Influence of Menopausal Status on Frequency and Pathohistological Features of Endometrial Hyperplasia and Carcinoma in Patients with Abnormal Uterine Bleeding

The aim of the study was to determine the frequency and pathohistological features of endometrial hyperplasia and carcinoma in premenopausal and postmenopausal patients with abnormal uterine bleeding (AUB). The frequency and pathohistological features of endometrial hyperplasia and carcinoma were investigated in 961 patients with AUB who underwent dilatation and curettage (D&C) between January and December 2006. Regarding the menopausal status, patients were divided into two groups: group of premenopausal patients (n=808) and group of postmenopausal patients (n=153). Endometrial hyperplasia was a significantly (p<0,05) more frequent cause of AUB in premenopausal patients (23,4%) than in postmenopausal patients (13,7%). AUB caused by endometrial carcinoma was significantly (p<0,001) more common in postmenopausal patients (18,9%) than in premenopausal patients (1,4%). Compared to the postmenopausal patients, endometrial hyperplasia without atypia was significantly (p<0,01) more frequent, while atypical hyperplasia was significantly (p<0,05) less frequent in premenopausal patients. In contrast to the premenopausal patients, endometrioid type and non-endometrioid type of endometrial carcinoma and carcinoma localized in endometrial polyp were significantly more common in postmenopausal patients (p<0,001, p<0,001, p<0,05, respectively). Endometrial hyperplasia (diffuse or localized to the polyp) is more frequent cause of AUB in premenopausal patients than in postmenopausal patents. Compared to the premenopausal patients, atypical hyperplasia and endometrial carcinoma are more frequent causes of AUB in postmenopausal patients. In contrast to the premenopause, there were higher risks for developing endometrioid type and non-endometrioid type of endometrial carcinoma and carcinoma localized in endometrial polyp in postmenopause. Acta Medica Medianae 2008;47(2):33-37.