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Endometrial atrophy

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

Clinical presentation

While most patients are asymptomatic, It is one of the commonest cause of post menopausal bleeding, accounting for approximately 75% of cases 1). 

Pathology

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

Ultrasound

To be considered atrophic, the endometrial thickness should measure less than 4 - 5 mm on a transvaginal ultrasound scan. The uterine body to cervix ratio will also tend to decrease and may approach 1 : 1.

MRI

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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