Change in endometrial thickness in postmenopausal women undergoing hormone replacement therapy.

Levine, Deborah; Gosink, Barbara B.; Johnson, Lynn

doi:10.1148/radiology.197.3.7480726

Cited by 99 publications

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“…Levine and coworkers reported a patient on CCT with an ET of 8 mm who was found to have atrophy on biopsy. 4 Four women receiving Kliofem with ET values ranging from 9 to 15 mm showed either pseudodecidual change or atrophy with polyps or a fibroid. 3 Of further note is the report that the SERM agent idoxifene induced an ET of 5 mm or greater in 16% of subjects over the course of 12 weeks, but histologic features were unremarkable.…”

Section: Discussionmentioning

confidence: 93%

“…The endometrium does not appear to change with time on treatment with opposed therapy. Histologically the endometrium did not show a tendency toward hyperplasia with time in younger women taking 2 mg 17 β-estradiol plus 1 mg norethindrone (norethisterone), 3 although a suggestion of increasing thickness with time was noted with sequential therapy 4 ; however, the effect of low dose CCT, e.g., 300 µg conjugated equine estrogens or 25 µg Estraderm patch (Ciba Consumer Pharmaceuticals, Woodbridge, NJ), on ET over the long term remains to be studied. The effect of age as a factor in determining endometrial response has been investigated infrequently, but one study of ET found no relation between ET and either weight or age.…”

Section: Ilona Wanda Chantler Mb Chb Michael William John Davie Mmentioning

confidence: 96%

“…ET in patients on CCT may be lower than in those on sequential HRT and be close to the thickness in those taking no hormones, 6 although the range of thickness may be similar. 4 It has been suggested that conventional CCT dosages using conjugated equine estrogens do not exhibit a dose response effect, 7 but a lower rate of endometrial hyperplasia has been found in women taking 300 µg unopposed equine estrogens, 8 suggesting that low doses of estrogen might be less stimulatory to the endometrium. The endometrium does not appear to change with time on treatment with opposed therapy.…”

Section: Ilona Wanda Chantler Mb Chb Michael William John Davie Mmentioning

confidence: 99%

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Low dose continuous combined hormone replacement therapy: early and late postmenopausal effect on endometrium.

Chantler

Davie

2000

Journal of Ultrasound in Medicine

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We investigated endometrial response to low (25 microg through the skin estradiol plus 700 microg norethindrone) and standard dose (2 mg oral estradiol plus 1 mg norethindrone acetate or 700 microg norethindrone) continuous combined therapy in postmenopausal women with time and bone mineral density response. Endometrial thickness was distributed logarithmically, with the means after use of 25 microg estradiol (4.3 mm) and 2 mg estradiol (3.8 mm) being similar. Subjects studied 15.4 +/‐ 7.0 months apart showed a difference of endometrial thickness of ‐0.55 +/‐ 1.3 mm. Neither pretreatment bone mineral density nor change correlated with endometrial thickness. Age, estrogen dose, bone mineral density, weight, and time on treatment do not relate to endometrial thickness. A commonly regarded cutoff point for biopsy, an endometrial thickness of 8 mm, is about 1 SD greater than the mean.

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Section: Discussionmentioning

confidence: 93%

Section: Ilona Wanda Chantler Mb Chb Michael William John Davie Mmentioning

confidence: 96%

Section: Ilona Wanda Chantler Mb Chb Michael William John Davie Mmentioning

confidence: 99%

See 1 more Smart Citation

Low dose continuous combined hormone replacement therapy: early and late postmenopausal effect on endometrium.

Chantler

Davie

2000

Journal of Ultrasound in Medicine

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“…This measurement represented two layers of the endometrium (17) . In the presence of fluid in the endometrial canal, the two half thickness endometrial measurements were added together (18) .…”

Section: Methodsmentioning

confidence: 99%

Relation of progesterone and luteinizing hormone serum levels and Ultrasound endometrium criteria with intracytoplasmatic sperm injection outcome

