Wirun Thongchumnum1, Sakda Arj-Ong Vallibhakara2,3, Areepan Sophonsritsuk4 and Orawin Vallibhakara4*
1Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi
Hospital, Mahidol University, Bangkok, Thailand
2ASEAN Institute for Health Development (AiHD), Mahidol University, Nakhon Pathom, Thailand
3Department of Clinical Epidermiology and Biostatistcs, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
4Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
*Corresponding Author: Orawin Vallibhakara, Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Received: June 15, 2020; Published: July 31, 2020
Objectives: To determine the etiologies, patterns of bleeding and the associated factors of endometrial hyperplasia and cancer in perimenopausal women.
Methods: A cross-sectional research approach was used in this study. Women (n = 346) with perimenopausal abnormal uterine bleeding (AUB) visited the Department of Obstetrics and Gynecology, Ramathibodi Hospital, Mahidol University, Thailand, a tertiary medical school were enrolled in this study. Ethical clearance was obtained from the University’s human ethics committee. Data collection included history taking, pelvic examination, transvaginal sonography, and endometrial pathology. Data analysis was through descriptive and inferential statistics the factors which had statistically significant (p-value < 0.10) were included in multiple logistic regression analysis to evaluate the significant factors related to endometrial hyperplasia and cancer.
Results: Among all the participants (n = 346) 164 were indicated for gynecologic surgery (47.4%). Causes of bleeding included fibroids (31.21%) and adenomyosis (24.28%), whereas the prevalence of endometrial hyperplasia and cancer was 12.5%. The common perimenopausal bleeding patterns were intermenstrual bleeding (IMB) (47.69%) and heavy menstrual bleeding (HMB) (47.11%). After the univariate and multiple logistic regression analyses, the significant risk factors of endometrial hyperplasia and cancer were endometrial thickness > 10 mm (OR 7.61, 95%CI 3.52 - 16.45) and IMB (OR 4.66, 95%CI 2.05 - 10.57), respectively.
Conclusion: The uterine fibroids and adenomyosis took a majority of perimenopausal AUB causes, which mostly presenting with IMB or HMB patterns. However, endometrial hyperplasia and cancer should be concerned, especially in present AUB, with evidence of thick endometrium or IMB.
Keywords: Perimenopausal Bleeding; Abnormal Uterine Bleeding; Endometrial Hyperplasia; Endometrial Cancer; Perimenopausal Woman
Citation: Orawin Vallibhakara., et al. “Perimenopausal Bleeding a Risk Factor for Endometrial Hyperplasia and Endometrial Cancer”. Acta Scientific Women's Health 2.8 (2020): 43-49.
Copyright: © 2020 Orawin Vallibhakara., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.