Transvaginal sonography and progesterone challenge for identifying endometrial pathology in postmenopausal women

Abstract

OBJECTIVE: To evaluate the usefulness of transvaginal sonographic (TVS) measurement of endometrial thickness combined with a progesterone challenge test (PCT) for identifying endometrial pathology in postmenopausal women. METHODS: Two hundred eighty-four postmenopausal women were examined by TVS: 130 asymptomatic women (group A) and 154 with uterine bleeding (group B). Endometrial thickness > 5 mm was considered pathological. All women with abnormal endometrium from group A underwent PCT. All women from group B underwent D&C. RESULTS: Thirty women with a positive PCT underwent D&C. There was no endometrial cancer. One hundred seven patients from group B had abnormal sonographic and histologic findings: benign (hyperplasia, polyp) or malign (endometrial cancer). There was no cancer in cases with endometrial thickness < or = 6 mm. The sensitivity, specificity and accuracy of TVS for detecting endometrial pathology were 99%, 89% and 96% if the cut-off limit of 5 mm was used. CONCLUSION: TVS combined with PCT is a simple, well-tolerated, safe and reliable method for identifying endometrial pathology in postmenopausal women.