2017

Evidence Based Women's Health Journal

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Background: Hormone levels (progesterone "P" and luteinizing hormone "LH) are vitally important to the proper functioning of the female reproductive cycle and together with Ultrasound assessment of endometrial receptivity may predict success of in vitro fertilization/ intracytoplasmatic sperm injection (IVF/ICSI). Objective: to study the effects of serum P and LH levels together with Ultrasound assessment of endometrial receptivity at the day of human chorionic gonadotrophin administration on fertilization and pregnancy rates. Patients and Methods: Thirty patients age ranged 22-38 years underwent ovarian stimulation using a gonadotrophinreleasing hormone (GnRH) agonist for pituitary down-regulation, and then ovarian hyperstimulation was initiated with highly purified human menopausal gonadotrophin (HMG). Final oocyte maturation was triggered 36 hours after human chorionic gonadotrophin (hCG) injection. On the day of hCG administration (Day 0), serum progesterone, LH levels together with Ultrasound assessment of endometrial receptivity (thickness, morphology and the spiral artery resistance index "RI") were evaluated. Fertilization and pregnancy rates were recorded. Results: There was no significant difference between the pregnant and non pregnant women, in respect to age. The pregnancy rate was not affected by the serum LH level but was only 18.75% in cycles in which serum P was more than 1.2 ng/ml on day 0, which was significantly lower than that in cycles in which serum P was less than 1.2 ng/ml on day 0 (64.28%) (P = 0.001). The fertilization rate was lower in the cycles with higher levels of serum P and/or LH than in cycles in which serum P was less than 1.2 ng/ml and serum LH was normal (51.66 vs. 68.85%). Failed cases had altered endometrium and a higher spiral artery RI (resistance index), meaning lower peri-implantation blood flow. Conclusion: This study concluded that the progesterone levels on the day of hCG administration (Day 0) can affect the success of in vitro fertilization, as higher progesterone levels were associated with lower rates of pregnancy and fertilization. Increase serum P level caused advanced endometrial maturation and impaired endometrial receptivity to embryo implantation. The embryo transfer (ET) in such cases can be canceled and freezing all embryos for future transfer must be considered, to increase acceptance of the endometrium and thus increase the success rate.

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“…Endometrial thickening is a non specific finding which is seen with secretory endometrium, estrogen therapy, early pregnancy, endometrial hyperplasia, polyps and endometrial carcinoma. Sub endometrial pathologic condition such as submucosal myoma and adenomyosis may also manifest as apparent endometrial thickening 3 . Abdominal or transvaginal sonography can identify thickened endometrium but unable to differentiate between potential etiologies of thickened endometrium like polyps, endometrial hyperplasia, submucous fibroid or endometrial carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Role of sonohysterography in evaluation of abnormally thickened endometrium causing abnormal uterine bleeding with histopathological correlation

Parveen

Azad

Mohammad

et al. 2014

Bangladesh Med Res Counc Bull

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This prospective randomized study was carried out in the department of Radiology and Imaging in collaboration with the department of Obstetrics and Gynecology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag and Dhaka Medical College Hospital (DMCH) during the period of January 2003 to December 2004. The aim of this study was to establish sonohyterography as a sensitive tool and superior to Transvaginal Sonography (TVS) for detection of endometrial pathology in women with abnormal uterine bleeding (AUB) and its validity by determining sensitivity, specificity, accuracy, positive predictive value and negative predictive value. For this purpose, a total number of 40 patients who had thickened endometrium (cut off level <15 mm for pre menopausal and <5 mm for post menopausal patients) detected on transabdominal or transvaginal sonography were selected. TVS and TV-SH were done in all these patients and findings were then compared with the final histopathological diagnosis. In our study, we found TV-SH has sensitivity of 100%, specificity of 80% and accuracy of 97.5 % compared to TVS (94 %, 66.66 % and 90 % respectively) in detection of endometrial pathology in women with AUB. TV-SH can thus be regarded as one of the most sensitive, specific and accurate modality in detecting and excluding endoluminal masses as the cause of AUB. It can be considered as the initial examination in the evaluation of all women with AUB.

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Change in endometrial thickness in postmenopausal women undergoing hormone replacement therapy.

Abstract: Women using sequential hormones show greater endometrial thickness than that in controls and show the most variation in measurements. They should undergo US either early or late in the hormone cycle to evaluate the endometrium at its thinnest.

Cited by 99 publications

References 0 publications

Low dose continuous combined hormone replacement therapy: early and late postmenopausal effect on endometrium.

Low dose continuous combined hormone replacement therapy: early and late postmenopausal effect on endometrium.

Relation of progesterone and luteinizing hormone serum levels and Ultrasound endometrium criteria with intracytoplasmatic sperm injection outcome

Role of sonohysterography in evaluation of abnormally thickened endometrium causing abnormal uterine bleeding with histopathological correlation

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