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Hysteroscopic findings in postmenopausal abnormal uterine bleeding: a comparison between HRT users and non-users
G Perrone1, C DeAngelis, C Critelli
1I Ist Clinic of Obstetrics and Gynecology, University of Rome La Sapienza, Rome, Italy.
Maturitas
|December 7, 2002
Summary
Benign intrauterine diseases like polyps and myomas are more common in postmenopausal women not using hormone replacement therapy (HRT). Irregular bleeding in HRT users is linked to these conditions, but absence of bleeding doesn't rule them out.
Area of Science:
- Gynecology
- Reproductive Medicine
- Menopause Research
Background:
- Hormone replacement therapy (HRT) is commonly used by menopausal women.
- Abnormal uterine bleeding (AUB) is a frequent concern in postmenopausal women.
- Hysteroscopy is a key diagnostic tool for evaluating intrauterine pathology.
Purpose of the Study:
- To investigate hysteroscopic findings in menopausal women, comparing HRT users and non-users.
- To evaluate the relationship between intrauterine disease, HRT use, and AUB.
- To assess the prevalence of specific intrauterine conditions such as polyps and myomas.
Main Methods:
- Office hysteroscopy was performed on 410 menopausal women (219 HRT users, 191 non-users).
- Indications for hysteroscopy included abnormal uterine bleeding (AUB) and periodic endometrium monitoring.
- Data were analyzed to compare disease prevalence between HRT groups and symptomatic/asymptomatic patients.
Main Results:
- Intrauterine diseases were more frequent in non-HRT users (P = 0.02).
- Endometrial polyps (30%) and myomas (8.7%) were common findings.
- Symptomatic patients had a higher frequency of intrauterine diseases (41%) compared to asymptomatic patients (28%, P = 0.003).
Conclusions:
- Benign intrauterine diseases are more prevalent in postmenopausal women not using HRT.
- In HRT users, AUB is associated with intrauterine diseases, but its absence does not exclude their presence.
- Hysteroscopy remains crucial for diagnosing intrauterine pathology in menopausal women, irrespective of HRT status or bleeding symptoms.
