The Impact of Hormone Replacement Therapy on Endometrial Pathology: A Retrospective Observational Study

Background and objective Hormone replacement therapy (HRT) is widely used for managing menopausal symptoms; however, its impact on the endometrium continues to be a clinically significant concern. This study aimed to investigate the association between HRT use and endometrial pathology in women presenting with various gynaecological symptoms. Methods A retrospective analysis was conducted involving a cohort of 62 patients who underwent hysteroscopy at the Princess Royal University Hospital. Data on patient demographics, clinical presentation, HRT use, and histological findings were collected and analyzed. Statistical analysis, including chi-square tests and Mann-Whitney U tests, was performed using Python with SPSS-style methodology to assess the relationships between variables. Results The mean age of the cohort was 52.7 ± 9.3 years. Of the 62 patients, 13 (21.0%) were on HRT, 11 (17.7%) were not on HRT, and 38 (61.3%) had an unknown HRT status. A statistically significant association was found between HRT status and histological outcomes (χ² = 22.0985, p = 0.0364). Significant associations were also observed between age group and HRT use (χ² = 14.6001, p = 0.0236) and between clinical presentation and HRT use (χ² = 18.1885, p = 0.0058). No significant difference was found in age (p = 0.2340) or endometrial thickness (p = 0.8776) between HRT users and non-users. Conclusion This study demonstrates a significant association between HRT use and endometrial pathology. The findings highlight the importance of endometrial surveillance in women on HRT. Further prospective studies with larger sample sizes are needed to validate these findings and to elucidate the long-term effects of different HRT regimens on the endometrium.