Transvaginal ultrasonography of women not on estrogen replacement therapy

1. Transvaginal ultrasonography (TVUS) has been used to select postmenopausal women with abnormal uterine bleeding not on estrogen-replacement therapy (ERT) who are at highest risk of having endometrial hyperplasia/cancer.

2. Endometrial biopsy is required for histological diagnosis if the stripe is >4 mm and in women with persistent bleeding. Persistent bleeding is worrisome even when the endometrial thickness is <4 mm, particularly if there are other risk factors for endometrial cancer.

E. Transvaginal ultrasonography in women on ERT. TVUS is not a useful screening tool for excluding endometrial hyperplasia/cancer in women on estrogen-replacement therapy that is given with cyclic progesterone.

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