Morphological pattern of endometrial pathology during postmenopause
Objective. To study the morphological pattern of endometrial pathology in the menopausal women considering clinical symptoms and duration of the menopausal period. Patients and methods. 1032 women in the postmenopause were observed. Clinical data, the results of ultrasound and pathomorphological examination were studied. All patients were divided into the following groups: group 1 consisted of patients with menopausal duration for 1-5 years; group 2 - for 6-10 years; group 3 - for 10-20 years; group 4 - for more than 20 years. Results. Abnormal uterine bleeding (AUB) was registered in 39% of patients from group 1, in 13% of patients both from group 2 and group 3, and in 7% of patients from group 4. Endometrial thickening according to the ultrasound results was observed in 39% of patients from group 1, in 58% of patients from group 2, in 53% of patients both from group 3 and group 4. The combination of AUB and increased endometrial thickness was found in 27% of patients from group 1, in 29% from group 2, in 34% from group 3, and in 40% from group 4. Functional changes in the endometrium represented by the regenerating endometrium, proliferative endometrium, and endometrial hyperplasia were found in 31% of patients from group 1 and in 4% of patients from group 2. The incidence of endometrial carcinoma increased with the increasing duration of the menopause and was 7% in group 1, 12% in group 2, 24% in group 3, and 30% in group 4. Conclusion. The leading cause of AUB in women during the first 5 years of the menopause is functional change in the endometrium. Patients with menopausal duration of more than 10 years and the presence of AUB constitute a risk group of developing endometrial carcinoma.