When should gynecologist perform endometrial biopsy in patient with menometrorrhagia or postmenopausal vaginal bleeding?


  • Cihan Comba

Received Date: 07.05.2018 Accepted Date: 18.05.2018 Med J Bakirkoy 2018;14(2):242-246


To compare endometrial biopsy results in patients with postmenopausal bleeding or menometrorrhagia.

Material and Methods:

A retrospective analysis of endometrial biopsies conducted by a single physician for diagnostic purposes in symptomatic patients at Yozgat Sorgun State Hospital between January 2015 and June 2016 was performed.


The results of 128 patients were evaluated. The mean age of 14 menopausal patients and 114 premenopausal women were 56.6±9.3 and 44.0±6.7, respectively. The endometrial thickness was statistically significantly thicker in premenopausal than postmenopausal patients. The most common pathologies in symptomatic premenopausal women were endometrial polyp and endometrial atrophy. In postmenopausal patients, normal pathologic result, endometrial polyp, cervical polyp was observed equally. Endometrium cancer has not been detected in any case.


The menstrual cycle normally lasts for 28±7 days. Vaginal bleeding occurs approximately 2-6 days. The amount of bleeding is circa 20-60 ml. Any deviation from these values is called menstrual disorders. Menometrorrhagia defines intermenstrual bleeding together with bleeding more than 80 ml per day and longer than six days with irregular intermittent characteristics. Menometrorrhagia can be a symptom of many different spectrum of diseases. These diseases may also change with aging. In particular, endometrium cancer may occur with this symptom. Menorrhagia can also be seen in cases such as endometrial polyps, endometrial hyperplasia, endometrial atrophy, endometritis, submucous myomas, adenomyosis, ovarian cysts andhemostasis diseases. Postmenopausal vaginal bleeding occurs after the ceasing of menstruation for one year. Endometrial atrophy, endometrial polyp, endometrium cancer, hormone replacement therapy, endometrial hyperplasia, other genital cancers may be the causes of postmenopausal bleeding. It is interesting that no case of cancer has been detected in our study. However, pathologies such as endometrial polyps, endometrial hyperplasia, and cervical polyps were detected and treated at the same time. Endometrial biopsy in symptomatic pre- and postmenopausal patients is effective not only in cancer diagnosis but also in the diagnosis and treatment of benign conditions.

Keywords: Endometrial biopsy, endometrium cancer, endometrial polyp, endometrial hyperplasia