The value of endometrial cell sampling in the management of post-menopausal women

The value of performing endometrial cytology on women receiving hormonal replacement therapy is discussed. Evidence is presented which shows that when this is routinely performed prior to beginning therapy, some 2% of women are found to have an abnormality ranging from polyps to carcinoma. When minimal dose combined oestrogen plus progestogen replacement therapy is used together with a monitoring procedure which involves routine annual Mimark endometrial sampling and curettage for abnormal cytology or bleeding, the risk of endometrial abnormality is reduced to a minimum. The benefits to be gained and the problems which detract from the use of endometrial cytology are discussed. It is recommended that every woman should have a routine cytological endometrial screening performed by a doctor experienced in the use of endometrial sampling equipment when she receives hormonal replacement therapy in the post-menopausal phase.