Volume 4, Issue 6, November 2016, Page: 38-43
Management of Proliferative Endometrium on Biopsy in Post-Menopausal Women
Sidharth Srinivas, Manchester Medical School, University of Manchester, Manchester, United Kingdom
Sachchidananda Maiti, Obstetrics & Gynaecology, The Pennine Acute NHS Hospitals, Crumpsall, United Kingdom
Perunkulam Jothilakshmi, Obstetrics & Gynaecology, The Pennine Acute NHS Hospitals, Crumpsall, United Kingdom
Received: Sep. 4, 2016;       Accepted: Sep. 21, 2016;       Published: Oct. 15, 2016
DOI: 10.11648/j.jgo.20160406.12      View  7396      Downloads  169
Post-menopausal bleeding (PMB) is usually caused by several endometrial conditions (hyperplasia and carcinoma) for which there are evidence-based treatments. However, there is little literature and no evidence-based treatments for a finding of proliferative endometrium without atypia on Pipelle endometrial biopsy in women presenting with PMB. Our aim is to explore management and treatment options for this subset of women. This is a retrospective, observational case series review of women presenting with PMB to a gynaecology rapid access clinic at a District General Hospital in Manchester, UK over a period of three weeks. Four women who were found to have a proliferative or secretory endometrium on endometrial Pipelle biopsy were chosen. Their history, examination findings, investigations, treatment and follow-up findings were then analysed. This case series has identified the management dilemma posed by patients with proliferative endometrium with no atypia on endometrial sampling. The four patients were followed-up with a repeat Pipelle endometrial biopsy six weeks after presentation to the specialist gynaecology unit. They were subsequently counselled or treated with oral progesterone therapy for six to eight weeks. The management options included the Mirena intrauterine system (IUS), oral progesterone therapy and discharging the patient back to primary care. There is no consensus on the importance of oral progesterone or the duration of follow up necessary to monitor for the development of endometrial hyperplasia or cancer in this subset of patients. Further research is needed to develop evidence-based, management guidelines for proliferative endometrium in women with PMB.
Post-Menopausal Bleeding, Proliferative Endometrium Without Atypia, Progesterone Therapy
To cite this article
Sidharth Srinivas, Sachchidananda Maiti, Perunkulam Jothilakshmi, Management of Proliferative Endometrium on Biopsy in Post-Menopausal Women, Journal of Gynecology and Obstetrics. Vol. 4, No. 6, 2016, pp. 38-43. doi: 10.11648/j.jgo.20160406.12
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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