Hysteroscopic Evaluation of Postmenopausal Bleeding

Khalidah Mohammed Amin

doi:10.54133/ajms.v9i2.2360

Authors

Khalidah Mohammed Amin Department of Gynecology and Obstetrics, College of Medicine, University of Kirkuk, Kirkuk, Iraq

DOI:

https://doi.org/10.54133/ajms.v9i2.2360

Keywords:

Hysteroscopy, Histopathology, Postmenopausal bleeding

Abstract

Background: Postmenopausal bleeding (PMB) is a common gynecological condition presented to national health institutes, and assessing the exact reason for postmenopausal bleeding is essential to detect the emergency status and to plan appropriately for management. For that, diagnostic technology is crucial in PMB. Hysteroscopy has proven to be a useful tool in visualizing and identifying common causes of PMB. Objective: To evaluate the role of hysteroscopy in identifying the most common causes of PMB and correlate clinically with histopathological findings. Methods: A cross-sectional study was conducted in the period from March 1, 2019, to February 28, 2025, involving 80 women with symptomatic ongoing postmenopausal bleeding who had been referred to hysteroscopy. Information was gathered from patient-based questionnaires, in addition to hysteroscopy and histopathology findings. Results: Most women were aged 50–59 years (51.2%), had a parity of ≥5 (62.5%), were overweight or obese (86.3%), and had been menopausal for ≤10 years (51.2%). Hysteroscopy detected abnormalities in 97.5% of cases. Histopathology confirmed abnormal findings comprising polyps (36.3%), hyperplasia (18.7%), submucous fibroids (16.3%), atrophic endometrium (15%), and endometrial adenocarcinoma (10%). Increased age was significantly associated with malignant lesions (p<0.001). Hysteroscopy showed high diagnostic accuracy for endometrial polyps (98.7%), submucous myoma (100%), atrophic endometrium (93.7%), and irregular growth (97.5%), but lower accuracy for polypoidal endometrium (71.2%). Conclusions: Hysteroscopy is a reliable and useful tool in visualizing the causes of postmenopausal bleeding and has shown that endometrial polyps are the most common cause of PMB.

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