Endometrial atrophy

Dr Vincent Tatco and Radswiki et al.

Endometrial atrophy is a response to a hypo-oestrogenic state. If it occurs after menopause it can be more specifically termed postmenopausal endometrial atrophy

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

The most common reason for a hypo-oestrogenic state is menopause. Other factors that can cause endometrial atrophy include

The 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.

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

Similar to ultrasound, there is a decrease in endometrial thickness. The junctional zone may no longer be evident. 

If there is cystic dilatation of the endometrial glands, this can be confused for endometrial polyp or endometrial hyperplasia.

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Article information

rID: 13049
System: Gynaecology
Section: Pathology
Synonyms or Alternate Spellings:
  • Atrophy of the endometrium
  • Postmenopausal endometrial atrophy
  • Post-menopausal endometrial atrophy

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