Ultrasonic thickness of the endometrium correlated to body weight in asymptomatic postmenopausal women

OBJECTIVE: To estimate the prevalence and significance of an endometrial thickness of 5 mm or greater measured by ultrasound in postmenopausal women without vaginal bleeding. METHODS: Three hundred asymptomatic postmenopausal women scheduled for cervical cancer screening were also examined by transvaginal ultrasound. When the endometrium was 5 mm thick or greater, ultrasound was repeated every third month. Curettage was performed at the end of the study or if endometrial growth or vaginal bleeding occurred. RESULTS: The mean (+/- standard deviation) endometrial thickness was 2.3 +/- 1.8 mm (range 0-10). In women with endometrium measuring less than 5 mm, the endometrial thickness correlated to body weight. The endometrium measured 5 mm or more in 22 women, who were followed with ultrasound for 1-25 months. Body weight and body mass index (BMI) were higher in women with a thick endometrium. Serum levels of estrone, estradiol, FSH, and LH differed from those in women with normal ultrasound findings. Curettage revealed no case of malignancy. Fourteen cases of benign ovarian lesions were also diagnosed, and only one case of pelvic fluid was found (in a patient with liver cirrhosis). CONCLUSION: The prevalence of a thick endometrium was high in asymptomatic women, and endometrial thickness correlated with BMI.