Ultrasound determination of the effect of progestogens on the endometrium in postmenopausal women receiving hormone replacement therapy

Evaluation of postmenopausal endometrium

“…Meuwissen and colleagues observed that endometrial growth rates in response to unopposed estrogen varied among normal women but could reach a maximum of 0.2 mm/week 48 . They recorded a normal thickness of 4 mm before initiating estrogen-only treatment and then observed the endometrial response to treatment in order to manage it 49 . They biopsied women and treated them with progestins if the endometrium reached 8 mm in thickness, if they bled or after every 6 months of estrogen use.…”

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“…They recorded a normal thickness of 4 mm before initiating estrogen-only treatment and then observed the endometrial response to treatment in order to manage it 49 . They biopsied women and treated them with progestins if the endometrium reached 8 mm in thickness, if they bled or after every 6 months of estrogen use.…”

Comparação do ultra-som e da histeroscopia como metodo diagnostico para as doenças intra-uterinas

“…Outro autor observou que a espessura do endométrio varia de 4mm a 8mm na fase proliferativa e 8mm a 16mm na fase secretora (Fleischer et al, 1990). Na pós-menopausa, a espessura do endométrio deve ser inferior a 4mm ou 5mm (O´Connel et al, 1998;Ylostalo, 1990;Gupta et al, 2002) e durante o uso de terapia de reposição hormonal o endométrio pode medir até 8mm (Meuwissen et al, 1994). Quase todos os estudos realizados para avaliar a acurácia do exame ultra-sonográfico utilizaram como ponto de corte 4mm ou 5mm, limite abaixo do qual a possibilidade de se encontrar doença endometrial é extremamente baixa (Gupta et al, 2002).…”