Skip Navigation LinksHome > April 2011 - Volume 18 - Issue 4 > Significance of incidentally thick endometrial echo on trans...
Menopause:
doi: 10.1097/gme.0b013e31820ad00b
Special Section: Causality, Diagnosis & Management of Abnormal Uterine Bleeding

Significance of incidentally thick endometrial echo on transvaginal ultrasound in postmenopausal women

Goldstein, Steven R. MD, FACOG, NCMP, CCD

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Abstract

Postmenopausal bleeding is "cancer until proven otherwise." A thin distinct endometrial echo on transvaginal ultrasound has a risk of malignancy of 1 in 917 and does not require an endometrial biopsy. If the endometrial echo is poorly visualized, then in such women, saline infusion sonohysterography is an appropriate next step. The prevalence of asymptomatic endometrial thickening (mostly due to inactive polyps) is high, approximately 10% to 17% of postmenopausal women. The risk of malignancy in such polyps is low (approximately 0.1%), and in structures that mimic polyps, it is also low (0.3%). The incidence of serious complications from an operative intervention in such postmenopausal women is not insignificant (1.3%-3.6%). Thus, automatic intervention in such women, without any high-risk status, is not warranted.

©2011The North American Menopause Society

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