Endometrial atrophy

Atrophy of the endometrium is often a physiological postmenopausal phenomenon where it is more specifically termed postmenopausal endometrial atrophy

Clinical presentation

While most patients are asymptomatic, it is one of the commonest cause of postmenopausal bleeding, accounting for approximately 60-75% of cases 1). 


Often the atrophic endometrium is associated with cystic dilatation of glands where it is then termed endometrial cystic atrophy 4.

Other factors that can cause endometrial atrophy include

  • prolonged oral contraception
  • hypo-oestrogenic state: ovarian dysfunction
  • Tamoxifen use

Radiographic features


Tthe endometrial thickness should measure:

  • <4-5 mm on a transvaginal ultrasound scan

The uterine body to cervix ratio will also tend to decrease and may approach 1:1.


May again demonstrate a decrease in endometrial thickness similar to that observed with ultrasound. The junctional zone may no longer be evident. 

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