Study Objective: To assess the frequency of intrauterine pathology among women with abnormal uterine bleeding (AUB) while taking hormone replacement therapy (HRT), and correlate pathology with clinical features.
Design: Retrospective review (Canadian Task Force classification II-2).
Setting: University teaching hospital-based outpatient clinic.
Patients: Ninety-nine women.
Intervention: Observational evaluation.
Measurements And Main Results: Intrauterine pathology was found in 16 (18.6%) of 99 women with AUB. The frequency was 4 times higher in those with AUB after achieving amenorrhea with a continuous combined regimen of HRT than in those with AUB with only 6 months of HRT. It was also higher in patients taking a continuous combined regimen in whom AUB lasted for more than 6 months.
Conclusion: Hysteroscopic examination with endometrial sampling is recommended if AUB continues after the first 6 months of HRT or if it occurs after a period of amenorrhea.
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