FACTORS INFLUENCING THE PRESENCE OF UTERINE CAVITY FLUID IN A RANDOM SAMPLE OF ASYMPTOMATIC POSTMENOPAUSAL WOMEN

Aims. To assess possible endometrial pathology and other factors influ encing the presence of uterine cavity fluid in postmenopausal women. S tudy design. A random sample of 559 asymptomatic postmenopausal women, recruited from the total population, were examined by transvaginal so nography (TVS) for the presence of uterine cavity fluid. Women with ut erine cavity fluid who had an endometrial thickness of greater than or equal to 8 mm (including fluid) were admitted for hysteroscopy and a dilatation and curettage (D & C), and those with <8 mm underwent a new TVS examination one year later. A medical history, including details regarding previous minor gynecological surgery, was taken from the wom en and from an age-matched control-group of women from the same popula tion. Results. Uterine cavity fluid was found in 8.9% (50/559) of the women. In four women with an endometrium measuring greater than or equ al to 8 mm, curettage revealed polyps in three women and atrophy with a pyometra in one woman. At the one-year follow-up, 22 women who origi nally had an endometrial thickness <8 mm had an endometrial thickness of <5 mm; 11 women had no cavity fluid and in the remaining 11 the cav ity fluid had decreased. In 17 women, endometrial thickness measured g reater than or equal to 5 mm and subsequent histology showed 11 endome trial biopsies with atrophy, four endometrial polyps and two cervical polyps. The prevalence of uterine cavity fluid increased with increasi ng age (p<0.0001) and was increased in smokers (p<0.013) but was unalt ered by the presence or absence of hormone replacement therapy (HRT). Conclusion. There were no indications that uterine cavity fluid was as sociated with malignancy. The prevalence of uterine cavity fluid incre ased with increasing age and was higher in smokers. We could not demon strate an increased prevalence of fluid in HRT-users.