Clinical and Endometrial Histopathological Profile of Women with Perimenopausal and Postmenopausal Bleeding

Abstract

Introduction:

Abnormal uterine bleeding (AUB) in perimenopausal and postmenopausal women is common and clinically important concern, as it may indicate anything from hormonal imbalance to serious pathologies like endometrial hyperplasia or carcinoma . The objective of this study was to assess clinical and endometrial histopathological characteristics in women with perimenopausal and postmenopausal bleeding in TUTH.

Methods:

This was a descriptive study carried out in the Department of Obstetrics and Gynecology at Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu from April 2018 to April 2019. All women > 40 years with abnormal uterine bleeding attending gynecology OPD were taken. Endometrial biopsy was done and histopathological examination findings were studied.

Results:

Among 328 women, 218 were with perimenopausal bleeding and those with postmenopausal bleeding were 110. The most frequent bleeding in ladies with perimenopausal bleeding was menorrhagia in 93(42.9%) and spotting accounting 68 (71%) in postmenopausal bleeding. Out of total 328 cases, 317(96.6%) had benign endometrial findings and 11 cases (3.4%) had malignant endometrial findings. The most frequent histopathological finding in women with perimenopausal bleeding was secretary endometrium. Among postmenopausal bleeding 110 (91%) were benign and 9( 8.2%) had malignant histopathology.

Conclusion:

The most frequent bleeding pattern in perimenopausal bleeding was menorrhagia and spotting  in those with postmenopausal bleeding. Malignant histopathological was found more in postmenopausal bleeding than perimenopausal bleeding.