ORIGINAL ARTICLES   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2000 June;159(3):83-8

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Correlation between endometrial histological and ultrasonography aspects during Hormone Replacement Therapy (HRT)

Camilli A., Camilli F. M., Di Benedetto L.

Università degli Studi di Roma «La Sapienza» - Roma, II Istituto di Clinica Ostetrica e Ginecologica

Background. The growing use of HRT calls for the development of simple repeatable and non-invasive monitoring methods. Pelvic scan using an endovaginal probe is proposed as an initial method used to monitor endometrial effects. The aim of this study was to evaluate the correlations between endometrial ultrasonographic and histological findings and HRT using various progestin associations (administered orally) and estradiol administered using transdermal systems based on different release methods.
Methods. Forty menopausal patients without contraindications for HRT, underwent pelvic ultrasonography using an endovaginal probe and an endometrial histological test before starting sequential cyclic treatment with oral progestins (MAP dydrogesterone or nomegestrol at the doses recommended in the literature) and estradiol using transdermal administration (reservoir system containing alcohol or matrix system). Twelve months after the start of treatment control tests were performed during the week of suspension and during the third week of treatment (endometrial histological analysis). The parameters in question were analysed before and during treatment using Student’s “t”-test for paired data.
Results. Endometrial thickness in one patient was >5 mm and histological analysis revealed hyperplasia; endometrial thickness was <5 mm in the other 39 patients and histological tests confirmed endometrial secretion in line with the phase of treatment. The difference between the mean values of endometrial thickness measured before and during treatment was not statistically significant (p=0.30).
Conclusions. No specific ultrasonographic pattern was found for each of the treatment protocols used in this study. However the authors confirm the good correlation between endometrial thickness measured using ultrasonography and the histological analysis. This emphasizes the value of pelvic ultrasonography using an endovaginal probe as an instrument for monitoring endometrial growth in women receiving HRT.