Histopathological correlation of abnormal uterine bleeding in perimenopausal women

Deepika Verma, Abhyudaya Verma


Background: Abnormal uterine bleeding (AUB) is one of the commonest conditions for which patients seek advice in the gynaecology outpatient department. The objective of this study was to evaluate various histopathological features in endometrial curetting’s of patients above 40 years of age, complaining of abnormal uterine bleeding (AUB) and correlating them with clinical presentations.

Methods: A total of 100 endometrial curetting’s were obtained by dilatation and curettage done at the department of gynecology and obstetrics, Mamatha Medical College, Khammam, Telangana, India.

Results: Out of 100 cases studied, menorrhagia (57%) was the commonest clinical condition. Hyperplastic (48%) change was the commonest endometrial change, followed by proliferative change (18%). Hyperplasia when further categorized showed simple hyperplasia as the dominant sub-type. Hyperplasia was the dominant change observed in menorrhagia, polymenorrhoea, metrorrhagia, and post-menopausal bleeding.

Conclusions: Menorrhagia was the leading cause of AUB. Hyperplastic endometrium was the most common histopathological finding, with simple hyperplasia being commonest sub-type. Hyperplasia is also commonest endometrial pattern seen in patients with menorrhagia. AUB occurring at perimenopausal age is alarming and needs thorough evaluation, as it could be the only clinical manifestation of endometrial cancer, as was noticed in this study.


Histopathology, AUB, Endometrium, Perimenopausal women

Full Text:



Munro MG. Abnormal uterine bleeding in the reproductive years: pathogenesis and clinical investigations. J Am Assoc Gynecol lapros. 1999;6:393-416.

Ghani NA, Razak AA, Abdullah EM. Abnormal uterine bleeding: a histopathological study. World Research Journal of Clinical Pathology. 2012:1(1);06-08.

Telner DE, Jakubovicz D. Approach to diagnosis and management of abnormal uterine bleeding. Can Family Physician. 2007;53:58-64.

Annigeri C, Katti T, Karaddi S. Histopathological spectrum of endometrium in dysfuctional uterine bleeding with respect to age, parity and bleeding pattern. BMR Med. 2014;1:1-12.

Gupta A, Rathore AM, Manaktala U, Rudingwa P. Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women. Int J Biomed Adv Res. 2013;4(8):509-13.

Oehler MK, Rees MC. Menorrhagia: an update. Acta Obstet Gynecol Scand. 2003;82:405-22.

Jairapuri ZS, Rana S, Jeteley S. Atypical uterine bleeding-histopathological audit of endometrium: a study of 638 cases. Al Ameen J Med Sci. 2013;6(1):21-8.

Yusuf NW, Nadeem R, Yusuf AW, Rahman R. Dysfunctional uterine bleeding. A retrospective clinic pathological study over 2 years. Pak J Obstet Gynaecol. 1996;9:27-30.

Moghal N. Diagnostic value of endometrial curettage in abnormal uterine bleeding: a histopathological study. J Pak Med Assoc. 1997;47:295-9.

Sutherland AM. Functional uterine haemorrhage: a critical review of the literature since 1938. Glasgow Med J. 1949;30:1-28.

Shrestha S, Sigdel B. Study of endometrial status of patients with abnormal uterine bleeding in patan hospital. J Coll Med Sci. 2013;9(2):20-4.

Ørbo A, Arnes M, Hancke C, Vereide A, Pettersen I, Larsen K. Treatment results of endometrial hyperplasia after prospective D-score classification: a follow-up study comparing effect of LNG-IUD and oral progestins versus observation only. Gynecol Oncol. 2008;111(1):68-73.