5 out of 30 (16.6%) women.

Conclusion: In this study frequency of endometrial hyperplasia was 13.17% in perimenopausal women with abnormal uterine bleeding. Abnormal uterine bleeding occurring in perimenopausal age is alarming and needs thorough evaluation including endometrial sampling, as it could be the only clinical manifestation of endometrial hyperplasia, a precursor of endometrial cancer.