ENDOMETRIAL SAFETY DURING HORMONE REPLACEMENT THERAPY - COMPARISON OFTRANSVAGINAL SONOGRAPHY AND ENDOMETRIAL BIOPSY

This study compared transvaginal ultrasonography with histologic findi ngs in endometrial evaluation of postmenopausal women using hormone re placement therapy and evaluated the endometrial safety of three differ ent hormone replacement therapy regimens. Eighty-four postmenopausal w omen underwent transvaginal ultrasonography immediately before endomet rial biopsy and after 6 months. Endometrial safety was evaluated using (a) no therapy, (b) a vaginal ring, (c) tibolone, and (d) transdermal 17 beta-estradiol. Climacteric symptoms, bleeding pattern, and endome trial histologic features were studied. Endometrial evaluation was con veniently performed by transvaginal ultrasonography, and endometrial t hickness correlated well with biopsy findings. All treatment regimens effectively relieved climacteric symptoms. Endometrial proliferation w as not observed. If endometrial thickness was <5 mm, the endometrial b iopsy sample was classified as either inactive/atrophic or insufficien t for histopathologic diagnosis. All three hormone replacement therapi es were safe with respect to the endometrium. Using 5 mm endometrial t hickness as the cutoff point, more than 90% of biopsies could be avoid ed. The three regimens were effective in alleviating menopausal sympto ms.