Interpretation of Genital Tract Bleeding and Increased Endometrial Thickness in Postmenopausal Women: A Clinical and Histopathological Study

Background and aim: The present study aims to the causes of genital tract bleeding and increased endometrial thickness in postmenopausal women, their clinical presentation, and histopathological changes.
Material and methods: A Prospective study performed over one and half years from January 2021 to June 2022, including 70 postmenopausal women coming to the gynaecology out patient department (OPD) with complaints of genital tract bleeding and having increased endometrial thickness in ultrasound (USG) have taken into the study. Clinical examination, blood investigations, radiological imaging, pap smear, and endometrial biopsy were done.
Results: Among the 70 study subjects, the most common clinical presentation was postmenopausal bleeding in 63 (90%) women, and the commonest USG finding was the increased endometrial thickness > 4 mm in 56 (80%) women. The histopathological analysis showed proliferative endometrium in 21 (30.5%) women, secretory endometrium in 9 (12.9%) women, endocervicitis in 8 (11.5%) women, atrophic endometrium in 7 (10%) women, cystic glandular hyperplasia in 6 (8.6%) women, cervical malignancy in 6 (8.6%) women, endometrial hyperplasia with atypia in 5 (7.2%) women, endometrial polyp in 3 (4.2%) women and endometrial malignancy in 3 (4.2%) women and cervical polyp in 2 (2.8%) women.
Conclusions: Genital tract bleeding and increased endometrial thickness are abnormal findings in postmenopausal women, which need a thorough evaluation using history taking, clinical examination, and investigations to eliminate the possibility of malignancy as early as possible.