Clinical and morphological features of endometrial pathologies during the perimenopausal period

BACKGROUND: Disorders leading to pathological (most commonly, hyperplastic) processes in the endometrium often occur during the perimenopausal period, in addition to the natural changes associated with a physiological decrease in the function of hormone-producing and hormone-dependent organs.

AIM: This study aimed to investigate the clinical and morphological features of endometrial pathological processes during the perimenopausal period.

MATERIALS AND METHODS: We examined 73 perimenopausal women with various endometrial pathologies. The mean age of the examined patients was 47.8±0.3 (45–51) years. All patients with perimenopausal endometrial pathologies underwent clinical, functional, endoscopic, and morphological examination.

RESULTS: Endometrial polyps, endometrial hyperplasia, chronic endometritis, and endometrial adenocarcinoma were present in 54.8%, 30.1%, 12.4%, and 2.7% of perimenopausal patients examined, respectively.

The most common clinical manifestations of endometrial pathologies in the perimenopause were polymenorrhea, acyclic menorrhagia, and menorrhagia in 42.4%, 39.7%, and 27.4% of patients, respectively. Moreover, a glandular fibrous endometrial polyp was diagnosed in 61.3% of patients with polymenorrhea and 50% of patients with acyclic bloody discharge and menorrhagia.

CONCLUSIONS: The revealed variety of clinical signs, including their absence in some cases, as well as the diversity of hysteroscopic and morphological endometrial pathologies in perimenopausal women, up to the detection of endometrial cancer, confirmed the need for both ultrasound screening and mandatory hysteroscopy with separate diagnostic endometrial curettage in echo signs of intrauterine pathologies for timely diagnosis and adequate treatment.