TRANSVAGINAL ULTRASONOGRAPHY AND THE PROGESTOGEN CHALLENGE TEST IN POSTMENOPAUSAL ENDOMETRIAL EVALUATION

Objective: To analyze the morphologic and ultrasonographic aspects of the endometrium of postmenopausal women according to the progestogen c hallenge test. Methods: The study was conducted on 150 postmenopausal women. Each patient was submitted to transvaginal ultrasonography for measurement of endometrial echo thickness and to endometrial biopsies, followed by the progestogen challenge test. Results: Women with a neg ative test presented atrophic endometrium in 94% of cases. The other 6 % have shown active endometrium, but none had hyperplasia. However, 56 % of the patients with a positive test had atrophic endometrium. There was a correlation between endometrial thickness less than 5 mm and en dometrial atrophy in patients with either positive or negative tests. Conclusion: Because the progestogen challenge test is cheap and easy t o deal with, it can be done as a primary screening method in asymptoma tic postmenopausal women. If the test is positive, ultrasonography is required in order to determine who needs a more accurate examination o f the endometrium. If the test is negative, ultrasonography is not req uired due to the great number of women who have atrophic endometrium. (C) 1997 International Federation of Gynecology and Obstetrics.