A cross-sectional study of endometrial thickness in perimenopausal women with abnormal uterine bleeding by transvaginal sonography and relation with histopathology

Background: Perimenopause, marked by hormonal fluctuations, often presents with abnormal uterine bleeding (AUB), impacting women’s quality of life. Transvaginal sonography (TVS) offers a non-invasive method to assess endometrial thickness, while histopathology remains the gold standard for diagnosis. Correlating TVS findings with histopathology aids in early detection and targeted management of endometrial pathology. Aim: To evaluate the correlation between endometrial thickness by TVS and histopathology in perimenopausal women with AUB. Methods: This cross-sectional observational study was conducted at SMS Medical College, Jaipur, involving 40 perimenopausal women (40–55 years) with AUB. Endometrial thickness was measured using transvaginal ultrasonography and correlated with histopathological findings. Data were analyzed using appropriate statistical tests, with p < 0.05 considered significant. Ethical approval and informed consent were obtained prior to study initiation. Results: In this study of 40 perimenopausal women with AUB, mean age was 48.9 years and mean ET 10.25 mm. TVS (AUC = 0.924, cutoff 7.7 mm) showed 96.6% sensitivity and 75% specificity, outperforming HPE (AUC = 0.786). Irregular and heavy bleeding were most common. Conclusion: This cross-sectional study found a strong correlation between TVS-measured endometrial thickness and histopathology in perimenopausal AUB. TVS is a sensitive, non-invasive screening tool, but histopathology remains the gold standard. Endometrial thickness >7.7 mm warrants biopsy to detect hyperplasia or malignancy, aiding early diagnosis and reducing healthcare burden.