The hyperaemic endometrium at hysteroscopy.

Five hundred and thirty seven hysteroscopies were performed on 523 patients. In 37 cases, diffuse hyperaemia was the only abnormality found. Directed biopsy or dilatation and curettage (D&C) was performed on 28 of these, none of which revealed histological abnormalities. The hysteroscopically visualized hyperaemic endometrium was detected in all phases of the menstrual cycle, in the postmenopausal state and in patients on hormonal therapy. In the absence of excessive thickness of the endometrium or other abnormalities, hyperaemia was not found in increased association with organic uterine pathology. The results suggest that hysteroscopy and directed biopsy of hyperaemic areas is adequate and may replace D&C as a first line of investigation.