Prevalence and clinical predictors of endometrial hyperplasiain anovulatory women presenting with amenorrhea

Abstract

The aim of the present study was to determine the prevalence and clinical predictors of endometrial hyperplasia (EH) in amenorrheic women with anovulation. Fifty-seven women were enrolled in the study. Of these, 43 were diagnosed to have polycystic ovary syndrome (PCOS) and 14 to have idiopathic anovulation. All women received transvaginal sonography to assess endometrial thickness (ET), patterns and abnormalities. At the same time, an endometrial biopsy was taken using a Pipelle instrument. The women's age, body mass index (BMI) and waist-to-hip ratio (WHR) were 32.0+/-6.0 years, 27.3+/-6.5 kg/m(2) and 0.82+/-0.06 (mean+/-standard deviation), respectively. Twenty (35.1%) and 19 (33.3%) women were classified as obese by BMI and WHR, respectively. Hypertension was found in 17 (29.8%) women. The prevalence of EH was 45.6%. Most cases were simple EH, and only one (1.75%) was simple EH with atypia. EH prevalence was 48.8% and 35.7% in PCOS and idiopathic anovulatory women, respectively. Age, BMI, WHR and ET did not predict EH, whereas the endometrial hyperechogenic pattern was a clinical predictor of EH with borderline significance. In conclusion, this study demonstrated that almost half of the anovulatory women with amenorrhea had EH and no significant predictor was found. In view of these findings, an endometrial biopsy should be performed in all women with this disorder.

Endometrial thickness predicts endometrial hyperplasia in patients with polycystic ovary syndrome

“…Our sample of young premenopausal obese patients with PCOS had a 30% rate of endometrial hyperplasia by biopsy, within the reported range of 12%-49% (3)(4)(5). Consistent with others, we noted that simple hyperplasia predominates, but complex and atypical histologies do occur (3)(4)(5).…”

“…Consistent with others, we noted that simple hyperplasia predominates, but complex and atypical histologies do occur (3)(4)(5). Atypia obviously raises the most concern, with 27.5% risk of progression to carcinoma over 20 years (10).…”

“…Risks of cancer include irregular cycles, hypertension, polycystic ovaries, obesity, nulliparity, and diabetes (5,7,8). It is hypothesized that chronic inflammation such as that observed with unopposed estrogens, anovulation, and PCOS may be involved in the pathogenesis of endometrial cancer (9).…”

Evaluation of Endometrial Precancerous Lesions in Postmenopausal Obese Women - A High Risk Group?

“…Anthony P et al (2001) and Tingthanatikul Y et al (2006) investigated EH in patients with PCOS in other words they investigated endometrial hyperplasia in risky population. The ET on ultrasound correlates positively with EH.…”

“…In view of these findings, an endometrial biopsy should be performed in all women with PCOS (Tingthanatikul et al, 2006). Viola et al, (2008) investigated 12 postmenopausal obese patients and hyperplasia was found 6 of 12 patients (50%) in their study group.…”