8mm Endometrial Thickness Postmenopausal With Bleeding
These factors exert their. Endometrium thickening may cause bleeding after menopause but even without bleeding the possibility of endometrial cancer cannot be ruled out.
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Upper limit is 5 mm no history of vaginal bleeding.
8mm endometrial thickness postmenopausal with bleeding. No difference in the incidence of endometrial cancer was identified between the two groups however it concluded that women with unscheduled bleeding on hrt require further investigation by hysteroscopy and biopsy if the endometrial thickness was greater than 8 mm. Endometrial thickness after menopause may indicate malignancy when it is more than 4 5 mm 8 9 nevertheless there may be other influencing factors such as age menopausal years parity bmi medical illness like diabetes hypertension drugs like tamoxifen hormone replacement therapy hrt myoma uterine volume ovarian volume and serum estradiol. 50 comparing combined hrt to sequential hrt the likelihood of identifying an endometrial pathology was significantly higher in patients with endometrial thickness 4 mm than the incidence observed in patients with unscheduled.
On hormonal replacement therapy. The thickness of the endometrium stabilizes after you reach menopause. For symptomatic postmenopausal women a thickness of 5 mm indicates that bleeding is likely secondary to endometrial atrophy.
The acceptable range of endometrial thickness is less well established in this group cut off values of 8 11 mm have been suggested. The rsna also state that in healthy postmenopausal people the endometrium typically measures about 5 mm or less. If you re close to reaching menopause but still have occasional vaginal bleeding the average stripe is less than 5 mm thick.
If an endometrial thickness of 8 mm is considered abnormal 0 9 of women without cancer and without bleeding and 12 of women without cancer and with bleeding will have endometrial measurements above this threshold and 95 of women with cancer will have endometrial measurements above this threshold. To determine at what endometrial thickness biopsy would be optimal michelle louie md and colleagues from magee women s hospital in pittsburgh pennsylvania performed a retrospective cohort analysis of postmenopausal women aged 50 or older who underwent transvaginal ultrasound tvus for indications other than vaginal bleeding. Endometrial thickness must be evaluated together with endometrial morphology as well as risk factors for malignancy when considering endometrial sampling.
The diagnosis is straight forward and be picked up in early stage when postmenopausal women present with bleeding. The algorithm for working up postmenopausal women undergoing hormone replacement therapy follows similar reasoning using endovaginal sonography as the first line screening technique for endometrial cancer. The risk of carcinoma is 7 if the endometrium is 5 mm and 0 07 if the endometrium is 5 mm 8.
Confirmation may be done using endometrial biopsy. How to measure ultrasound is the most common way to measure the thickness of the. In the largest analysis to date looking at the extent to which vaginal bleeding is associated with endometrial cancer in women who have gone through menopause 90 of women diagnosed with endometrial cancer reported bleeding before their cancer diagnosis approximately 9 of postmenopausal women who saw a doctor for bleeding later received a diagnosis of endometrial cancer.
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