ASSESSMENT OF ASYMPTOMATIC ENDOMETRIAL THICKNESS IN POSTMENOPAUSAL WOMEN AND THOSE WITH MEDICAL DISORDERS AT UNIVERSITY OF ILORIN TEACHING HOSPITAL
Background: Menopause is the time when permanent cessation of menstruation occurs due to loss of ovarian activities. Postmenopausal asymptomatic endometrial thickening is an endometrial thickness of ˃5mm in the absence of bleeding per vaginal. There is a strongassociation between endometrial thickness and endometrial disease. Factors influencing endometrial thickness includes parity, postmenopausal years, body mass index and medical illness. These factors exert their influence on the endometrium and resultant chaanges may be picked by transvaginal scan.
Aim: This study assessed asymptomatic endometrial thickness in postmenopausal women and those with medical disorders at the University of Ilorin Teaching Hospital, Ilorin using transvaginal scan.
Objectives: The objectives of the study were to determine the endometrial thickness among asymptomatic postmenopausal women attending selected out-patient clinics at the UITH, relationship between body mass index and asymptomatic endometrial thickness among postmenopausal women and endometrial thickness in postmenopausal women with diabetes and hypertension.
Methods: The study was conducted in the Department of Obstetrics and Gynaecology and other out-patient clinics of the University of Ilorin Teaching Hospital. It was carried out among asymptomatic postmenopausal women who attended the gynaecological, endocrinology, cardiology and general out-patient clinics. It was hospital-based, cross- sectional descriptive study. Participant selection was based on purposive non-probability sampling on the set inclusion criteria. A study proforma sheet was used to obtain information
on age, parity, age at menopause, postmenopausal years and associated medical illnesses. Anthropometric measurements were taken and body mass index was calculated. Theparticipants’ blood pressure was measured using a mercury sphygmomanometer and the blood glucose levels using a standardised glucometer. The endometrial thickness was measured using a tranvaginal scan and women with abnormally thickened endometrium were counselled on endometrial biopsy for histo-pathological diagnosis and subsequently referred to the Gynaecology clinic for further investigations and definitive management. Descriptive analysis was performed using SPSS software version 23. The results were presented in tables and charts. P – Value was set as 0.05 as the level of significance.
Results: The mean age of participants was 64.90 years ± 8.20 and their mean age at menopause was 48.65years ± 2.67. The mean (SD) of postmenopausal years was 15.65 (6.69) years. There was a documented increase in the mean values of endometrial thickness for participants with the hypertension; 2.82mm ± 4.07 and DM; 2.27mm ± 1.08 when compared with those with no medical disorder; 1.42mm ± 1.16 and this was statistically significant with p values 0f 0.026 and 0.005 respectively while duration of medical illness showed no statistical significant relationship with endometrial thickness. Endometrial thickness of participants increased as BMI increased though not statistically significant. There was an inverse relationship between duration of menopause, parity and endometrial thickness and this was statistically significant (p values = 0.048 and 0.005).
Conclusion: This study suggests that parity, duration of menopause, presence of hypertension and diabetes mellitus are related to asymptomatic endometrial thickness in postmenopausal women.
Recommendation: Postmenopausal asymptomatic endometrial thickening should be evaluated on a case-by-case basis and risk factors for endometrial cancer including diabetes mellitus and hypertension should be considered in decision making.