Assessment of Symptoms and Endometrial Histopathology in Women with Perimenopausal Abnormal Uterine Bleeding: A Cross-Sectional Study

Abstract

Introduction: Abnormal uterine bleeding (AUB) is a common and often distressing complaint in perimenopausal women. Endometrial histopathology remains the diagnostic cornerstone, yet systematic data correlating bleeding pattern with histopathological findings are limited in the Indian context.

Objectives: To assess the pattern of clinical symptoms and correlate them with endometrial histopathological findings in perimenopausal women (aged 40–55 years) presenting with AUB at a tertiary care hospital.

Methods: Hospital-based cross-sectional observational study of 100 perimenopausal women with AUB. After informed consent, detailed history, clinical examination, relevant investigations, and endometrial sampling (pipelle or dilatation and curettage) were performed, followed by histopathological examination.

Results: Mean age was 47.3±3.8 years. Heavy menstrual bleeding was the most common symptom (52%), followed by irregular bleeding (31%) and intermenstrual bleeding (17%). Proliferative endometrium was the predominant histopathological finding (38%), followed by secretory endometrium (24%), endometrial hyperplasia without atypia (18%), atrophic endometrium (12%), endometrial hyperplasia with atypia (5%), and endometrial carcinoma (3%). Heavy menstrual bleeding was significantly associated with proliferative and hyperplastic endometrium (p=0.023).

Conclusions: Preventable obstetric complications, particularly hypertensive disorders and antepartum hemorrhage, remain leading IUFD causes. Strengthening antenatal surveillance, early high-risk pregnancy identification, and timely intervention may reduce IUFD incidence and maternal morbidity.