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Avicenna Journal of Health Sciences
By Fareeha Khaliq Khan, Shahnilah Zafar, Aneeta Tajammul and 3 others.
Abnormal uterine bleeding is common during perimenopause and may reflect functional, structural, premalignant, or malignant endometrial changes. Histopathological assessment is important for identifying endometrial pathology.
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To determine the histopathological spectrum of endometrial changes in perimenopausal women with abnormal uterine bleeding and assess its association with age and selected clinical and diagnostic characteristics.
This descriptive cross-sectional study included 300 consecutive women aged 40–55 years at Fatima Memorial Hospital, Lahore, from 20thJanuary 2026 to 20th July 2026. Clinical assessment, complete blood count, coagulation profile, pelvic ultrasonography, and endometrial sampling by dilatation and curettage, Pipelle biopsy, or hysteroscopy-guided biopsy were performed. Histopathological findings were analyzed using IBM SPSS Statistics version 26.0; p<0.05 was considered significant.
Mean age was 48.31±4.89 years; 217 (72.3%) women were older than 45 years. Irregular bleeding occurred in 141 (47.0%) and heavy menstrual bleeding in 113 (37.7%). Secretory endometrium was the commonest diagnosis (99, 33.0%), followed by endometrial polyp (60, 20.0%), disordered proliferative endometrium (45, 15.0%), chronic endometritis (44, 14.7%), hyperplasia without atypia (29, 9.7%), and carcinoma (12, 4.0%). Histopathological patterns were not significantly associated with age group (p=0.539), but were associated with ultrasonographic findings and biopsy method (both p<0.001).
Benign and functional endometrial changes predominated, although hyperplasia and carcinoma were also identified. Histopathological evaluation remains important in perimenopausal abnormal uterine bleeding.
Published in Avicenna Journal of Health Sciences. The abstract is shown as published and remains the work of its authors; read the full article at the source.
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