Hysteroscopy and transvaginal sonography in menopausal women receiving hormone replacement therapy.
OBJECTIVE
To evaluate the endometrial cavity of menopausal women with irregular bleeding while receiving hormone replacement therapy.


METHODS
Comparative evaluation of hysteroscopic and biopsy findings.


METHODS
A center for reproductive studies.


METHODS
Forty-one patients receiving different regimens of hormone replacement therapy.


METHODS
Hysteroscopy, endometrial biopsy, and transvaginal sonography were performed in all 41 women. In 10 patients, endometrial polyps were removed with the resectoscope.


RESULTS
Irregular bleeding during hormone replacement therapy was associated with atrophic endometrium whenever transvaginal sonography showed endometrial thickness to be less than 4 mm. In patients who developed increased endometrial thickness after hormone replacement therapy, hysteroscopy revealed the presence of endometrial polyps in the uterine cavity. Histopathologic examination of excised polyps revealed cystic or adenomatous hyperplasia confined to these lesions.


CONCLUSIONS
Endometrial polyps can appear in menopausal women receiving hormone replacement therapy despite the presence of progestins to oppose the action of estrogens.
Maia
H
H
Centro de Pesquisas e Assistencia em Reproducao Humana, Salvador, Bahia, Brazil.
Barbosa
I C
IC
Marques
D
D
Calmon
L C
LC
Ladipo
O A
OA
Coutinho
E M
EM
D001284:Atrophy; D001706:Biopsy; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008593:Menopause; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000139:chemically induced / Q000175:diagnosis / Q000000981:diagnostic imaging