HYSTEROSCOPY AND TRANSVAGINAL SONOGRAPHY IN MENOPAUSAL WOMEN RECEIVING HORMONE REPLACEMENT THERAPY

Study Objective, To evaluate the endometrial cavity of menopausal wome n with irregular bleeding while receiving hormone replacement therapy. Design, Comparative evaluation oi hysteroscopic and biopsy findings. Setting. A center for reproductive studies. Patients. Forty-one patien ts receiving different regimens oi hormone replacement therapy. Interv entions. Hysteroscopy, endometrial biopsy, and transvaginal sonography were performed in all 41 women. In 10 patients, endometrial polyps we re removed with the resectoscope. Measurements and Main Results, Irreg ular bleeding during hormone replacement therapy was associated with a trophic endometrium whenever transvaginal sonography showed endometria l thickness to be less than 4 mm. In patients who developed increased endometrial thickness after hormone replacement therapy, hysteroscopy revealed the presence of endometrial polyps in the uterine cavity. His topathologic examination of excised polyps revealed cystic or adenomat ous hyperplasia confined to these lesions. Conclusions, Endometrial po lyps can appear in menopausal women receiving hormone replacement ther apy despite the presence of progestins to oppose the action of estroge ns.